How do I get workers' comp to start paying a weekly disability?
Three months ago I fell at work and injured my knee. I developed a blood clot that was treated and went away. The pain and instability have not. After 3 months of a variety of medicines to help with pain and swelling, the Dr. took me off of work altogether to undergo a physical therapy/ rehab treatment.
This has been working wonderfully, and it is nice not to be feeling the highs of so much pain meds and the sick gut feeling from taking them. While going through this, I was terminated from my job. I have accumulated more than 30 calendar days of being unable to work (temporary disabled) since the termination.
To this point, workers' comp has refused to pay any weekly benefit. The Dr. presented them with a letter stating I was unable to work until most medically improved. My state has a 7 day waiting week before benefits can start. I have surpassed that by far.
Worker's comp will not return my calls either. I have a family to feed and bills to pay. I am not eligible for unemployment because I am not available for work because of my injury.
I shouldn't need a lawyer for an insurance company to abide by the state laws. They never sent a letter of denial on the claim, but can their inaction be deemed a denial after a certain period of time? Can I then go after my former employer and ask for medical coverage and pain and suffering? Thank you.
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ANSWER for "How do I get workers' comp to start paying a weekly disability?":
Mike (Omaha, NE):
Unfortunately, you can be terminated from your employment if you aren't able to work. In your case, it appears that's exactly what happened. While you have accumulated 30 calendar days of being unable to work, this will not entitle you to workers' compensation benefits for that period of time.
Workers' comp laws do not permit compensation for pain and suffering. You should be entitled to about two-thirds of your wages for the period of time you were unable to work, prior to your termination.
If the workers' comp office will not call you back, you may have no alternative but to seek the advice and counsel of an experienced workers' compensation attorney. Most will not charge for an initial office consultation.
Gather copies of all your medical and therapy records, along with copies of receipts for your out-of-pocket expenses (for medications, crutches, etc.). Make several appointments with various attorneys, and bring all the documentation along.
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,
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