Here is a question I received from a gentleman named Leon: Injured shoulder 11/16. Have seen Comp Dr. twice. Mentioned pain and 'popping' in shoulder. Diagnosis is a mussle or ligament tear. There was no mention of a possible rotator cup injury. Comp. insurance company has approved 2-3 weeks PT. Company has said they will pay me thru this period @full pay while on 'light duty'. I have agreed to this. It was skilfully implied that this arrangement was in lieu of filing a claim. Can I wait to see if this PT is effective and file a claim at a later date?
Jodi Ginsberg responds: Leon, the thing you need to realize is that if you wait to file a claim you may be compromising your claim should you need to pursue it. There are many complications that can occur when you hold off on filing. For example, your employer may try to use your delay against you by contending that you hurt yourself at home or that you had a pre-existing claim. Some employers try to pursuade you not to file the claim so their premiums do not go up. If you agree and then find yourself with no claim, no coverage and no job and a denial of the claim.
There is a 30 day notice requirement to report the injury to a supervisor and a one year filing requirement with the State Board of Workers' Compensation to perfect the claim.
Although workers' compensation is supposed to be a "no fault" system that covers you if you are injured while on the clock, over the years it has become a very adversarial system. In some instances, employers will turn on loyal employees with a long work history and solid performance history. Often the employer will demand a resignation as part of settlement negotiations.
On the other hand, I do not necessarily think you would be acting wisely to trust your employer to do the right thing. Although I would want to speak with you further about your claim, I generally advise anyone who is injured on the job to report that injury as a workers compensation injury sooner rather than later. I also think you need to get a better idea of exactly what is wrong with your shoulder and what your likely course of treatment would be. You did not specify what you do at work so it is difficult to give you any specifics. Feel free to call me at 770-351-0801 and I would be happy to discuss your case with you further.
Technorati Tags: shoulder injury on the job, georgia workers compensation, State Board of Workers' Compensation, rotator cuff injury
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My question is that, I've been out hurt for a year and 3 monthswith a crushed heel. I've seen 2 workers comp doctors and just saw a independent doctor. The independent doctor said that he could heal me,and do surgery but the workers comp doctor disputes his opinion. Now the insurance company says that their not going to let me see him nor pay for the surgery. If the workers comp doctor would have x-rayed my foot he would've saw that its still broke but he hasn't x-rayed it in 6months or hasn't seen me in 3 months and refuses to give me anything for pain. Isn't that refusing me treatment? Please give me some advise???
-John
Jodi Ginsberg responds: John, thanks for your question. I am going to assume that you are not yet represented. If you are, you should speak with your lawyer to discuss the reasons for the denial and what you can do about it.
There are a number of approaches I would consider in your case. First, I would evaluate whether you have a good argument to ask for a change in your authorized treating physician. If you are not getting better and the independent medical exam doctor states that surgery is indicated, I think that the State Board would consider a request for change in treating physician. The law provides for such a change if the current doctor demonstrates a "failure to effect a cure or give relief."
I would also discuss with you whether you might consider a settlement of your claim. Sometimes, when there is uncertainty in a claim (differing opinions by the doctors), you have an opportunity to maximize your settlement dollars since the insurance company faces an unknown risk in future surgeries and wage benefits. Settlement would only be appropriate if you feel comfortable that you could pursue medical treatment on your own and are prepared to assume that risk.
Technorati Tags: independent medical examination, workers compensation doctor, company doctor, georgia workers compensation
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I am frequently called upon by my clients to explain the difference between settling their workers' comp cases and agreeing to a "no-liability" stipulation.
If the insurance company has paid benefits, paid for medical care and accepted the on-the-job injury claim as compensible, then the only type of settlement permitted is a standard settlement.
Yesterday, I settled a very intense closed head injury case for almost $200,000. In looking back over this case, it strikes me that there are several important lessons here for anyone pursuing Georgia workers' comp benefits.
More on Closed Head Injury Case Results in $195,000 Settlement
I am pleased to introduce the Georgia workers' compensation blog. In the days and months to come, I will be posting case studies, observations about the Georgia workers' compensation system and answers to your questions about Georgia workers' compensation. Please let me know what you think and what you want to know.
–Jodi
