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Workers Comp Question

I am posting this for a friend --- she is out on workers compensation due to a back injury at work which led to lumbar surgery in October - she was just informed by her job that they can no longer hold her exact same position but would have another position offered to her when she returns.  The workers comp doctor (which is their doctor) is stating she is not ready to return to work.  Her job is saying besides not holding her exact job that she would also loose her health insurance.  Can they do that?

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Comments

  • L4_L5LL4_L5 Posts: 1,480
    edited 03/05/2018 - 3:47 PM

    Hi Linda,

    Does she have a lawyer?

    WC issues get complicated.

    Every state has different laws.

    What conditions are allowed in her claim (if you know). A herniated disc or discs which then led to surgery? 

    Do you know what type of surgery she had?

    Microdisectomy? 

    Fusion? 

    Other?

    Where I live, there is no guarantee for your job. 

    Most of the WC people who post here say that if they could have done anything differently it would have been to have a lawyer on day one rather than retain one months (or years) later.

    A lawyer would be her best option to make sure she doesn’t lose her health insurance. 

    Sometimes COBRA is an option (other times someone may be able to get SSDI and Medicare, even if they’re nowhere near 65).

    These are options a lawyer may look into. 

    WC lawyers generally don’t charge anything upfront either.

    For a minor injury without lifelong impairments a lawyer may not be necessary but when you start getting into the potential of losing your job and health insurance it’s hard to argue a lawyer would be a bad option.

    I’m kind of surprised she’s not back on light duty at her job, given her surgery was five months ago.

    Then again I don’t know the whole story.

    She must have a very compassionate and understanding doctor since usually the insurance company doctor wants you back to work ASAP.

    As immensely helpful as this forum is it’s hard to help specifically with certain things (such as WC) because the laws vary state to state.

    But you should get quite a few replies.




  • dilaurodilauro ConnecticutPosts: 13,587

    Holding a job, but not necessarily the same job is pretty standard across the board.   I have never heard of a situation where the person could also lose their health insurance.   I always believed as long as they were still employed (even in a different job), health insurance and other company benefits will still be valid.

    But workmen comp cases are many times a different animal.  I would have you friend ask again about the health insurance situation and make sure that it could happen and then under what specific situations would that happen.

    Based on that, hiring a lawyer might be her safest outlet.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
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  • Thank you for your replies - I do not understand how someone can get hurt at work and then they turn around and say if you can not come back to work (even on light duty was a lower lumbar fusion) that they can loose their job where they got hurt


  • L4_L5LL4_L5 Posts: 1,480
    edited 03/05/2018 - 3:58 PM

    I always believed as long as they were still employed (even in a different job), health insurance and other company benefits will still be valid.
    I think that’s what the poster is saying. The employer is saying if you come back to work then we’ll have to give you a different position but you’ll get to keep your health insurance (but only if you come back to work).

    Just like you said if she doesn’t already have a WC lawyer I can’t think of anything more valuable for her situation at the current time.

    I could understand the company’s demands if their doctor says she’s past due to return to work but it appears to be the exact opposite.

    Nonetheless the company doesn’t have to agree with what even their doctor recommends. 

  • A question your friend may want to ask is if they pick up premiums for healthcare, can they keep coverage.  Most likely, that's the case.  In KY, if you are off long term, employers have the right to either terminate coverage; offer you the option to pay for coverage so you don't lose it; or continue paying it for the injured worker.

    I actually applaud the doctor for not sending the worker back too quickly.  It's usually the other way around.  I was once against hiring an attorney for representation if the company was treating the person fairly.  But oh boy, have I learned how fast a company can flip when they hire new adjusters wanting to make a name for themselves.

    It doesn't hurt to contact an attorney for a consultation.  Most will provide the first appointment at no charge.

    Keith

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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  • I actually applaud the doctor for not sending the worker back too quickly.
    Me too, so long as there’s nothing nefarious going on. 

    If I was five months post-op and feeling pretty good I would be confused why the doctor doesn’t want me to go back to work. 

    If I was severely struggling then I wouldn’t question the WC recommendation/decision, of course. 

    The original poster didn’t say what type of job her friend has (whether it’s very physically demanding or a desk job). 

    That certainly is a substantial factor to consider.

    It also is not known what exact procedure was done (open back surgery as opposed to something minimally invasive).

    If light duty was an option that both the employer and WC doctor agree on I think I would rather try that than lose my job and insurance.

    Light duty doesn’t have to be forever but can buy you valuable time while you’re progressing through the healing process.

  • There’s not enough information on the original post. But regardless, W/C vary State to State. Was she offered a light duty job that could accommodate her restrictions? Did she tell her employee no? If she lives in a State that has a right to work law then by all means the employer has the right to offer her another job even if the job pays lower or has less benefits. Regardless she needs to hire a workman’s comp attorney that who can guide her.

    DavidG

    Veritas-Health Forum Moderator

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