I worked for a doctor for 3 years where I developed carpel tunnel. I reported it to my supervisor who then bought me supports and a argonomic keyboard and accessories but never filed a claim with workers comp.The only treatment I received from my PCP was advice on pain medications during those 3 years. I now work for another doctor and had very severe symptoms one evening. I reported it to my new supervisor who reported it to workers comp. The insurance company told me that treatment now won't be approved because my previous employer never filed a claim.
Am I going to have to end up using my personal health insurance for my claims? Should I do something about my previous employer not filing a claim?
2007-02-15 03:30:33 · 4 answers · asked by Ahphooey 2 in Business & Finance ➔ Insurance
How did that PCP get paid? It SHOULD have been billed to the workers comp carrier!!
Have the new insurance company deny the claim in writing. Because the prior employer never filed a claim, they're in violation of the State Department of Labor - so put in a complaint with them. And I almost never say this . . .but I think you're going to need to take the written declaration, a copy of the PCP record that you told him it was work related, and go sit down with a lawyer.
2007-02-15 06:08:18 · answer #1 · answered by Anonymous 7 · 0⤊ 0⤋
Hello - your employer has no decision-making authority about whether your workers' compensation claim will be accepted. If you experience lost time from work, the amount and duration of your workers' compensation payments are determined by individual state laws. Workers' compensation laws and regulations vary from state to state.
Workers comp, if approved, will pay for your medical bills but most likely you will still have to use any STD or LTD funds that you have through your employer.
Keep in mind that carpel tunnel is usually not approved by work comp, it falls into a similar situation as vision. Yes staring at a computer can weaken your eyesight as typing may cause carpel tunnel. 100% proven = No , ... technically an "on the job" injury - nope ....
To answer your questions ---
If you did not seek continuos treatment for carpel tunnel then check your insurance plan with you current employer and see if there is a pre-excisting clause. If so see if it applies to your treatment dates. If so, there is your loop hole. If not contact your state WCB department but chances are you will have to use your personal health insurance.
There is really nothing you can do about your previous employer not filing a claim. It was/is your responsibilities to follow up with a case worker anytime workman comp or short/long team or FMLA claims have been submitted.
2007-02-15 14:25:38 · answer #2 · answered by MD 1 · 0⤊ 0⤋
Was it a small company you were working for? Not all employers have to have Workers Comp. Check your state but I know here in Louisiana if you have less than 50 employees then you do not have to carry Workers Comp. That may be the reason. Your health insurance may have to pay because it is very hard to prove Carpral Tunnel is work related. Good Luck.
2007-02-15 22:43:37 · answer #3 · answered by Nette 5 · 0⤊ 0⤋
See a worker's compensation attorney. You usually have two years to file after the date of last treatment.
It is also possible to file a worker's comp claim against the new employer for aggravating a pre-existing injury.
2007-02-15 12:00:46 · answer #4 · answered by Anonymous · 0⤊ 0⤋