When working at the hobby store I fell off a 10′ ladder to the floor. I was seen immediately after by my doctor and sent to physical therapy. I was out of work for over 3 months and could not return to my job. I couldn’t live off of 66% of my wages (which was what workmans comp paid) so I started a new job.
I couldn’t continue with the physical therapy as they wanted me to go 3 times a week in the middle of my workday. So I just dealt with the pain. I had tendinosis, sciatic nerve pain, leg pain and numbness, and piriformis syndrome.
Well it just progressively got worse so I called and asked to be seen and evaluated again. Now they are talking surgery. The insurance company wants to settle with me prior to my surgery being done. Is the workers comp from my original job responsible for the surgery? Can’t I wait until after the surgery is done to settle the claim?
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This is difficult because an astute adjuster might point out the fact that you did not continue with physical therapy as scheduled and as a result, the pain worsened over time. Whether they will accept liability for the surgery is a subjective determination made by the adjuster.
If you are wondering whether they will be responsible for the surgery, I would certainly have that discussion before scheduling a procedure to avoid being stuck with a very large bill that you thought workers compensation would cover.
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Best of luck!
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