Claim Dispute. What to do?

[Fishhawk]

Hello all im new here. I filed a claim for the first time ever a month ago and they r disputing it saying it wasnt work related.. I had a surgery in 1997 on L5-S1 but this is up from there. I have a herniated disc says the MRI and am in therapy and Steroid injections for the next six weeks at least.. They are saying not work related when my boss says it was. I have never delt with this before and was looking for some help. The person i am dealing with from comp is a tptal a?}-Holw to me whenever i call so they r no help. Thanks for any input i can get!!!

Michigan Guy...

[Manley2]

Are they trying to say this is part of your 1997 injury? Was this at the same employer? Who is paying for the treatments you are getting right now?

[Fishhawk]

(01-26-2011 07:35 PM)Manley2 Wrote:  Are they trying to say this is part of your 1997 injury? Was this at the same employer? Who is paying for the treatments you are getting right now?

No this is a new injury i got in december.. I have had no problems or pain meds since 97 for other one. Its not in the same spot as before its one up. At the present time there is nobody paying for anthing. The 97 injury was a car reck

[1171]

If a worker or an employer has any questions about workers’ compensation benefits, he or she can obtain help by simply calling the nearest agency office. Very often minor disputes concerning workers’ compensation can be resolved by the mediators that are available in these offices. Sometimes the problem is solved by simply providing the needed information. Sometimes the mediator will make a phone call to the other party involved in the case and sometimes the mediator will arrange for an informal conference between all the people involved. When problems can be resolved in this way, the need for formal litigation is avoided. Sometimes, however, there is no simple solution and formal litigation will be necessary.
http://www.michigan.gov/documents/wca_PU...5317_7.pdf

Customer Service (517) 322-1980
or
1-888-396-5041
http://www.michigan.gov/wca

[Cervical_Fusion]

Each state WC laws vary, but I am in another state i had a fusion in 2003, in 2008 which was 5 years later, the disc above and below the 2003 disc that i had surgrey on blew out. Mine was not a new claim but added to the 2003 claim. But like i said each state laws with wc can vary. What does the pcp say, does he relate it to the old claim or does he consider it to be a new claim. Did you have open medical from the 1997 claim.

[Fishhawk]

(01-27-2011 04:12 AM)Cervical_Fusion Wrote:  Each state WC laws vary, but I am in another state i had a fusion in 2003, in 2008 which was 5 years later, the disc above and below the 2003 disc that i had surgrey on blew out. Mine was not a new claim but added to the 2003 claim. But like i said each state laws with wc can vary. What does the pcp say, does he relate it to the old claim or does he consider it to be a new claim. Did you have open medical from the 1997 claim.

He doesnt say he just says previous back injury. Like i said my MRI says previous fusion ok. According to my Michigan WC book it says that doesnt even matter. You can be born with a birth defect and are still entitled to WC if you irritate it at work. The second problem they say is i didnt report it As soon as it happened. I reported it as soon as happened. I did i told my coworkers and i went home. I didnt tell my boss cause he was gone for the day and there is no second in charge. So i told the loongest working employeye in the building and left at 2 pm. I called doc and he got me in at 8 am next day.. Doc is half hour from my home so i called my boss and told him at 7:30 on my way in. The shop didnt open till 8 so i actually reported it before business hours of him returning to work. Bosses report shows that i reported it same say it happened. Again going back to my book it says Michigan law states i have 90 days to report it and it doesnt have to be in writing it can be verbal. I have never delt with this sort of thing before and am hoping i can do this on my own. I havent had a check in seven weeks and im gonna start loosing things to the bank. I contacted a lawyer yesterday and they want 40 percent to do it. Im hoping for a way around that since i found laws backing me on both the decisions they made it from. I appreciate the help so far people!! I am learning more here than i have anywhere else. Its haed to believe they would do this to a person!!!

[Manley2]

Brace yourself because yes they do this employees all the time. It sounds like your current employer is going to try and say this is because of your past injury which means you are going to have fight on your hands. Yes there are laws that can help with this but without a lawyer it's going to be hard for you to get what is right. And yes I understand that is not right but it's the truth. Not sure what the limits are in your state on fees the lawyer can get but you might want to check with another lawyer and see what they say. You are going to need a doctor that will say this is a new injury and even if you do they will send you a doctor saying it is not a new injury. Then it will be up to the judge to decide which one he believes. This could take a good deal of time to get heard and for them to decide. Nothing happens fast in WC other then employers denying your claim. When you do get a hearing it will be their lawyer for the employer and then you, and you will need to be well versed in the laws and rules to know what to say and how to say it. Now you may get a hearing officer that will feel sorry for you and help some but their lawyer is not going to be easy with you. Plan on this taking time and for the employer not to be paying unless you win. Its not a fair system for the injuried employee at all.

[Fishhawk]

(01-26-2011 08:08 PM)1171 Wrote:  If a worker or an employer has any questions about workers’ compensation benefits, he or she can obtain help by simply calling the nearest agency office. Very often minor disputes concerning workers’ compensation can be resolved by the mediators that are available in these offices. Sometimes the problem is solved by simply providing the needed information. Sometimes the mediator will make a phone call to the other party involved in the case and sometimes the mediator will arrange for an informal conference between all the people involved. When problems can be resolved in this way, the need for formal litigation is avoided. Sometimes, however, there is no simple solution and formal litigation will be necessary.
http://www.michigan.gov/documents/wca_PU...5317_7.pdf

Customer Service (517) 322-1980
or
1-888-396-5041
http://www.michigan.gov/wca

1171:
Thank you for posting the link to Michigan laws!!!!!! I read thru it andevery excuse they were giving me there was a law in that link putting the courts on my side. I called back and talked to them with the specific law numbers and they had a meeting and called me back within an hour and said it was approved and they were sending me a check with back pay.. I never even heard of this site before but you 1171 have made my day, an i thank you very much!!!!!! I wish everyone on here good luck and i will keep up on this form and help were i can. Again thank you everyone for the help!!!!