AboutMargot RN BScN GNC Expertise Please feel free to ask anything, but the more specific you are, the easier it is for me. Please share as many details as you are comfortable doing. I do check my Emails daily Monday through Friday so you should receive an answer within 24 hours on most business days. Thanks.
Experience I have 18 years experience as a Small Business Owner-Operator; I own a Nursing Agency so often deal with both employee and client injuries. I would be pleased to offer any assistance I can. If I can not answer your question I'll do my best to direct you to an appropriate resource. Thank you. Experience in the area 20 years of Long Term Care and Community Nursing, specialising in Geriatrics, Gerontology and PalliativeCare.
Education/Credentials Registered Nurse , Certified Gerontological Nurse, Bachelor of Science in Nursing >
Question I am an RN in an office. 2 weeks ago; I stood up from my desk with a few "light" charts in my hand & my knee popped & i couldn't walk or bear weight. Needless to say.... I tore my meniscus. I was told to report this to comp because it was a workmans comp issue. Workman's comp filed a claim # & have been in touch. I simply stood up from my desk to intake a patient & pop. I need to have surgery in 2 weeks & our Comp. carrier notified me today that they are investigating & potentially rejecting the claim because they do not feel it was work related. I have had NO injury to this or complaints prior. It happened at work & i was seen by the physician that day & 3 days after. I have continued to go to work limping but the ortho said i need the arthroscopy soon. I have been with my employer for 9 years now. I am very concerned because I do not want to be stuck with a huge bill. I don't know why this is happening or if they can reject this. And what are my options? I appreciate your time.
Answer Hi Jillia and thanks for writing,
I am sorry to read about your work-related injury, it sounds like you’ve been through a lot. I would consult with a Labor Lawyer, I always recommend people at least consult with a lawyer experienced in WC cases, even if you don't want them involved in the case just to protect yourself and make sure you're aware of all your rights.
Unfortunately Worker's Comp is like all other Insurance Companies - it is in THEIR best interest to drag things out as long as possible, and usually they hold most of the cards and have the laws on their side. Sadly, this can cost people their jobs, and sometimes their families due to the stress associated with lingering pain and other disabilities; the financial and/or emotional drain can be too much for some people.
60 Minutes did a show a few years back where large insurance company executives admitted there is an unwritten rule to deny most claims initially as tey know a good percentage will just give up and not fight the claim.
It is important to be sure you do everything correctly during your claim period and you don't want to miss out on any payments you may be entitled to now or in the future, so I advise that you consult with a lawyer who does WCB cases and find out exactly what your options are, and what you need to do in your state to cover yourself (WCB regulations do vary state to state).
Dealing with WC is one of the most frustrating things we have to do, like most big insurance companies, their number one interest is guarding their own money. I always find it's best to do a little brown-nosing when talking to those people and ask "how can we make this a win-win for both of us and how would you like me to proceed" etc...
Laws do vary state to state, so I always advise people to go online and talk to WC Helpline about what their rights are so you're informed of what you are and are not entitled to with coverage.
Most States have Lawyer Referral Services which will give you the name of a few local lawyers who specialize in your area of concern (Labor Law) and you can usually get an appointment to meet with them for 30 minutes for a nominal fee. You could go and ask some basic questions, exactly like you asked me and hopefully s/he can give you some advice and possibly some resources to help you.
I hope this helps, it may feel like you're constantly hitting a brick wall, but perseverance is necessary whenever you deal with them.
