questionshave you ever dealt with workman's comp before?

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I also learned that my doctor (the one the company required me to go to) knew this game. The company wanted to drag its feet in getting me the tests I need? His response was to pull me from work 100% until results are in. Maybe now they will get me what I need.

The tweak in the shoulder I mentioned? From early assessment we believe multiple discs in my neck are squirting out the wrong way messing with most of my major nerves on the right side.

I guess in all my years (almost twenty years of work) I never had to deal with workman's comp, unless one of my employees got hurt, but on this end I see how frustrating and stupid it is.

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Good Luck. Workers compensation was supposed to help stop litigation by exempting your employer from most workplace injury liability in exchange for health care and possibly disability payments. Even though the fraud rates for most states are under 5%, It seems the emphasis is on denying claims and accusing the worker of wrong doing rather than taking care of the injury. I am not aware of one instance where the WC doctor has agreed with the workers private doctor.

A personal example:A relative of mine twisted his ankle at a loading dock. WC doctor had him walk across the exam room room and told him he was faking. His private doctor ordered x-rays and I think a MRI and found several hair line fractures. He fought it close to a year.

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My suggestion is to keep notes and paperwork on EVERYTHING. Dates, times names etc. Make sure you know who you are talking to before you make statements. Make sure you understand anything you are asked to sign. You may end up needing an attorney. Keep in mind your employer is probably utilizing an outside company that specializes in denying WC claims and they already have attorneys who are probably on a first name basis with the WC officials because they see each other all the time.

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I've always wondered why people would go through Workers Comp instead of just going to their primary care physician.

Sure you might save a couple bucks because of the copay but I'd rather pay $15 and get the care I need immediately. What is the benefit of "blaming" your company for the injury assuming you were really hurt at work? Is it so you can sue the company for pain and suffering or something? I don't get it.

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@cengland0: the reason you go thru workmans comp instead of your regular doc is because when the injury leads to permanent disability the company usually owes you a lump sum payment since you cant work anymore.

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@cengland0: Because not everyone is able to pay $15 to get unlimited medical care. Also the whole idea behind workman's comp is so that you CAN'T sue your employer for workplace injuries. Their insurance picks up the full bill for a worker's injury and in-turn the worker can't sue the company. That is where the "compensation" part comes from. I'd really like to know what insurance you have that only costs $15 for a doctor's visit including x-rays, prescriptions, consults, physical therapy, possible surgery, and then 6 month's lost wages if surgery is needed. Please let me know!

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many here have heard me talk about hubby. he's completely disabled because of work accident. was driving company vehicle from one site to another when old man in big car behind him got gas and brake confused & put it to the floor trying to stop, pushing truck hubby was driving uphill, across railroad tracks, & almost into phone poll (man admitted this to on scene cop). workman's comp said nothing wrong, just stressed muscles, after month(s?) went to reg doc & she ordered mri. never heard from her so we called back two months later and asked her to look into it. got an emergency phone call two days later. "you have an appointment tomorrow with neurosurgeon". turns out three blown disc. company insisted on out of state doctor second opinion-said only need surgery on one.. original surgeon did surgery on one, but used weird hardware. told us "if you ever go back to what you were doing you will be permantly wheelchair bound in five years" wrote on file "fit to return to work".
TBC

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cont.
while hubby was waiting on surgery (took over yr between diagnosis &surgery because of w.c.) he was fired so they could end his insurance benefits. when released frm hosp sent w scripts to get filled. since company didn't use state w.c. no one could fill scripts. i ended up crying @ walgreens telling them i was gonna have to take hubby back to hosp. because i couldn't get the pain meds filled. (at least walgrns took pity & made bunch of calls to get approval). 1 script would have been over $500 to fill. every doc, etc kept trying to bill private insurance which had been canceled by company. so no one was getting paid until a bill collector called & we explained it to him. we had even tried to contact ins to let them know, but since we had no active policy they wouldn't talk to us. the bill collector was able to get ins informed & the docs paid. now 12 years later he needs surgery again but is not a canidate because of weird parts would have to be removed & started all over again.

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@eraten: Yes, the $15 does cover my doctor's visit as well as any Xrays or MRI's. The prescriptions is a different plan so that has it's own deductible.

So you really confirmed for me that it's better to go to my regular doctor. Why would I give up my rights to sue the company if they were negligent just so I can save myself $15. According to some, the amount you can get if you sue your employer is more than you can receive under worker's comp. There are even laws that limit how much a lawyer is allowed to receive if they are representing you in these cases so that helps you keep more in your pocket.

Not sure how many of you reading this have ever been injured but as for me, I want the best healthcare I can get. If that requires me to go to my regular doctor instead of a company appointed one, I will take that route. Sorry to those that cannot afford your copay but I'm not going to go through the rest of my life in pain.

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@cengland0: Actually you already lost the right to sue in most states. The workers comp system is the only way to get any form of compinsation for your injury. The paperwork also proves there is a safety issue the company needs to address. If the company isn't aware because you went to your own Dr. and never told them, they can't fix the issue so no one else gets injured. Also, in most places not reporting the injury can result in your termination, because you are putting your coworkers safety at risk.

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@cengland0 You're better off using your health insurance, but they won't pay if they find out an injury is work related. In fact, there's a specific spot for it on the claim form. @xarous if workers comp continues to drag their feet, you might want to contact a reputable attorney(not an ambulance chaser) to find out what your options are. Get well soon!

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Wow! I knew that some folks don't like to deal with HR, and I guess this gives me an inkling of why that is. I would like to think that I would never have agreed to allow this to happen to any of our employees.

As with most employers, our workers comp claims were handled by an outside company. We did, occasionally, run into employees who were trying to take advantage of the system (I have some stories!), but we insisted that employees report even the smallest work-related injuries so we had a record for safety reasons and in case something more severe showed up later. Our workers' comp plan did NOT require the employee to use a specific doctor. Employees went to their own physician unless a second opinion was required.

@xarous, definitely keep records of everything that happens regarding this claim. If you need services and can't wait for WC, then I suggest that you check with your own insurance company. You might need to schedule the procedure you need and let them subrogate it!

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Thanks to all that have shared their personal stories, ideas, comments, and such. That's why I love this community so much. Even though I've been lurking as of late.

Don't worry I've kept many records, details, and have been careful of what I say and to whom.

I don't have the option @cengland0 has.

My private insurance would have billed me for the initial care visit ($15), return visits ($15 a piece), $35 per physical therapy appointment (12 appointments booked = $420), 30% of MRI (which would be approx 900 dollars as contrast and multi-regions are needed), and about 100$ in meds so far. So yeah, my private insurance is great for the sniffles, but is rough for a possible life-changing injury. And also I would have to pay for litigation and be tied up in the court system for a while just to try and re-coup some of my losses.

I'll go the WC route and attempt to be just as stubborn as I need to be.

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In the course of one of my jobs a few years ago, I talked to perhaps a hundred people who had had to file workers' comp claims. Not one of them felt they'd received adequate medical care in a timely manner, any sense of empathy or concern from the health care providers with whom they dealt, or any positive support from their employers. Workers' comp claims become, almost by definition, adversarial situations in which the first assumption of most employers and most medical-care providers is that the claimant is exaggerating or just plain lying about the injury. From there, things can go rapidly down hill. My observation now is that the primary focus of anybody involved in the entire WC chain of care and treatment is to minimize or completely deny any claim at all.

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@xarous: I'm glad to hear that you're on top of the situation and that your physician knows how to play the game to get you the care you need.

Your discovery reminds me of the "undercover boss" non-reality tv show I stumbled upon a few weeks ago. Is there any chance that your experience can be translated into some serious changes in how your company's stores and senior management can be better prepared to assist employees once a job-related injury occurs? I suspect many employees are far less prepared than you when it comes to getting the care they need and deserve when injured. Perhaps this could end up being some sort of silver lining to your own situation?

It's well documented that patients who feel their doctors did their very best to provide appropriate care are far less likely to sue, regardless of the medical outcome. I'll bet there's similar data regarding WC claims, so helping workers at the beginning may be a major cost-saver down the road.

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I was out in the middle of a soybean field doing my research when an insect flew in my ear and wouldn't come out. I had to go to the nearest doctor to have the insect removed. Because I was on the job at the time, I received Workman's Comp. I didn't have to pay anything at the doctor's office. I talked to someone who was very cordial and they asked me whether I would need any immediate prescriptions and I received a prescription card a few days later (even though it wasn't necessary). I only had to fill out 1-2 forms after that to explain what happened and how I could prevent that injury from occurring in the future. Someone called me to verbally go over that form with me after I had sent it back in. The woman calling laughed at my situation; I'm sure she didn't very often have such odd incidents.

In summary, receiving Workman's Comp. didn't seem like that much of a hassle. I felt like they cared, but also wanted to prevent further injuries.

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@djanlp: Your experience seems to go against the norm. Glad that it all worked out for you though.

I've been in contact with our WC rep now and am going to attempt to use this experience as a teaching tool for the company as a whole. We are in the middle of a massive expansion into new territories and would hate for this to hinder future employees.