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Workers comp

posted 8 months ago in Legal
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    1.
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    Helper bee
    Goodatlove    August 2013  

    Do any bees out there know anything about disputing workers comp decisions?

    I passed out at work and I now have over $3000 in hospital/ambulance/xray bills that workers comp is denying payment on. The doctors didn't really give a reason for why I passed out except that I had been super stressed out and I hadn't had enough to eat. While I was working I didn't feel well so I got a snack out of the fridge. I didn't actually get to eat it though, because a customer came in and I had to help them. I went from not really feeling well to uhoh the lights are getting kinda fuzzy to wtc why am I laying on the ground. I was just standing there when I passed out (not lifting heavy boxes or going up and down ladders like I often do) so it's not like performing my job caused me to pass out. However, if I hadn't had to be with a customer I could have eaten and skipped the whole passing out thing.

    So anyway, do any of you legal / HR people think I have a chance at getting them to reverse their decision? Any tips on that process? I havn't actually officially disputed it or w/e yet because I'm waiting on information on how to do that. I had originally thought that the bill was only $400 so I was like whatever I'll just pay and be done with it. But then I got the rest of the bill and holy smokes thats over a month's salary! Is this something I will need a lawyer for? Or should I even bother because they will just deny me anyway?

    BTW, this is 3000 after what my insurance paid.

     
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    Busy bee
    profiterole    May 6, 2012   Denver, wedding in Las Vegas

    are you given breaks during work?  15 minute and lunch breaks?  you should be eating during your breaks. do you have a health condition?  because in the normal course of the day, you should probably start off with breakfast before work, get a mid morning break that you should be long enough for you to eat something, at least a 30 minute lunch break at mid day, and then another late afternoon break for another opportunity to east.  if you have a health condition, you should be eating during those breaks and you should know not to wait until the last minute to eat something.

    you didn't actually sustain an injury so i'm not sure if you will be able to get the workers comp company to pay for your medical bills.

     
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    Busy bee
    profiterole    May 6, 2012   Denver, wedding in Las Vegas

    just wanted to add: if you fainted because you missed a meal when you were given the opportunity to eat, then i say no you do not have a claim.  if you fainted because your employer is denying you meal breaks, then i think you prob have a workers comp claim and also your employer is violating the FLSA.  If you informed your employer of a medical condition (let's use diabetes as an example) and ask for a reasonable accommodation then this may fall under ADA but it depends on the severity of the illness.

     
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    Helper bee
    Baby_Diva    November 11, 2011   Arkansas

    I work in a medical office, and we deal with Worker's Comp claims all the times. I would advise that you get copies of your medical records from all your doctors, and them take them to a lawyer and see what they say. 

     
    5.
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    Helper bee
    Goodatlove    August 2013  

    @profiterole: I normally can take meal breaks, but on this particular day I was the only one at the store and could therefore only eat when there wasn't a customer. And, no health conditions. I had just been really stressed out from work for a week or two prior so I think that also had alot to do with it.

    Also, I broke my nose because of the fall. Does that help my case?

     
    6.
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    Busy bee
    SugerPlum    April 7, 2012   Orange County, CA

    I believe whether or not you need to take your lunch break depends on which state you live in and possibly how many hours your shift was. If you can post the state you're in, someone can probably give you more specific information. Either way, I think it sucks taht your employer won't pony up the cash for this!  

     
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    Helper bee
    Goodatlove    August 2013  

    @SugerPlum: I live in South Carolina and it was supposed to be a 9.5 hour shift.

     
    8.
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    Blushing bee
    missblueshoes    November 2011   Florida

    If you haven't read it already, this link might be helpful:  http://www.wcc.state.sc.us/Frequently%20Asked%20Questions/FAQ.htm

     

     

     
    9.
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    Buzzing bee
    Miss Orchard    September 8, 2012   Cambridge, MA

    If workers comp is denying payment than your personal health insurance has to pay it. If you don't have health insurance my suggestion would be to get a lawyer and go from there. In Mass, upon denial, you have about 2-3 weeks to meet with a conciliator to try and come to an agreement. If that fails, its another 3-4 months until you can get in front of a judge. I think the issue may be whether you sustained an actual injury on the job, workers comp is usually granted to people who harmed themselves at work (ie: cut themselves with a saw, fell of a ladder, etc.) as opposed to passing out...I wonder if that is the issue?

     

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