Am I being blacklisted

[snowbear]

Hi BB. Why do you say any cervical fusion is high risk? Just wondering because I've had a 2 level cervical fusion. Thanks for your reply.

[Cycler]

What would be the rationale for settling a claim with such a high probability of significant future surgery ? Also, As far as I understand it, the mere fact a claim is settled does not burden a new employer with a claim when it is found to a reasonable degree of medical certainty that a problem is related to a the settled claim and I'm not going to even begin on just because you are standing under an employers roof when something starts to hurt is not proof of work relatedness.

Bad Boy Bad Boy Wrote:I'm from Illinois, and when a Work Comp Claim is settled, mostly 85% of the time the Medical is closed out also.

So, if reagravation of an old injury takes place, the new employer takes on the case.

[Bad Boy Bad Boy]

Cycler, as I can speak from my State. To try and reopen a case, the injured would need to pay an Attorney for this, as their case had been settled for one. Second, anything new to a settled case in Illinois would be a new claim, and new claim number. Surely the IC will argue Pre-injury to this, and a Hearing will take place to show Re-Agravation of an old injury, making the new claim come to life, and the new employers Insurance handling the claim. That's life in Work Comp.

Snowbear, if it is Cervical, Thoraic, or Lumbar Spine, fusions, their all considered a Risk factor to a new injury, aggravation to an old injury and such. It is also said, once a fusion took place, the chance of another fusion in the future is more likely then not. Such said meaning another medical cost at a high level for the Insurance Carrier, or the new Insurance Carrier. Being said, they then consider the person a High Risk for that reason.

[Cycler]

I dont believe that is that case in every state then. It makes no sense.

" Re-Agravation of an old injury, making the new claim come to life, and the new employers Insurance handling the claim. That's life in Work Comp."

[Bad Boy Bad Boy]

Cycler, that is why Work Comp claims are called (((No Fault))).

No fault to either the employer, or the employee....

[1171]

distinguishing between an aggration which is a new injury and an exacerbation which is not is a difficult medical and legal tight rope.
to protect themselves a claim is filed against the new employer and when such issues are settled with a buyout contribution from the new employer would be expected.
so whether there is a new injury or not the employer often pays.

most states have specific casuation requirements. the prior injury often has to be the "proximate cause" or "the major contributing factor" or "the predominate cause" etc. etc. depending on the state.
very few comp systems will hold an original comp injury liable when and where there have been intervening non-industrial events.
liability usually has to be more then "any cause" and more then "related" to a finalized claim.
it makes sense from a legal point of view.

[Cycler]

I understand and is what i was referring to earlier whereby relatively minor issues in comparison to a pre-existing serious injury to same body part do not automatically become a bew claim for a subsequent employer if the determination is of an exacerbation. In this state the term aggravation has been further parsed into substantial and non-substantial which has implications as to claim determination.

thanks

[Cycler]

BBB;

No fault or not, in this state a simple and minor claim will often be enough to have an employer dropped from it's group rating discount program and it is not unheard of for a demand for a check of $50-75,000.00 to meet the new premium being set. More than one small business has folded up as a result of not being profitable enough to meet the new demand. So, there is a strong incentive to deny any new claim to a previously effected body part from a prior employer and therefore often in the employees best interest to instead pursue treatment under their old claim as the going is undoubtably easier.

[Bad Boy Bad Boy]

Cycler, I too understand the premium issues, but I don't make the Laws and Rules. In many cases of a minor issue, it would just be easier for the injured to take care of that themself. Unless the injured person was able to settle their past claim with Open Medical. Even with the Open Medical, there will be loop holes.

Now, like in this posters Thread here they had a Cervical fusion of 2 levels. If they went to work, and were re-injured, and it was medically found a 3rd or even a 4th level needs to be fused now, that then will fall on the New Employer.

Sorry, but that is just the way it is, has been, and for time to come. I am living proof of that also.

[Cycler]

That would be fine if that would actually occur, a bona fide easily recognized by all parties new injury. Unfortunately the truth of the matter is more along the lines of working for a new employer for 5 to 10 years when neck starts giving a little trouble till finally sees a Dr. over some trivial work incident and finds that adjacent levels are now involved and causing instability so a new claim is filed. Nonsense claim and employer who gave a guy a chance is screwed on a bogus claim.