What can I do if I was injured at work but my worker's compensation does not cover all costs? 31 Answers as of July 08, 2013

I slipped and fell at work on the school bus steps. I hurt my back and the xray and MRI says I'm fine but I can't function and I am in constant pain. The doctor says I have lower lumbar pain and my left sciatic nerve is giving me problems. I went to physical therapy but workers comp only approved 12 visits. I have a list of restrictions. Workers compensation won't approve my 2nd opinion on my back and won't approve any more therapy and they just started pay me but they are under paying me. On January 13th, I would have been off work for 3 months. I have an 11 month old child and due to non payment from workers comp I lost my apartment and my lights and water got cut off. I had to pull my child out of daycare. My job wont let my come back unless I am free from restrictions and free from doctors care. If I do a settlement case with my job and workers comp how much do you think I'll get? Because I am so far in debt and now I have to go to court over the apartment I just lost.

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The Lucky Law Firm, PLC
The Lucky Law Firm, PLC | Robert Morrison Lucky
You need to contact a workers compensation attorney as soon as possible. Many times employers and/or the insurance companies fail to abide by the workers compensation laws. You need someone on your side who can make sure you are receiving everything allowed/provided by law.
Answer Applies to: Louisiana
Replied: 1/5/2012
The Carlile Law Firm, LLP
The Carlile Law Firm, LLP | D. Scott Carlile
You cannot sue your employer because you accepted worker's compensation. Your only option is to contact the worker's compensation ombudsman and see if they can help. You could also speak with an attorney that handles worker's compensation claims and they might have knowledge of ways to correct the mistakes. Be for warned though, worker's compensation does not have to pay you 100% of your normal wages and they have the right to control the source and amount of your treatment. Needless to say, the worker's compensation system is not fair to the worker and is rigged in favor of the employers and insurance companies. That is why most lawyers (including my firm) do not handle worker's compensation cases.
Answer Applies to: Texas
Replied: 1/3/2012
Ford, Howard & Cornett, P.C. | Bradley Cornett
If you are not pleased with the employer's chosen physician, you have a right to demand a panel of three physicians from which to chose a new primary treating physician. You may want to exercise this option. You should be receiving benefits equal to two-thirds your average weekly wage for the past fifty-two weeks. You may need to speak with an attorney who handles work comp claims. Most work comp attorneys will provide an initial consultation for free.
Answer Applies to: Alabama
Replied: 1/3/2012
Goodman & Goodman PA | Bruce Elliott Goodman
Your question is far too complex to be answered in this forum. However, you should immediately consult an attorney who can assist you in all aspects of your Workers' Compensation claim.
Answer Applies to: Maryland
Replied: 1/3/2012
Cary J. Wintroub & Associates
Cary J. Wintroub & Associates | Cary J. Wintroub
Based on the many issues you raise, you should immediately consult with an experienced workman's compensation lawyer. Lawyers in this area of law do not charge unless they collect. Interview a couple of lawyers until you find one you can work with.
Answer Applies to: Illinois
Replied: 1/3/2012
    J Wayne Turley BC
    J Wayne Turley BC | Wayne Turley
    Unfortunately workers compensation is not a complete remedy. It allows for payment of medical expenses and partial compensation for lost earnings when a physician has you in a no-work or limited work status and you are not receiving your regular wages. If your physician is recommending additional physical therapy and the insurance carrier does not authorize it, you can write a letter to the Industrial Commission of Arizona and attach a copy of the physical therapy prescription and ask for an investigation and hearing as to the denial of the treatment recommended. A hearing will be scheduled if the carrier does not authorize the therapy which a doctor prescribes. Workers compensation carriers often will not authorize second opinion evaluations but if you have health insurance you can see another physician using your health insurance and find out if another doctor has other recommendations for you. If so, and you want to change physicians, you can attach the new doctor's report to a letter to the Industrial Commission and ask for a change of physicians. If denied, you can request a hearing. Workers compensation statutes usually only require the carrier to pay for one physician at a time, but you are allowed to request a change of physicians if you think that would be helpful. Workers compensation disability benefits are based on your average monthly wage at the time of injury. You should be receiving 2/3 of your average monthly wage while your doctor has you off work, up to a maximum set by law. If the average monthly wage set by the Industrial Commission is too low, you can request a hearing to prove what you were actually making on the average each month. Usually the Industrial Commission will use what you actually earned in gross earnings in the 30 days before your injury as your average monthly wage unless that is inaccurate for some reason. There are limited time periods for requesting a hearing so you should read each notice you receive carefully to see what the time limit is for asking for a hearing if you disagree with the actions of the insurance carrier or the Industrial Commission. When you believe you need to request a hearing, contacting a lawyer is a good idea.
    Answer Applies to: Arizona
    Replied: 12/30/2011
    E. Ray Critchett, LLC
    E. Ray Critchett, LLC | Ray Critchett
    If you have an attorney assisting you with your claim, he or she may help you fight the decision of the Bureau to get these additional medical treatments allowed. If you have exhausted all of those avenues, you may be able to use your own health insurnace even though you may be responsible for co-pays and deductibles. Unfortunately, I do not know enough about your specific case to discuss values or settlement offers and it may be too early to discuss such options if you are still recovering from your injuries.
    Answer Applies to: Ohio
    Replied: 10/25/2012
    Downriver Injury and Auto Law | Michael Heilmann
    You need to run and file a PIP application with your auto insurance carrier. In Michigan, an injury involving a motor vehicle is a claim on your own personal auto policy. The Comp carrier must pay first and then the auto carrier pays any and all other costs provided that the application states that the injury is due to a motor vehicle. We handle these cases all the time. Good Luck.
    Answer Applies to: Michigan
    Replied: 12/30/2011
    Lacy Fields, Attorney at Law, LLC
    Lacy Fields, Attorney at Law, LLC | Lacy Fields
    The work comp insurance company is not going to play ball until a Judge orders them to do so. Right now you have little to no access to a judge.
    Answer Applies to: Missouri
    Replied: 12/30/2011
    Law Office of Jared Altman
    Law Office of Jared Altman | Jared Altman
    You need to hire a workers compensation lawyer right away. They work on a contingency fee. Sent from my iPhone On Dec 29, 2011, at 2:28 PM, "Question From LawQA" wrote: > ANSWER A QUESTION THAT WILL BE DISPLAYED ON NEW YORK PERSONAL INJURY WEBSITES ON THE LAWQA NETWORK. > > LAW AREA: PERSONAL INJURY > STATE: NEW YORK > ID:46295 > > Question: What can I do if I was injured at work but my worker's compensation does not cover all costs? > Question Detail: I slipped and fell at work on the school bus steps. I hurt my back and the xray and MRI says I'm fine but I can't function and I am in constant pain. The doctor says I have lower lumbar pain and my left sciatic nerve is giving me problems. I went to physical therapy but workers comp only approved 12 visits. I have a list of restrictions. Workers compensation won't approve my 2nd opinion on my back and won't approve any more therapy and they just started pay me but they are under paying me. On January 13th, I would have been off work for 3 months. I have an 11 month old child and due to non payment from workers comp I lost my apartment and my lights and water got cut off. I had to pull my child out of daycare. My job wont let my come back unless I am free from restrictions and free from doctors care. If I do a settlement case with my job and workers comp how much do you think I'll get? Because I am so far in debt and now I have to go to court over the apartment I just lost.
    Answer Applies to: New York
    Replied: 12/30/2011
    Law Office of Mark J. Leonardo
    Law Office of Mark J. Leonardo | Mark Leonardo
    If you don't have a workers comp attorney it sure sounds like you need one. They get paid from settlement proceeds and their fee is generally 15% but could be higher if the court approves it. But from what you are describing, you certainly need help and should not hesitate to get an attorney, otherwise you are at a disadvantage. If you already have one, you need to pin him or her down on these questions you have.
    Answer Applies to: California
    Replied: 12/29/2011
    Paris Blank LLP
    Paris Blank LLP | Irving M Blank
    You need to get an attorney who concentrates on representing claimants in workers comp cases ASAP.
    Answer Applies to: Virginia
    Replied: 12/29/2011
    Kelaher Law Offices, P.A.
    Kelaher Law Offices, P.A. | James P Kelaher
    I would strongly suggest you hire a good, reputable workers' compensation lawyer as they can give you far better advice which would be specific to your factual scenario. Plus, most comp lawyers work on a contingent fee basis and will only get paid if they get you benefits that the workers comp carrier is not usually paying you.
    Answer Applies to: Florida
    Replied: 12/29/2011
    Bulman Law Associates PLLC Injury Law Firm
    Bulman Law Associates PLLC Injury Law Firm | Thomas Bulman
    You need to find an attorney who specializes in Montana Worker's Compensation law like our office. What city do you live in? The biggest mistake you could make would be to settle the case on your own then get an attorney later.
    Answer Applies to: Montana
    Replied: 7/8/2013
    Bernard Huff, Attorney/Mediator
    Bernard Huff, Attorney/Mediator | Bernard Huff
    Contact your State's Worker's Compensation Board or Commission for assistance.
    Answer Applies to: Indiana
    Replied: 12/29/2011
    Dunnings Law Firm
    Dunnings Law Firm | Steven Dunnings
    Nothing, workers comp is your only remedy.
    Answer Applies to: Michigan
    Replied: 12/29/2011
    McKell Christiansen
    McKell Christiansen | Michael McKell
    Worker's comp is very different is every state. I would encourage you to find a good worker's comp lawyer and have your case reviewed. Most attorneys will provide a free consultation for worker's comp case. Good luck!
    Answer Applies to: Utah
    Replied: 12/29/2011
    Gilbert & Bourke, LLP | Brian J. Bourke
    If you are in California, immediately consult with an attorney in your area who handles workers compensation claims. There are procedures to get medical treatment approved and you should be receiving temporary disability payments based upon your wages, i.e. of your average weekly earnings.
    Answer Applies to: California
    Replied: 12/29/2011
    RECHTMAN & SPEVAK | DAVID RECHTMAN
    It sounds like you have a good workers compensation case. You would benefit from a discussion of your case details with an attorney, such as myself, that specializes in workers compensation. Employers/insurers are not allowed to restrict your physical therapy visits. The prescription for physical therapy is controlled by your principal treating physician. You will likely benefit from an attorney to help you enforce this right. Given your circumstances, you appear to be entitled to a second opinion, given Georgia law. You will likely benefit form an attorney to help you enforce this right. An attorney could help determine the scope and amount of insurance underpayments for disability. You will likely benefit from an attorney to help you obtain additional disability benefits you are entitled to. As to your settlement amount, this depends on a lot of details that are not included in your question detail paragraph. A good workers comp attorney would likely be able to give you a range of settlement value after an extended meeting going over the details of your case. Be wary of someone who quickly tells you settlement value, they are likely guessing or exaggerating in order to get you as a client. Finally, do not be afraid of talking to or hiring a good attorney specialist. Most attorneys, such as myself, will speak to you for free with no obligation to sign up. Then, if you do decide to hire a lawyer, the State of Georgia regulates lawyers in this field & we only earn an attorneys fee when we can show that you received a benefit due to our services.
    Answer Applies to: Georgia
    Replied: 12/29/2011
    The Law Firm of Shawn M. Murray
    The Law Firm of Shawn M. Murray | Shawn M. Murray
    There is no way to estimate a fair settlement amount without significantly more information than what you have provided here. Settlements are negotiated on a case-by-case basis and are contingent on both the injured employee's and the employer/insurer's motivation to try to settle the claim. Also, you must understand that neither party can force the other one to settle. It sounds as though some additional diagnostic testing may be necessary based on what you have related. Have you been given your choice of physician or are you still treating with a doctor that the employer/insurer directed you to? If you are you should probably assert your right to choose your own doctor at this juncture. Finally, it is definitely in your best interest to consult with, and hire, a workers' compensation attorney to protect your interests.
    Answer Applies to: Louisiana
    Replied: 12/29/2011
    Garruto & Calabria, LLC
    Garruto & Calabria, LLC | Andrew F. Garruto
    Please retain a workers' compensation lawyer so you can promptly attempt to get the treatment and temporary disability benefits you seem to be entitled to. Unfortunately, your treatment is controlled by an insurance company that is responsible for these benefits, and it's in their own interest to deny you these benefits. Don't hesitate another day.
    Answer Applies to: New Jersey
    Replied: 12/29/2011
    Andrew T. Velonis, P.C.
    Andrew T. Velonis, P.C. | Andrew Velonis
    You are entitled to have all of your medical costs covered as well as your lost wages at an amount of 66% of the average of your wages for the 52 weeks immediately preceeding the accident. As for the 2nd opinion, they can take the position that it is not medically necessary. As to therapy and underpayment, you can take an appeal. As to a schedule award, your doctor has to assign a percentage of permanant loss of use of the body part injured, the comp carrier can hire its own doctor to dispute that opinion and the board applies a formula determining the number of weeks you are entitled to on a lump-sum basis.
    Answer Applies to: New York
    Replied: 12/29/2011
    Rose, Senders & Bovarnick, LLC
    Rose, Senders & Bovarnick, LLC | Paul S. Bovarnick
    You need to see a workers comp lawyer immediately. It sounds like the insurer may have violated a number of regulations. However, there are time limits for appealing, and if you wait, you can lose important rights.
    Answer Applies to: Oregon
    Replied: 7/8/2013
    Paul Whitfield and Associates P.A.
    Paul Whitfield and Associates P.A. | Paul L. Whitfield
    You are entitled under the law to your medical bills and 2/3s of your average weekly wages up to a cap. You don't get paid in full in a comp case. If the carrier doesn't like the opinion of your doctor you can ask the Industrial Commission to give you a hearing and present your medical situation. Your doctor will likely be deposed and the hearing officer will decide the value of the 2d opinion you might get a small lump sum if you have a percentage of disability. Does not sound like you do but then maybe that is what this case is all about. If your doctor goes to bat for you, you may prevail. You really need a good comp lawyer to advise you particularly.
    Answer Applies to: North Carolina
    Replied: 12/29/2011
    Law Office of Ronald Arthur Lowry
    Law Office of Ronald Arthur Lowry | Ronald Arthur Lowry
    This is, unfortunately, how employers often treat unrepresented employees in a workers' compensation case. Get a workers' compensation lawyer ASAP. I am amazed you let this get this far without already getting an attorney
    Answer Applies to: Georgia
    Replied: 12/29/2011
    Diana K. Zilko, Attorney at Law
    Diana K. Zilko, Attorney at Law | Diana K. Zilko
    It sounds like you need a work comp attorney to help you understand your rights.
    Answer Applies to: California
    Replied: 7/8/2013
    Joel H. Schwartz, P.C.
    Joel H. Schwartz, P.C. | Steven A. Schwartz
    From the complexity of your situation, I suggest you contact an experienced worker's compensation attorney immediately. You may be entitled to medical benefits that the wc carrier is currently denying. In addition, you should NOT be settling this claim without talking to someone who knows proper values of cases like yours. The amounts are based on many factors, including your average weekly wage and extent of your injury.
    Answer Applies to: Massachusetts
    Replied: 12/29/2011
    Lombardi Law Firm
    Lombardi Law Firm | Steve Lombardi
    It's way to early to even think about settling your claim; so forget about doing so. The authorized treating physician is the one with the medical license, not some adjuster with a bachelors degree in Frisbee tossing. Get the physician to prescribe necessary medical care in writing and then communicate that to the insurance company. Keep a copy of all written medical orders. If the insurance case mismanager doesn't authorize the treatment hire an attorney.
    Answer Applies to: Iowa
    Replied: 12/29/2011
    Broad Law Firm, LLC
    Broad Law Firm, LLC | Donald K. Broad
    In Indiana, your only course of action against your employer is worker's compensation. However, that does not prevent you from pursuing any other parties that may be liable for the incident. For instance, in your case, if your employer did not own the school bus where you slipped, there may be liability against the owner of the bus. You should consult a personal injury attorney in your area to discuss your rights and options. Most will meet with you once free of charge.
    Answer Applies to: Indiana
    Replied: 2/17/2012
    The Law Office of Stephen R. Chesley, LLC
    The Law Office of Stephen R. Chesley, LLC | Stephen R. Chesley
    You should contact a lawyer to represent you in you workers compensation case. Under normal circumstances, the workers compensation has begun a managed care type of medical care. They authorize a certain amount of treatment and the doctor must request additional treatment and you need a lawyer to make sure you obtain same.
    Answer Applies to: New York
    Replied: 12/29/2011
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