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Pre-existing Injury Claim
#1
I am a Louisiana state employee , Registered Nurse in a Louisiana charity hospital. Around Nov. 2008 as I entered the door to clock in for my regular shift and I stumbled on a turned-up entry rug. A claim was filed and aproved by workers comp , arthroscopic surgery/physical therapy to repair tear in knee and returned to work in Jan.2009 . All claims have been paid by workers comp . I had been working 6-7 months since my return with some minor pain and locking up of the knee , somewhat normal from from this type surgery. However my knee locked at home while as I was turning to walk from a location and re-injured my knee requiring the same surgery again . I been told I have a open claim by the contact within my employment whom reports to workers comp. Workers comp refused to pay first vist to the doctor and refused payment for a MRI. I have had the MRI done results show a tear and sugery needed but workers comp again refused to pay . Doctors office phoned workers comp for approval, workers comp requested a doctors report. I was given my works com contact info. and placed a call to find out the status of my claim but my worker comp contact has not returned my calls in two weeks. Can anyone tell me what is the rules of contact between worker and workers comp. ? I just want to get this surgery done with and return to work.
Many thanks
TC
 
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#2
the general rules of contact are that if you have retained legal representation the carrier is ethically required to go thru them rather that discuss the claim directly with the client.
P.S.
aggravations are considered a new injury so unless you have medical opinion that connects the incident at home to your job or your prior injury it's not likely to be covered.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
I have not retained legal representation , from the discussion I had with my doctor his medical opinion and also stated in the report requested by workmans comp supports locking of the knee can be linked to my prior injury .
 
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#4
put your request in writing. if they still refuse to provide or deny then ask the comp court for a decision.

http://www.laworks.net/FAQs/FAQ_WorkComp...Claims.asp
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#5
1171 Wrote:put your request in writing. if they still refuse to provide or deny then ask the comp court for a decision.

http://www.laworks.net/FAQs/FAQ_WorkComp...Claims.asp

Thanks for the reply !
 
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#6
Why would your employer be liable for what you did on your own time at home? I understand the one at work, but you did the other one on your own.
Why do you think your employer owes you for this? Why can't you use your own insurance and just get it fixed?
 
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#7
Locking of the knee is due to the original injury, andd if not for the original injury the knee would not be locking, causing the re-injury.

One can not control where or when a knee locks up.

I would like to hear what Bad Boy has to say on this.
Bummer Knees
 
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#8
Yep! That's exactly what my knee did after a meniscus tear....and surgery made it 98% better! But it still does lock up on occasion (2%) It NEVER happened until I injured it the first time at work.

I bet your lawyer will get them straightened out. If you get a denial letter from WC, put bills on your reg insurance...they'll want to see the denial of the claim. But I'm hoping that you'll get accepted.

Lilly
Injured worker, & tired of it all! I'm too old for games!!

A careless word may kindle strife, a cruel word may wreck a life, a timely word may level stress, and a loving word may heal and bless!
 
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