Worker's Comp procedure questions

[Rwedunyet]

What is the name of your state (only U.S. law)? North Carolina

Hello all!

It's been awhile, but I have a new question. I have never done the worker's comp thing before.

I was injured while working at my place of employment yesterday. Immediately upon the incident, I called my supervisor. She arrived with a lot of paper work, which she filled out. I never filled out anything, nor did I sign anything. She did give me a bag of ice to place on the injury, and handed me a bottle of over the counter pain medication (which I did not take). When I told her that I would be going to urgent care, she suggested that I go home and "rest" for the weekend, and see how it feels on Monday. I pointed out the swelling and discoloration, and again stated that I needed to be seen by a physician.

She proceeded to fill out her paperwork, asking me to stay while she did, I stayed but encouraged her to be quick since I was definitely hurting, and the swelling was getting worse. 45 minutes later, she finished her paperwork and her "sketch of the scene" (for her records), and I left. She told me that I needed to provide her with the name of the Dr, his telephone number, and a written diagnosis and medical history on his letterhead within 24 hours or I would not be covered.

Upon my arrival at the Dr's office, they asked if this was a workplace injury. I responded "yes" and they asked for the authorization form. I had no clue what they were talking about, and the receptionist asked for the contact info for my boss. I provided it and the receptionist asked my boss for some information about the worker's comp insurance. My boss told them to just bill my insurance and that I would be reimbursed. I refused this option.

The receptionist got the required information, and asked my boss if a drug screen was required. My boss said that she did not know and did not know how to find out. She ended up telling them not to do a drug screen because she "knew I was clean".

The appointment revealed a painful but minor injury after a physical exam and x-rays. I should heal easily, but there is a potential for future problems, so it is important that things are done correctly. The physician provided me with a statement that I was to give to my boss when I am allowed to return to work (I was written out for a week by the Dr). I went ahead an took this paper to my boss. It provided a diagnosis, prescriptions given, and work restrictions along with follow up care needs. Boss says she will not accept it because it does not include a medical history and insinuated that if I was "accident prone" she would have to find someone else to do my job. (the accident was not due to my negligence, it was a failure of work provided equipment).

To date, I have not filled out ANYTHING except the paperwork at the Doctor's office, and I have signed NOTHING except at the Dr's office.

Is this proceeding the way it should be?
Should I not have to fill out an accident report myself? I did not even get to see what she filled out, and am honestly concerned that she filled something out for me.
Shouldn't I have been drug screened? I asked for the Dr to go ahead and do it, but he said that without a request by the employer he could not do it unless I paid for it out of pocket. I can't afford that right now.
Does my boss have to see my medical history? I really have nothing to hide, but I don't want to provide more information than needed.

Thank you, I appreciate your time!

 

[Dave1952]

I suspect that it would be wise to call the insurer to find out whether a claim has been registered and what documents you should supply to the insurer.

 

[quincy]

What is the name of your state (only U.S. law)? North Carolina

I was injured while working at my place of employment yesterday. Immediately upon the incident, I called my supervisor. She arrived with a lot of paper work, which she filled out. I never filled out anything, nor did I sign anything. ... She told me that I needed to provide her with the name of the Dr, his telephone number, and a written diagnosis and medical history on his letterhead within 24 hours or I would not be covered ... the receptionist asked my boss for some information about the worker's comp insurance. My boss told them to just bill my insurance and that I would be reimbursed. I refused this option.

The receptionist got the required information, and asked my boss if a drug screen was required. My boss said that she did not know and did not know how to find out. She ended up telling them not to do a drug screen because she "knew I was clean".

Your employer, if she has not had any workers compensation issues before, seems to have handled your injury as well as she could. Nothing is jumping out at me as being questionable except you probably should have been asked to review the accident report and sign it.

The appointment revealed a painful but minor injury after a physical exam and x-rays. I should heal easily, but there is a potential for future problems, so it is important that things are done correctly. The physician provided me with a statement that I was to give to my boss when I am allowed to return to work (I was written out for a week by the Dr). I went ahead an took this paper to my boss. It provided a diagnosis, prescriptions given, and work restrictions along with follow up care needs. Boss says she will not accept it because it does not include a medical history and insinuated that if I was "accident prone" she would have to find someone else to do my job. (the accident was not due to my negligence, it was a failure of work provided equipment).

Have you had accidents in your workplace before? Could your injury in any way be connected to a pre-existing medical condition?

What was the work equipment that caused your accident and how did it fail?

To date, I have not filled out ANYTHING except the paperwork at the Doctor's office, and I have signed NOTHING except at the Dr's office.

You probably should have been asked to read over and sign the accident report.

Is this proceeding the way it should be?
Should I not have to fill out an accident report myself? I did not even get to see what she filled out, and am honestly concerned that she filled something out for me.
Shouldn't I have been drug screened? I asked for the Dr to go ahead and do it, but he said that without a request by the employer he could not do it unless I paid for it out of pocket. I can't afford that right now.
Does my boss have to see my medical history? I really have nothing to hide, but I don't want to provide more information than needed. ...

Nothing seems too off-kilter except I question why the accident report was not reviewed by you and signed. I do not see that a drug screen would be necessary, unless there was some suspicion that the accident was caused by your use/misuse of drugs or to rule that out as a contributing factor. As to the medical history, that can be important in determining if you had a pre-existing condition.

Without more facts, though, it is hard to advise - other than to follow what Dave1952 has suggested and to file a claim. Also, if you can tell me what sort of equipment failed, and how it failed, that interests me.

Following are links to the North Carolina Industrial Commission on worker compensation claims.

Your employer's responsibilities: http://www.ic.nc.gov/employers.html

FAQs: http://www.ic.nc.gov/faqs.html

I hope you are recovering nicely from your injury.

 

[Rwedunyet]

Thank you both for your responses. I do feel a little better about this situation. The links were very helpful, thank you!

To answer your questions, Quincy....

No, I have never been injured on the job before. This is my first (and I hope only) go around with Worker's Comp.

There is no way that this injury is related to a previous condition.

As for the injury, I had to climb on a ladder and the ladder failed. A bolt in the ladder was badly rusted and broke, which caused the leg of the ladder to come partially detached and as a result the ladder fell. I was on the third from the top rung, so I fell about five feet, and landed on my hip and rear end. I have a small bruise on my face where the ladder bonked me upside the head. I have a contusion on the ball of my hip joint (bruised bone), and a bruised tailbone (that HURTS). The x-rays revealed that the very tip of my tailbone is cracked. I was told that there is a potential that it could break the rest of the way off, possibly resulting in a need for surgical removal of the bone fragment.

Apparently, I am now old enough that I don't bounce when I hit the ground.

The bolt was in the underside of the top of the ladder, and under a "lip" of sorts, so it was not readily visible. Several of the other bolts in the ladder were rusted as well. The ladder was set up when I arrived at my workstation.

As for healing, well.....my rear end is pretty sore. I have this nifty donut thingy that I sit on, and my son is the "bringer of the frozen corn". Frozen corn makes a great ice pack. But oddly enough, no one will eat the corn once it thaws!

 

[quincy]

Thank you both for your responses. I do feel a little better about this situation. The links were very helpful, thank you!

Thank you for the thanks, Rwedunyet. Dave and I both appreciate them.

To answer your questions, Quincy....

No, I have never been injured on the job before. This is my first (and I hope only) go around with Worker's Comp.

There is no way that this injury is related to a previous condition.

As for the injury, I had to climb on a ladder and the ladder failed. A bolt in the ladder was badly rusted and broke, which caused the leg of the ladder to come partially detached and as a result the ladder fell. I was on the third from the top rung, so I fell about five feet, and landed on my hip and rear end. I have a small bruise on my face where the ladder bonked me upside the head. I have a contusion on the ball of my hip joint (bruised bone), and a bruised tailbone (that HURTS). The x-rays revealed that the very tip of my tailbone is cracked. I was told that there is a potential that it could break the rest of the way off, possibly resulting in a need for surgical removal of the bone fragment.

Apparently, I am now old enough that I don't bounce when I hit the ground.

The bolt was in the underside of the top of the ladder, and under a "lip" of sorts, so it was not readily visible. Several of the other bolts in the ladder were rusted as well. The ladder was set up when I arrived at my workstation.

Oh, ouch. That sounds like a very painful injury. I hope you heal without the need for surgery.

I wanted to know about the equipment failure, thinking you might have a product liability action available. I don't see that particular action but I do see the possibility of a civil action against your employer for negligence, if he was aware or should have been aware of the defective condition of the ladder. If the bolt was not readily visible, though, a suit might not be supportable - and I am not sure it would be worth your time or effort to pursue a civil suit anyway.

As for healing, well.....my rear end is pretty sore. I have this nifty donut thingy that I sit on, and my son is the "bringer of the frozen corn". Frozen corn makes a great ice pack. But oddly enough, no one will eat the corn once it thaws!

Ha. I think the only time we ever use our frozen vegetables is when we need them for ice packs. I don't recall ever eating any, at any rate - but, then, I tend to eat anything put in front of me without thinking too much about its source so it is possible I have consumed ice packs in the past.

I wish you rapid healing and good luck with your worker compensation claim.

 

[Rwedunyet]

Thanks Quincy.

It is possible that some people would consider my employer negligent for not ensuring the safety of the equipment. But I don't think they were negligent. Honestly, it was just an accident, not really any one party to blame. However, since I was on the clock, doing my job, with their equipment, I believe the burden of payment is on the employee. I called corporate and checked on some things. You were right, I was supposed to at least sign documentation. My boss was not aware that the paperwork needed my signature. Fax machines to rescue! We have that taken care of now.

Everything is good to go with the worker's comp. They did not require a drug screen (I am surprised about that).

Despite my initial concerns, it looks like my employer is doing the right thing. So long as all my medical needs are covered, I just can't find a moral reason to include the courts.

lol, they already purchased new ladders!

Thank you so much! Time to chill the rear end some more.

 

[quincy]

Thanks Quincy.

It is possible that some people would consider my employer negligent for not ensuring the safety of the equipment. But I don't think they were negligent. Honestly, it was just an accident, not really any one party to blame. However, since I was on the clock, doing my job, with their equipment, I believe the burden of payment is on the employee. I called corporate and checked on some things. You were right, I was supposed to at least sign documentation. My boss was not aware that the paperwork needed my signature. Fax machines to rescue! We have that taken care of now.

Everything is good to go with the worker's comp. They did not require a drug screen (I am surprised about that).

Despite my initial concerns, it looks like my employer is doing the right thing. So long as all my medical needs are covered, I just can't find a moral reason to include the courts.

lol, they already purchased new ladders!

Thank you so much! Time to chill the rear end some more.

I am glad to hear there are new ladders now in your workplace. Your employer acted fast.

Although you might not want to think about filing a lawsuit against your employer now (or against the ladder manufacturer should facts show the bolts were somehow defective), the statute of limitations for premise liability suits (and product liability suits) is 3 years. You have time to see how your injury heals and how your workers compensation claim plays out.

Enjoy your Thanksgiving Day. I hope you can enjoy eating some vegetables rather than having to wear them all.

Good luck.

 

[Just Blue]

There is a possibility of getting a civil action against the employer for his negligence in this case. It's good to call the insurer to check whether a claim is registered and what all documents you need to supply to the insurer to get the benefits. I wish you a speedy recovery and good luck to get the workers compensation claim.

And why to you feel the need to post to an old thread?

 

[commentator]

Just for the money here, since it has popped up the process followed by the employer's representative is almost exactly what a worker's comp/safety specialist who is very close to me would advise. If the employee goes to the doctor or hospital ER, especially with a minor injury, the injury becomes a "reportable" accident, which means the employer's worker's comp insurance goes up. Many times, especially with a bruise-type injury, (not an open wound or obvious broken bone)they are counseled to hold off a few minutes, take a statement, do a report, take pictures, and try to determine if the employee is just bruised and shaken up or if there is a more serious injury.

This person was really hurt badly enough to need medical care, and I'm glad they picked it up and found out what was going on soon enough. But in many cases, an HR person has rushed the person off in an ambulance or had them go straight to a doctor with a Worker's Comp claim, and have them be given OTC anti inflammatories (by prescription, which makes it a reportable injury) and told to take it easy, ice it down. In other words, nothing that couldn't have been dealt with on site. So the latest thinking on work accidents is that they postpone medical treatment for a while and evaluate carefully.

It is generally unwise for an employer to have a selective policy of drug testing after incidents, in well managed companies it usually is mandatory even if you are the president of the company, when you have a workplace injury, you get a drug test. I don't understand why the employee made a big deal out of it and requested one so diligently, but whatever, it did not prove to be important.

Likewise the defective or faulty equipment issues. Product liability is a stretch, and if the company has any kind of effective safety program in place, it would be very tough to figure out a way to sue the company for having unsafe conditions or defective equipment. They made immediate corrections as soon as the problem was discovered. It also would be highly questionable as to whether this person was following exact recommended "no safety violations" procedure when the fall occurred, for example, perhaps was a spotter required when a person was climbing on a ladder like this? And could the company have reasonably known about the defective equipment before the fall? Had anyone reported it, had there been reasonable equipment inspections performed on the equipment?

Workers comp is usually the "sole remedy" in workplace accidents, and there is pretty much a fixed amount that the person will receive. Especially in the southeastern states like North Carolina they are busy sewing up all the loopholes whereby an employee can sue for anything above and beyond worker's comps' very specific clearly spelled out payments. If you give an attorney money to handle your case, you still get the same amount of money, you just have to share it with the attorney.

I was horrified to discover that a law firm here in our area a few years ago which was obtaining a copy of information from all the worker's comp cases filed, and sending out a very official looking letter (looked just like the state seal on the top) which said the injured employee needed to contact this number AT ONCE. And the rest of the letter was one of those "you may have a case for this and a case for that and you KNOW your employer is going to cheat you and try to deprive you of your rights!" This was nothing but predatory behavior on their part. It is now harder to access the information, but you know, they're still at it.

 

[quincy]

... Likewise the defective or faulty equipment issues. Product liability is a stretch, and if the company has any kind of effective safety program in place, it would be very tough to figure out a way to sue the company for having unsafe conditions or defective equipment. They made immediate corrections as soon as the problem was discovered. It also would be highly questionable as to whether this person was following exact recommended "no safety violations" procedure when the fall occurred, for example, perhaps was a spotter required when a person was climbing on a ladder like this? And could the company have reasonably known about the defective equipment before the fall? Had anyone reported it, had there been reasonable equipment inspections performed on the equipment?

Workers comp is usually the "sole remedy" in workplace accidents, and there is pretty much a fixed amount that the person will receive. Especially in the southeastern states like North Carolina they are busy sewing up all the loopholes whereby an employee can sue for anything above and beyond worker's comps' very specific clearly spelled out payments. If you give an attorney money to handle your case, you still get the same amount of money, you just have to share it with the attorney.

I was horrified to discover that a law firm here in our area a few years ago which was obtaining a copy of information from all the worker's comp cases filed, and sending out a very official looking letter (looked just like the state seal on the top) which said the injured employee needed to contact this number AT ONCE. And the rest of the letter was one of those "you may have a case for this and a case for that and you KNOW your employer is going to cheat you and try to deprive you of your rights!" This was nothing but predatory behavior on their part. It is now harder to access the information, but you know, they're still at it.

I can't speak to the actions of the law firm near you, commentator, but a workers compensation claim does not preclude a civil action from being filed over a workplace accident. In fact, civil actions often accompany workers compensation claims. A workers compensation claim is not the SOLE remedy for an injured worker, in other words, but only ONE of the remedies potentially available to an injured worker.

Rwedunyet is a long-time member of this forum. Perhaps there will be an update soon.



One additional note: The poster who revived this old thread (kripash) resides in Dubai. I cannot understand why so many of our foreign (or actually even our domestic) visitors have such difficulty reading posting dates.

 

[commentator]

Worker's comp as the "exclusive remedy" for work related injuries is a big thing in my Southeastern part of the country. It seems to be a very strong principle in North Carolina, where only in cases of extreme negligence is there any other way the worker can sue the employer in addition to having the worker's comp case and what it provides.

"The exclusive remedy provision remains strong in
North Carolina. There is a limited exception if the
employer is engaging in conduct that is substantially
certain to result in death or serious bodily injury. In
addition, an employee can sue a co-worker for
intentional torts."

 

[quincy]

Worker's comp as the "exclusive remedy" for work related injuries is a big thing in my Southeastern part of the country. It seems to be a very strong principle in North Carolina, where only in cases of extreme negligence is there any other way the worker can sue the employer in addition to having the worker's comp case and what it provides.

"The exclusive remedy provision remains strong in
North Carolina. There is a limited exception if the
employer is engaging in conduct that is substantially
certain to result in death or serious bodily injury. In
addition, an employee can sue a co-worker for
intentional torts."

The source of the quote ... ?

I don't argue that a workers compensation claim is the primary remedy for a worker's workplace injury, in North Carolina and elsewhere. I am saying that it is not necessarily the "sole" or "exclusive" remedy available to a worker who is injured in the workplace. All facts of the injury must be considered, including work conditions, third party actions, and any product defect that might have led to a worker's injury.

Following is a link to a North Carolina Supreme Court decision from 1991 (Woodson v. Rowland). Similar claims are now sometimes referred to as "Woodson claims."

http://www.leagle.com/decision/1991629407SE2d222_1621/WOODSON v. ROWLAND

From Woodson, the Court said: "Notwithstanding these important trade-offs, the legislature did not intend to relieve employers of civil liability for intentional torts which result in injury or death to employees. In such cases, the injury or death is considered to be both an accident for which the employee or personal representative may pursue a compensation claim under the [Workers Compensation] Act and also the result of an intentional tort for which a civil action against the employer may be maintained."

In addition to civil actions that are possible against an employer (depending on the facts of the injury), you also have third party claims that may need to be considered.

In other words, while the letters from the law firm you mentioned in your previous post may have had a predatory feel, many workers are led to believe that they only have workers compensation and cannot take civil action - and, while this may be true for many and even most workplace accidents and injuries, it is not true for them all. A worker is entitled to know that his rights do not necessarily begin and end with workers compensation.

I am not arguing with anything except your use of the words "sole" and "exclusive," commentator. I am not fond of these words.