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My husband was injured 16 years ago on the job. He fell while making a delivery. Ended up having fusion surgery on 2 discs in his neck. There was never any settlement on the case. He has lifetime medical, but the case was never closed as far as we know. He never regained full usage of his left arm. He has started to have pain in the area, as well as pretty severe headaches. We have contacted Workers's Comp and the insurance company to get him seen by a doctor, but they are making us request for medical records and make several phone calls to get them the info they need. Any
advice?
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10-27-2014, 02:08 PM
(This post was last modified: 10-27-2014, 02:10 PM by 1171.)
the issue may not be whether the claim is open or closed.
unless there is medical evidence that the current need for treatment is due to the original injury and not anything subsequent, it will likely not be covered. the future treatment coverage is only for the original injury and does not apply to anything that happens to that part of the body ever afterwards; it's a medical determination.
if there has been a re-injury or other causes, it's excluded from future treatment.
what do his doctors say?
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After surgery he went through all of the physical therapy, but was told that he would never get back all strenght and range of motion of his left arm. We have that documented by the surgeon at the time. There have been no furterh injuries, but he has always had residual pain. It has just increased over the last year. Doctors now say it could be from injury, but he hasn't been for any real testing.
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it looks like coverage will come down to medical opinion as to its cause. if there is contradictory evidence as to the basis of his current problems, the issue may have to be resolved by the comp court. if your husband had an atty for his original claim, he should contact them again.
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He did not have an attorney. He has been told by others that he would need to be "rated" by a doctor. There was never any attempt by worker's comp to close out or settle the case. It's almost like it just went away and now they are telling him they have no record of anything, which is why we had to go in search of and pay for copies of medical records. Does that sound normal?
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10-27-2014, 05:58 PM
(This post was last modified: 10-27-2014, 06:07 PM by 1171.)
if he was awarded lifetime medical, the carrier should have archived their records.
if he kept his original award documents they should have a claim number assigned that would make it easier for the commission to search their records.
if his physician released him to full duty without limitations, his "rating" may have been interpreted as 0.
not every injury results in permanent impairment.
you should not have to pay to refresh their claims information.
if you need help from the commission in locating claims information:
"you may contact the Commission by phone toll-free at 1-877-664-2566 or by email at Questions@workcomp.virginia.gov. "
http://www.vwc.state.va.us/content/injured-workers
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Sorry to here about all the things that you are going through. I hope that everything work out for you. This is why it's my opinion that any time you have a serious accident you should have a attorney.
