Visitor Question

Workers Comp Not Paying for Knee Injury…

Submitted By: Jeannie (York County, Maine)

While caring for a patient I tripped over the patient’s wheelchair wheel and twisted my left knee. The employer’s insurance company has denied me benefits due to a pre-existing arthritis condition. I did not know about this condition. I had no problems with my knees until after I twisted my left knee. There wasn’t anything I could not do, my range of motion was as normal as anyone else’s until AFTER I twisted my knee.

My understanding is, the employer accepted me as I was when they hired me, which means they hired me with the pre-existing condition, though I did not know I had one at the time. The employer did not send me to any physician to determine my health status before hire.

Tripping over the wheelchair has caused at least a 75% reduction of my range of motion.

I would like to know, for the state of Maine, if there are any laws that protect an injured employee even with a pre-existing condition? Also, if you know of any case law?

I am supposed to go to a mediation hearing soon.

Another co-worker who was also injured was denied benefits due to a pre-existing condition. She said the hearing was a nightmare. I want to go into my mediation armed with some kind of law or argument that the employer’s attorney can’t shoot down.

Many thanks.

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Jeannie,

Jeannie:

You might request a copy of the medical narrative prepared by the physician who examined you. Do not request the information from your employer. Instead, contact the physician’s office directly. Tell them you will be coming by in person the next day to pick them up. If they determined your pre-existing arthritic condition by X-rays, you will want those as well.

The next step would be to file an appeal.

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

Best of luck,

Published: February 20, 2011

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