Workers comp legal question

[richard200593]

Thank all of you very much it's glad to have a little help in understanding all of this. I will defintely try and talk to my doctor about going on disability and not light duty as my company honestly has me doing nothing but sitting around anyway.

[richard200593]

Does wc really deny claims that often? The injury happened at work, mentioned it to the company that day, and two weeks later pain became unbearable and went to a doctor and found out I was working with a torn meniscus. I feel like it should be open and shut work injury case

[CHMSC]

Originally Posted by jewel25

What I was asking is, what if WC asks for the MRI to investigate the claim but in the end denies the claim then who pays for the MRI?

Then in that case they would authorize the MRI and have to pay for, even if at a later date they reject and deny the claim.

[CHMSC]

Originally Posted by richard200593

Does wc really deny claims that often? The injury happened at work, mentioned it to the company that day, and two weeks later pain became unbearable and went to a doctor and found out I was working with a torn meniscus. I feel like it should be open and shut work injury case

Happens all the time. As long as your employer isn't fighting it you should have no problems. I will go into more detail later tonight if you have more specific questions.

[CHMSC]

Originally Posted by jewel25

Thanks. I think I just overthought it and confused myself.

Hope it helps the OP.

No problem. Any question just let me know. If I don't know the answer I can ask someone who does.

[richard200593]

Originally Posted by CHMSC

Happens all the time. As long as your employer isn't fighting it you should have no problems. I will go into more detail later tonight if you have more specific questions.

To my knowledge my company is not going to fight the claim at all and I have received calls from our safety department backing me 100 percent. I've been here long enough to prove how much of an asset I am and their concern is more on getting the MRI done ASAP and getting surgery if needed so I can recover and get back to work as soon as possible.

[Mr_Draco]

Originally Posted by richard200593

Thank all of you very much it's glad to have a little help in understanding all of this. I will definitely try and talk to my doctor about going on disability and not light duty as my company honestly has me doing nothing but sitting around anyway.

Before you ask your doctor, talk to HR first. Most companies require you to take disability insurance in order to draw a paycheck during the time you are disabled. If you are not paying for Short Term Disability, then you may not get a paycheck during the time you are out. WC will eventually pay you for the time you was out but only after everything else has been taken care of and I've seen numerous people not get their 1st WC check for 6-8 months or longer. Also keep in mind disability and WC may be less than what you are currently getting on light duty. Every company I've worked for only pays for 20 hours of whatever your hourly rate is.

Originally Posted by richard200593

Does wc really deny claims that often? The injury happened at work, mentioned it to the company that day, and two weeks later pain became unbearable and went to a doctor and found out I was working with a torn meniscus. I feel like it should be open and shut work injury case

The only time I've ever seen WC deny a claim is if it was an existing condition and the accident simply brought the condition to light so you finally noticed it.

[richard200593]

I just don't understand how any of this is legal. How is it I get hurt in the workplace and I'm going to end up losing thousands of dollars because of it, I'll only be out a month or two I can't imagine a serious injury that puts someone out for a while.

[jewel25]

Originally Posted by richard200593

I just don't understand how any of this is legal. How is it I get hurt in the workplace and I'm going to end up losing thousands of dollars because of it, I'll only be out a month or two I can't imagine a serious injury that puts someone out for a while.

That is what Short Term and Long Term Disability is there for. I always opt to get it when available because you never know. You can be in a car accident on your way to work and then out of work for months. Any one of us can become disable at anytime. Its a scary thing to think about.


And don't overthink it, you don't know the outcome of this yet.

You are also in luck with working in California. I believe the pay out for STD is much more than other states.

Edit: Yes they have this:






California is one of the few states that has a short-term disability insurance (SDI) program for employees. Employees fund the program through payroll deductions, and can receive benefits when they are temporarily unable to work due to disability, including pregnancy. California's program also provides for paid family leave for employees who need time off to care for a seriously ill family member or to bond with a new child. (California does not provide long-term disability; if you are disabled for a year or more, you can apply for Social Security disability.)


But I wouldn't even think about that until you find out what is going on with the claim.

[richard200593]

I do know for sure that my company has short and long term disability if it comes to that, and good to know California has a short term disability also. For now I guess it's just play the waiting game.