Can I get some answers please? Much appreciated :)

[Hferna]

Hello everyone!
Well, I'm a newbie to this forum and workers compensation so I have a bunch of questions and I'm hoping for at least some answers from you knowledgeable wonders

On July 3rd, I had a severe allergic/anaphylactic reaction which included hives, swelling of limbs, face, neck and throat, and inability to breathe properly while working at Petsmart. I was rushed to the ER where the treating physician told me that he was "99.9% certain" that my reaction was caused by an airborne allergy from wherever I was (Petsmart). For the first week after, I was unable to leave my home (which was okay since I looked like a swollen, red lethargic monster for 6 of those days) and I have now been out of work for 13 days.

I was contacted by the Claims Management service who got a recorded statement and then called back a few days later and said I would be getting weekly benefits after she "ascertained my wages" since I only worked two weeks. She also urged me to get an earlier appointment with a specialist (its August 10th). But anyway, here's my questions:
1) If I cant return to Petsmart (or any animal related job as I'm studying to be a vet tech) what will workers comp do? Continue weekly wages until I get a new job?
2) Should I get a lawyer? How important are they? I'm only 20 so I'm not really sure about all this.
3) If I have to change majors, will workers comp have anything to do with it (benefits, training, etc)
4) How do settlements work? Ive seen a lot of posts about them but don't know why you get a settlement.
5) Should I call the CMS and tell them I need them to pay for the EpiPen I need? It is $300 and I don't have insurance. Will they pay for that?
Honestly, I didn't know diddly squat about wc before now so I'm in the dark, so to speak. I'm not even sure how to proceed from here.
Any answers and advice are much appreciated!

[1171]

(07-16-2012 04:54 AM)Hferna Wrote:  Hello everyone!
Well, I'm a newbie to this forum and workers compensation so I have a bunch of questions and I'm hoping for at least some answers from you knowledgeable wonders

On July 3rd, I had a severe allergic/anaphylactic reaction which included hives, swelling of limbs, face, neck and throat, and inability to breathe properly while working at Petsmart. I was rushed to the ER where the treating physician told me that he was "99.9% certain" that my reaction was caused by an airborne allergy from wherever I was (Petsmart). For the first week after, I was unable to leave my home (which was okay since I looked like a swollen, red lethargic monster for 6 of those days) and I have now been out of work for 13 days.

I was contacted by the Claims Management service who got a recorded statement and then called back a few days later and said I would be getting weekly benefits after she "ascertained my wages" since I only worked two weeks. She also urged me to get an earlier appointment with a specialist (its August 10th). But anyway, here's my questions:
1) If I cant return to Petsmart (or any animal related job as I'm studying to be a vet tech) what will workers comp do? Continue weekly wages until I get a new job?
2) Should I get a lawyer? How important are they? I'm only 20 so I'm not really sure about all this.
3) If I have to change majors, will workers comp have anything to do with it (benefits, training, etc)
4) How do settlements work? Ive seen a lot of posts about them but don't know why you get a settlement.
5) Should I call the CMS and tell them I need them to pay for the EpiPen I need? It is $300 and I don't have insurance. Will they pay for that?
Honestly, I didn't know diddly squat about wc before now so I'm in the dark, so to speak. I'm not even sure how to proceed from here.
Any answers and advice are much appreciated!

---

1) depends on your state law.
2) they provide settlement expertise and handle litigation. is your case litigated?
3) depends on your state laws.
4) depends on your state laws.
5) have your doctor call.

[Hferna]

1171,
I'm in Louisiana. Sorry, I thought I had that in my profile but it apparently didn't stick.
I don't know what litigated means in this case. Basically, my case has just begun. My biggest fear is that the CMS will say that this isn't an allergy to work when I know it is. Ive never had anything like this before.

I think one of my big problems is going to be that I don't have a primary care physician.

[hurt back]

(07-16-2012 11:44 AM)Hferna Wrote:  1171,
I'm in Louisiana. Sorry, I thought I had that in my profile but it apparently didn't stick.
I don't know what litigated means in this case. Basically, my case has just begun. My biggest fear is that the CMS will say that this isn't an allergy to work when I know it is. Ive never had anything like this before.

I think one of my big problems is going to be that I don't have a primary care physician.

In regards to allergy, they ( dr or insurance company ) can perform test to see what you are / aren't allergic too.. My wife once worked for a department store, they transfered her to the perfume dept. and then BAM... she was having a reaction to all the different colognes & perfumes.. Of course we didn't know it was work related until the dr did the test.. You may want to ask the Dr how they can " convince " the I/C if they disagree with his diagnosis...

[Hferna]

I have an appointment with an allergist on August 10th for testing, but the IC is trying to get me to get an appointment sooner than that with another doctor. Theres only one near my home (small town) that MIGHT take wc.

Ive noticed that there aren't that many threads about allergic reactions - I'm wondering if people put it off to other things more often than not. Its such a confusing thing because I don't know if I'm considered TTD or what :/

[1171]

(07-16-2012 11:44 AM)Hferna Wrote:  1171,
I'm in Louisiana. Sorry, I thought I had that in my profile but it apparently didn't stick.
I don't know what litigated means in this case. Basically, my case has just begun. My biggest fear is that the CMS will say that this isn't an allergy to work when I know it is. Ive never had anything like this before.

I think one of my big problems is going to be that I don't have a primary care physician.

the term "litigation" refers to actions within the court system i.e. disputes. workers comp has it's own administrative law adjudication/dispute resolution process.
http://www.laworks.net/FAQs/FAQ_WorkComp...Claims.asp

I don't know anything about a "CMS" --maybe that is a self-Insurance adminstration company?
but you are correct that neither your opinion or that of the employer means much in the comp system.
any decision to provide or deny benefits has to rest on the medical evidence. without it neither side has much of a chance at winning a dispute.

if you are determined by the system to be unable to return to your former occupation because of the permanent effects of your injury workers compensation can provide vocational rehabilitation benefits.
contact your claims adjuster about additional information.

any permanent disability will be rated and additional payments provided.
changing your major will not factor in.

settlement can mean a cash buyout of your future or disputed benefits or the additional permanent disability benefits.
permanent disability benefits depends on a disability rating from a doctor. that would occur after a doctor determines that you have reached maximum recovery.

read up on workers comp benefits and process here:
http://www.laworks.net/Downloads/Downloads_OWC.asp

[Hferna]

Wow! So much information!
Would an allergy to the store be considered a permanent disability? Or would the IC say something like "you can work elsewhere so you aren't permanently disabled"?

[1171]

(07-16-2012 01:57 PM)Hferna Wrote:  Wow! So much information!
Would an allergy to the store be considered a permanent disability? Or would the IC say something like "you can work elsewhere so you aren't permanently disabled"?

so many questions!

I don't think there is any medical evidence to support an allegeric reaction to a building but there is a "sick building syndrome" that is trying to gain legitimate legal status.

generally an allergic reactions are to specific chemical compounds and molecules but you'd have to discuss it with your physicians.
the rating guidelines do allow for allergy conditions.

permanent impairment has little to do with where you work or don't; it has to do with functional limitations to your body that are more then temporary. e.g. can't be returned to normal or are damaged beyond repair. those restrictions can apply to any job.

you can read more about permanent impairment here:
http://emedicine.medscape.com/article/314195-overview

[Hferna]

Thanks 1171, you're a huge help!

[1171]

(07-16-2012 03:06 PM)Hferna Wrote:  Thanks 1171, you're a huge help!

you're welcome.
you have a lot of reading to do to get basic understanding of comp.
message boards handle specific problems issues best.
too much to cover for general stuff.