surgery for a nine YO work related injury

[ovarb]

What is the name of your state? iowa


approximately nine years ago I injured my back at work. the doctor's diagnosis was a lumbar strain and prescribed pain pills along with physical therapy. since then I've been back to hospital several times whenever my symptoms acted up which was at first every six months but lately only evry other year. each time my employer took care of the fees even though it was difficult explaining that no new injury had occured . often I would ask if tests could be taken but was always told it was a strain and nothing more, so I would get the pills and go through PT.

In December my symptoms started again and wanting to take care of the problem called my own specialist.They said since it was work related I should still contact my employer so I talked with my employer's safety director and he said it would be best to see my own doctor because it had been two years since my last hospital visit and he wasn't sure how the "new" insurance company would handle the claim. Which I told him was OK because I was
only planning on PT. After PT didn't work I called my safety director and he set up an appointment with the doctor.

The doctor said he couldn't treat me with out an actual accident so after a lengthy discussion with the him I finally convinced him that my symptoms had never gone completely away. So he said he'd order an MRI but would have to see if the Insurance company would cover it. My director informed me theu wouldn't but told me if I found it was work related they'd try to "help me out".


After MRI's from my own doctor it turns out I have a "floating fragment" from a herniated disc pressing on a nerve which causes my almost unbearable pain. Now I'm having surgery soon to have that removed and possibly to fuse two vertebre together.

Part of me wants to keep pressing to ask my doctors if they think my problems stem form the first injury and get compensation from my employer. But part of me is afraid if they feel it's work related I'll be back to a WC doctor/surgeon. I want to have the surgery ASAP.

any advice is appreciated.

 

[Beth3]

Nobody here would know whether your present medical condition - the floating disc fragment - is actually related to your injury of nine years ago or not. Consequently, whether you should try to have the old claim re-opened and claim this as WC is an unknown. (Having gone two years with no treatment, I can just about guarantee that your claim from nine years ago was closed.)

It's up to you. If the WC carrier declines to re-open the claim or they decline to pay your surgery expenses as not being work-related, then you will have the option of filing for a hearing with the State to resolve the matter.

 

[ovarb]

updated:

I had surgery scheduled for April 28th and days before left a message with my safety director saying my doctor feels it's work related.

The Friday before surgery he calls me saying the insurance co. is trying to get hold of my doctor to see why he thinks it's work related. He told me not to cancel any of my appointments so I wouldn't delay the surgery.

So I've had the surgery and haven't heard from him since. So far I haven't had any pain in my leg which reinforces my belief that this all stems from the accident I had long ago. I left a message yesterday asking for an update and he's yet to call.

I'll be on STD for approx. 4 weeks and had to burn a week of vacation.
Is this something I should keep pressing? I don't really wan't to have to fight the company I work for but I'm convinced it's work related. What kind of chance would I have getting my vacation time back and WC?

thanks

 

[Beth3]

You can either wait and see if the Safety Director calls you back or you can call the WC carrier directly and discuss your claim and status with them.

 

[ovarb]

I had called my WC carrier after the last reply and talked to an agent who had just taken over my case from another who was in the process of getting a response from my doctor. She conducted a short interview about my job functions now and in the past as well as touching on home activities and hobbies.

I hadn't heard from her since so I called today and she said she was waiting for a video of my job funtions from my safety director. I asked if they needed a video of my current job or the job that I was performing at the time of the original injury. She explained that she was working on the current claim for my current job and that my old WC carrier would be responsible for the original injury, even though she understood my point of all my medical visits being related.

So as Beth3 had said it might be a matter of the original WC carrier deciding to re-open the case which she didn't sound too likely to happen. So what do you think my chances are of winning a case like this if I had to file it with the State?

I'm sorry if I'm being redundant or repetative. I just don't want to start a legal battle I have little chance of winning.