Stupid workmans comp- *cry*

[Nephythys]

I am just at a loss.

I have worked for the same company for 7 years. For the last several months I have been in increasing pain at my desk. I asked for help- I got an ergonomic keyboard. The pain did not improve so I sought help again- and my manager sent me to my Dr.

My Dr. diagnosed carpal tunnel and my manager filed a workmans comp claim. The workmans comp insurance company called me and had me go to a specialist (fill out ppwk etc) ok.....the hand specialist confirmed carpal and radial nerve inflammation. I was put on restrictions (can only work 40 minutes out of each hour on the computer)- I am on anti-inflammatory meds and I wear wrist splints at night.

Ok- everything seems to be hunky dory- til today...today I get a letter telling me that my employer has denied liability and my claim is denied.

WTF?

I found the Notice of Contest- all it says is they want more information.

Ok- what information? And why the hell has my claim been denied putting me in a situation where I have to demand a hearing and maybe get a frelling lawyer?

The other possibility is that my manager, who has never handled something like this, had no clue what she was doing and screwed it up from the get go.

I am so upset. If I have to continue in my work situation as it is I will be in constant pain, and it affects everything else in my life. I'm scared and confused and the claim adjustor won't call me back. I can't afford to keep fixing the medical issues if they won't ever correct my work station issues- I'm in a screwed cycle!

Does anyone have any experience with this stuff at all?

:(

[blueerica]

I have no personal experience with Workmen's Comp, but I do know that it's a huge hairy deal. My mom has had a number of continued problems due to a work-related injury that has yet to see a conclusion. On top of it, there was human error, both accidental and at least one was on purpose (there was a trail leading back to someone at the central office that my mom has had issues with). It's not been an easy road, one that I hope I never-ever-ever have to go down.

[Morrigoon]

advice: get a lawyer. Now. Even if you don't have/want to sue, at least start working with one now so they can make sure you go through the right steps.

[Prudence]

I'm convinced that it always gets denied the first time through. The company gets to say "yup, all our fault" or "nope, prove it!" I doubt it's uncommon for them to say prove it. I wouldn't panic until it gets past the more information page. But, don't admit anything you don't have to. This is based on my experience with L&I claims, which admittedly was quite some time ago.

[wendybeth]

Bleh, I feel for you! WC is a convoluted mess in most states, and comparable to applying for SSI disability. Stay the course and don't let them defeat you- they'll try to wear you down, but it sounds like you have a perfectly normal, reasonable medical condition going on and they will eventually capitulate. I've got some real horror stories regarding L&I, but they all end happily. (Mostly).

[Nephythys]

I think at this point I need to talk to the claim adjustor. It makes zero sense to me (the neophyte layman) why they would DENY the claim because they want medical records.

I guess I need to shake trees today. I have a phone # for a local attorney on hand-if needed.

[RStar]

My wife was dissabled, but denied Social Security twice, untill we fially broke down and got a layer. After all was said and done, we got it, and they paid for the year and a half that they screwed around. But of course the layer got his $5,000 out of it.

My daughter got a hernia lifting heavy stuff at work. She started by going to our family Dr. who said she needed the operation. We realized it should go through workers comp, so she applied. They sent her to their Dr who said she didn't have a hernia. :eek: She continued to have the pain so she had the operation through our insurance. Then she submitted it to worker's comp after having the operation, and now they are saying "oh, maybe you did have a hernia" and "we will reconsider, but because you had it done outside of our group we don't know if we'll cover it". If they come back with a no, we will get a layer. I think the layer will get her more money, but he'll take some of it too. Perhaps we should sue for malpractice.

Good luck with your case, but I agree with Prudence, I think they tend to deny at first to prevent people from filing frivolously. I know Social Security definatly will almost ALWAYS deny at first.

[Nephythys]

ok- drama over.

There is nothing much worse than not knowing how things work-

Turns out the claim adjustor had 14 days to either file an admission or a denial- and she needed my medical records and stuff from the Dr's I saw. She did not have these in those 14 days so she had to file the denial.

Now she has those, she has reversed the denial and will file a letter of general admission- which authorizes the medical treatment and ergonomic stuff.

Phew!

I apologized for coming unglued in my message (I was certainly upset) but she understood.

Thanks! Hopefully it will sail smoother from now on.

[Snowflake]

You know, it's a really nice feeling to come into a thread with bad news and find out all's well in the end.

Hope you feel better soon, too, Nephy. :snap:

[Nephythys]

Thanks- :)

I am anxious to get started with the physical therapy and to have them come in an evaluate the ergonomic situation here. I've been here for 7 years and am not anxious to leave for any reason.