Injured at work but benefits denied for pre-existing condition?
I was working in medical in Texas on a contract with a contract agency. I worked one Sunday & while turning a patient I felt a pop in my neck, then a sharp pain down the right side. I continued to have pain while I was working. When I got home, I was in a great deal of pain. Pain in neck, shoulder down my right side followed with numbness and tingling in my neck, shoulder, arm, hand, right leg, and I had a headache along with dizziness.
It also felt like my right leg was very heavy, and I basically had to lift it to walk. I called in the Monday around 02:00am and left a message on the call-in answering machine. I said I couldn't return to work due to a lot of pain and barely being able to walk. I got a call that morning from the manager, but I was still sleeping after taking pain medicine and muscle relaxers I take for my lower back.
The manager left a message that I was supposed to come in but never showed. So I called the call-in answering service and someone answered the phone. I was told the call-in message was forwarded to the nurse manager. My recruiter did call and I told him that I called in, and said the reason I could not come in was due to pain and barely being able to walk. We did speak about my chronic back problem and that I may have to have back surgery.
My doctor informed me if a patient starts to have numbness or tingling that usually back surgery is required. He said I should call the manager and let her know that I can return to work. He also asked if I can finish the contract. I said yes since I was off until Friday. I called the manager several times but got no answer. He called me about 3:00pm that day and said the contract was ended and they were looking for someone else.
I was still in pain dizziness headache numbness tingling on Tuesday so I went to the ER. I was admitted for a possible TIA CVA. I stayed for 3 days then discharged after being seen by a neurologist. I sent my recruiter an email Friday morning saying I was in the hospital for 3 days and something was wrong with my neck, that's why I was having problems on Sunday. I did mention in the report that it was a work r/t injury., so the HR manager sent me an email with workmans comp info.
I was denied initially for having no supporting evidence and a pre-existing condition that happened outside the scope of employment. Once the doctor received supporting evidence the problem started while at work, the adjuster said I retaliated & that's the reason I filed workman comp. I kept the email that I sent my recruiter saying he never denied me, telling him about that on Monday morning in regards to why I did not go to work.
My diagnosis was a spondylosis bone spur and a bulging disc in my cervical spine. What should I do, since my case was initially denied? Will I not be able to get my workman compensation? Is there anywhere else I can go for coverage? Thanks.
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ANSWER for "Injured at work but benefits denied for pre-existing condition?":
Angel (Newton, MS):
You're in a precarious position. Your preexisting injury is going to continue to be an impediment to your workers compensation claim. While Spondylosis can be the result of an injury, it is much more likely to be a degenerative disease. In any event, you are going to have a difficult time differentiating your recent injury from your previous back problems.
Another problem may be your apparent failure to report your injury at the time it occurred. Because you didn't timely report your injury the insurance company will likely claim your injury occurred sometime after you left work, or they will continue to persist in their lack of evidence claim.
The issue of retaliation is irrelevant. If workers compensation denied your claim they did it for factual and medical reasons. The issue of retaliation was not controlling. You might contact the contract agency. See if you can get workers compensation benefits from their insurance company.
If your contract agency won't cooperate you can always visit with a workers compensation attorney. Most will not charge for an initial office consultation.
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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