WC After 10 Months?!?

LindaS

I have an employee who has been seeing several physicians since August 2002 for back problems. He has brought in restriction sheets, etc. and we have been accomodating him as necessary. Recently he has informed me that one of his specialists feels he needs to see a nutritionist to help him lose 20-25 lbs. before they will do surgery. Our health insurance does not cover this and I informed him of this yesterday. During the discussion he stated that the original injury occurred at work and when I informed him that nothing was reported, that portion of the conversation ended. About 20 minutes later he cam back to my office and informed me that he did report it, although he admits nothing was documented, and was able to give me the specific injury date. He now wants this to go through WC.

Nothing in any of the paperwork he has brought in states that this is a work-related injury but I think that since he is not claiming it is, I have no choice but to report it and let WC do their investigation, etc..

Any thoughts as to anything else I can do?

sonny

I would do the same.

Whatever

Who did he report the injury to? Speak to that person. What is your company on reporting wc injuries?

LindaS

He reported it to the Acting Supervisor for that department at the time. I did speak with him and he doesn't remember anything specific. This is an employee who has a myriad of problems and one just seems to run into another.

Whatever

>He reported it to the Acting Supervisor for that department at the
>time. I did speak with him and he doesn't remember anything specific.
> This is an employee who has a myriad of problems and one just seems
>to run into another.

Who has the problems the acting supervisor or the employee? At this point, since the ee says he reported the injury and there is no proof to the contrary, I would probably let the issue die after reporting it to the insurance company.

LindaS

The employee has the problems. I have reported it to the insurance company and plan to ensure they engage in a full investigation to determine compensability.

Balloonman

Keep on your adjuster to investigate. If this has been going through the health insurance then most likely when he initially reported it to the doctor he reported it as non-work related. Somewhere on the initial paperwork he had to indicate if it was work related. If he checked no, the WC Carrier can use this to justify the denial. Don't get to stressed, the health insurance would have long ago rejected the claims if he indicated it was work related. Also the initial doctors notes will reflect how he described how the injury occurred.
My $0.02 worth.
DJ The Balloonman

cebudragonlady

A little while ago, I chanced to meet a doctor who practices in a Southern State. We had a discussion about Worker's Comp. The doctor stated that some states allow up to TWO years for a injured worker to file a claim!

Chari