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  1. #1
    Join Date
    Dec 2008
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    3

    Default Released for Light Duty & Employer Stalling

    My workers compensation claim was made in the State of: Missouri

    I was injured in April '08 and to make a long story short, WC has yet to deny or accept my claim. I, along with my attorney decided to go ahead with surgery in Sept. and file it on my personal insurance. Four weeks ago, my dr released me to return to work, light duty. My employer keeps requesting additional information from dr. I now have 6 very discreptive release forms to return to work on light duty. My dr doesnt know what else to tell my employer but they keep stalling and not allowing me to return to work. I understand an employer has to make "reasonable accomodations" for light duty (I am a store manager) and my light duty consists of "sedentary" work since I have a knee injury.

    My questions are: How long can WC drag this out without making a decision to accept or deny the claim and How long can an employer prevent me from returning to work once released by my dr and at what point can I file an EEOC violation against my employer for preventing me from returning or even trying to make "reasonable accomodations" for me to return??

    Thanks for any support you can provide

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Released for Light Duty & Employer Stalling

    Q I've been injured on the job. What should my employer do?
    A. Your employer should make sure you receive immediate medical attention to treat the injury. The employer must report the injury to the insurance company, or the administrator if self-insured, within five days of the date of the injury or within five days of the date on which the injury was reported to the employer if that is later. The insurance company or administrator then reports the injury to the Division of Workers' Compensation.

    If your employer denies that the injury is work-related, you should determine through the employer if the injury has been reported. Then contact the Division's Dispute Management Unit at (573) 526-4951.
    The law also provides for the ER/IC to control medical, and select the doctor providing treatment... you are free to go to a doctor of your choice, but pay out of pocket. If your private health coverage has provided treatment, they may have to be reimbursed....
    You can select your own medical provider at your own expense. If your employer refuses to provide medical treatment, you may receive reimbursement for any medical treatment that is reasonable and necessary to cure the work-related injury. If possible, you should obtain a written refusal to provide medical treatment from the employer.http://www.dolir.missouri.gov/wc/faq_employees.htm#faq3
    I understand an employer has to make "reasonable accomodations" for light duty (I am a store manager) and my light duty consists of "sedentary" work since I have a knee injury.
    YOur ER is required to engage in the ''interactive process'' to determine IF, they can make the 'reasonable acommodation', the law doesn't say they 'must' offer the light duty/sedentary or modified position if there is none available.
    They cannot however demand you RTW at a 100% capacity.

    at what point can I file an EEOC violation against my employer for preventing me from returning or even trying to make "reasonable accomodations" for me to return??
    At any time you can fully document the situation...your 'word' on this may or may not be sufficient for EEOC/ADA to issue a 'letter to sue'...and keep in mind that not all work related injuries are considered 'disabilities' under EEOC/ADA rules...
    Information on filing a claim can be found here...http://www.eeoc.gov/charge/overview_charge_filing.html

    As to your WC claim...you AA should be filing for a hearing to determine AOE/COE and acceptance of your claim....have you not been receiving benefits for your injury...?

  3. #3
    Join Date
    Dec 2008
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    3

    Default Re: Released for Light Duty & Employer Stalling

    I have not been receiving any WC benefits at all. My AA has filed a Hardship hearing and the judge requested more information from the WC dr who determined that my injury was "pre-existing". I have video of the fall and also have hand written statements from everyone who was there at the time.

    I chose to have the surgery and file it on my personal insurance because I was in so much pain and had no quality of life. Since the surgery, my insurance company has filed suit against WC for reimbursement.

    I am still waiting to see if my employer will allow me to return to work with restrictions. I know for a fact they have allowed others to return to work on light duty and had them working at the corporate office doing paperwork at a desk.

  4. #4
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Released for Light Duty & Employer Stalling

    the employer/carrier can delay & deny as long as there is no court order. file for a hearing in comp court to get things moving.

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
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    18,021

    Default Re: Released for Light Duty & Employer Stalling

    --------------------------------------------------------------------------------
    I have not been receiving any WC benefits at all. My AA has filed a Hardship hearing and the judge requested more information from the WC dr who determined that my injury was "pre-existing". I have video of the fall and also have hand written statements from everyone who was there at the time.
    The claim won't go anywhere until there is a determination to AOE/COE, in the course of, and due to your employment...after that, WC is 'no fault', so your hand written statements may or may not have any bearing....everything depends on medical evidence.

    The fact you had/have pre exisiting issues is not always relative... IF the 'injury' aggreviated the pre exisisting injury/illness, the ER/IC would still be liable for medical treatment, and PD directly due to the injury you suffered AT WORK...only a doctor can determine what % of any PD is due to the job, that is called 'apportionment to cause'...and is dealth with when a impairment rating is determined.

    You're just going to have to let your AA handled this, and wait for the process to play out..

  6. #6
    Join Date
    Dec 2008
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    3

    Default Re: Released for Light Duty & Employer Stalling

    I just want to say thank you so very much for your help, it has been much appreciated!!

  7. #7
    Join Date
    Dec 2008
    Posts
    1

    Red face Re: Released for Light Duty & Employer Stalling

    New Question. I was on light duty. Harrassed in early stages of Workers Comp .. whom sent me a letter and confirmed by phone that my claim was being under investigation still.. Taking them well over 1.5 months. I have a snapping hip injury. I just want my life back and choose to dis engage in this whole sad process. I was told that I would not have to see their company doctor unless .. I was out of work and I am not and have not been or. was about to have or.. have had surgery. I was also put in charge a nurse case worker. So.. I called up Workers Comp Division in my city and was told the ajuster had no right to appoint a nurse case worker when the claim has yet to be approved. I have not run up any large bills and I have not had an MRI. Just emergency room Xrays. I am scheduled to see their doctor .. however received.. a new job .. easier work on me as well then there. My question is.. if I do not go to the doctors appointment, it says It will affect the determintation, however.. after the arguement with the ajuster I had... I think that they already determined denial to be honest. What will happen to the medical bills then>? I had an Emergency Room Xray.., about two visits with a general MD, and about six or seven Physical Therapy Appointments. Low expenses compared to what could have happened and then.. I would have been responsible. I can not.. get time off my new job for any of this.. not to mention.. appeals and court proceedings... let alone to see docs for them. Also.. I was told they are allowed to come to your new job or phone them to try to make waves and find things out. I am scared to even walk the dog. This was starting to ruine and control my life. I seriously felt like I was going to have a heart attack from all the stress. The Physical Therapist, wants to rack up appointments and knows.. I have no insurance to cover this. Also.. no medical insurance from my understanding will approve your condition all over again and treat you... or continue to treat you later on... if or.. once they hear about a workers comp ,it scars and prevents you from getting any further treatment and surgeries later. Who has the money to pay cash>>? I dont. If workers comp drops and denies my claim.. am I able to later on with my new insurance... be treated down the line? Because they cant prove if the injury was even work related. Which is to my benefit later. I hope.

  8. #8
    Join Date
    Dec 2008
    Location
    Pa.
    Posts
    4

    Thumbs up Re: Released for Light Duty & Employer Stalling

    Quote Quoting cynn2568 View Post
    My workers compensation claim was made in the State of: Missouri

    I was injured in April '08 and to make a long story short, WC has yet to deny or accept my claim. I, along with my attorney decided to go ahead with surgery in Sept. and file it on my personal insurance. Four weeks ago, my dr released me to return to work, light duty. My employer keeps requesting additional information from dr. I now have 6 very discreptive release forms to return to work on light duty. My dr doesnt know what else to tell my employer but they keep stalling and not allowing me to return to work. I understand an employer has to make "reasonable accomodations" for light duty (I am a store manager) and my light duty consists of "sedentary" work since I have a knee injury.

    My questions are: How long can WC drag this out without making a decision to accept or deny the claim and How long can an employer prevent me from returning to work once released by my dr and at what point can I file an EEOC violation against my employer for preventing me from returning or even trying to make "reasonable accomodations" for me to return??

    Thanks for any support you can provide
    Try to type up a letter requesting "light duty accomodations" In this letter,please state what you CAN DO.. Is your injury permanent? If so, you may fall under the ADA act. ( I had to tell my w/c dr. what to write on my notes to get me back into work) If you have a light duty note stating a 5lb limit & that isn't working, get a 10lb note instead That should work. You did the right thing by getting a lawyer. Good luck & make sure to document every single thing that goes on. Start up a filing system that pertains to your case.Also, keep in mind you have 180 days from date of incident to file a charge with EEOC. Please go to the eeoc website to look over the laws. Timing is critical! Do not delay! Good luck & I wish you the best!!!!!!!!!!

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