Dentures damaged in fall down stairs...

by Cindy
(Stockton, CA, USA)

My son in law's father was at work in California. He was heading up some stairs and there were two identical clear glass doors at the top, one was usually open. However, this particular day both doors were closed; without any stickers, sign or caution tape on them, the doors appeared open.

He ran straight into the door, broke his nose, cut his lip, and fell over backward down the stairs. He had false teeth and his dentures were pushed back so hard that they broke into pieces and also injured the roof of his mouth. The dentures are obviously not repairable. He would like to go to his own dentist for replacement, but his employer wants to send him to a dentist of their choice. What his rights are in this situation?

I can attest to the fact that his previous dentures were so well made and well fit that I couldn't tell he even had dentures. He is worried that the company's choice of dentist may not be able to do as good of a job as his own dentist could. Is he required to see their dentist or can he see his own personal dentist (if he accepts Workman's Comp cases)?

Remarkably, he was not injured more seriously and his injuries are healing quickly with little pain. Thank you in advance for your attention.

Visitor Question:
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ANSWER for "Dentures damaged in fall down stairs...":

Cindy (Stockton, CA, USA):

Here are some suggestions:

First: It’s perfectly alright for him to go “over the head” of his employer and speak directly with the workers' compensation insurance adjuster assigned to his claim. There he can plead his case. He has a right to be compensated so that after treatment he is as close as possible to the place he was in prior to the injury.

To convince the adjuster to permit your son-in-law’s father to return to his own dentist, he might first do some research. If the dentist who originally designed and fit his dentures is a specialist (an orthodontist specializing in dentures) and the company-approved dentist is not, that fact alone can be the basis for his having his original orthodontist approved.

Second: If the adjuster still won’t agree, he can ask for an administrative hearing. A California Workers Compensation Administrative Hearing is a forum where an aggreived injured worker can argue his claim. Administrative law judges are normally sympathetic, and because your son-in-law’s father isn’t asking for anything unreasonable, and only that he be restored to his former status, the judge may be inclined to agree.

Third: If your son-in-law’s father doesn’t want to go through an administrative hearing, he can tell the adjuster he wants to see his own orthodontist and will pay the difference between the company approved dentist and his own orthodontist.

Finally, if all else fails, your son-in-law’s father can retain a workers' compensation attorney. An attorney has clout. It is likely the workers' comp adjuster will agree to let your son-in-law’s father see his own orthodontist rather than have to deal with a contested hearing with an attorney involved.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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