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  1. #1
    Join Date
    Sep 2010
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    3

    Question Injured Several Years Ago, and Again More Recently - Is it Too Late to File Claim

    Hi.

    I have a few questions.

    I slipped and fell in the restroom where I was working, about 6 or 7 years ago (I can look up more exact dates). I filed an injury report at the time. A month or two later, I had back pain and was diagnosed with sciatica. I wasn't certain if it was related to the fall, so I didn't file a WC claim.

    I had therapy, meds, and an injection, and the pain eventually went away.

    A few years later, working at a different job, the pain returned. At this job, I was at the storage facility across the street, and had to move boxes of files around, which involved taking them off of shelves, and putting them back. There was not enough room to pull them out without pulling them and then twisting to put down or carry away.
    There was about 2 - 3 feet between racks of shelves.

    Again, I did not file a WC claim, because I could not be sure what caused the back pain.

    Now, having been laid off 6 months ago, I have a hard time finding a job that doesn't require lifting of boxes, and I am taking 2400mg of ibuprofen a day to combat pain.

    Can I file a claim? Which employer? What info would I need?
    The first employer closed their local office after being bought by a larger corporation.

    Back doctor had sent note to more recent employer, stating that I was able to resume all duties, but if I were to get another job doing the same things, I am sure my back would get worse again.

    Just wanted to add that my office was upstairs, and there was no elevator or escalator, so even with back pain, I had to go up and down stairs (which had only one handrail). I also had a crappy old chair with a loose back for over 2 years. They ordered a new ergonomic chair after my back pain flared up, and it sat downstairs for a week before it was brought up to my office. I was laid off shortly afterwards.

    Thank you.
    Last edited by ramonv; 09-07-2010 at 11:45 AM. Reason: add info

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

    Default Re: Injured Several Years Ago, and then Again More Recently. Too Late to File Claim

    WC claims are filed with the current ER....you don't go backward... the former ER/carrier would reject a claim at this point. They would claim you have done something to injure yourself in your current job.

    Being laid off doesn't negate a claim.
    You have one year from the date of knowledge the injury is related/due to your job functions.
    Beyond that...you are "SOL".

    All the 'ifs', or your question as to whether the injury is job related are not pertinent to filing a cliam for WC benefits.
    WC is about the ER's liability for industrial injury/illness. Once you know or your Dr knows the injury is work related, the law requires you to file the claim.
    You are not responsible for medical costs, nor is your own health care carrier.
    Can I file a claim? Which employer? What info would I need?
    At this point...all you can do is file the claim with the most current ER. Looks like it's going to be a CT/Cumulative Traumal injury/claim. The DOI/date of injury is the first day there is time loss. You are entitled up to 10K in medical care during the first 90 days they have to investigate the claim.
    You did not say you are in need of treatment at this point. If you are not working, there would be no wage loss, no TTD would be paid. This would be a medical only claim.
    Expect denial. WC is not a substitute for your own health insurance, nor for UI compensation.

  3. #3
    Join Date
    Sep 2010
    Posts
    3

    Default Re: Injured Several Years Ago, and then Again More Recently. Too Late to File Claim

    The only treatment I am currently in need of is the prescription-strength ibuprofen. Aside from that, I am unable to perform the same job functions w/o risk of further injury.
    How can anyone "know" if the injury is job-related? That's one of my questions. There's no way to say for sure, but it is very likely. It's been several months since the first day of time lost. Am I SOL?

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Injured Several Years Ago, and then Again More Recently. Too Late to File Claim

    The only treatment I am currently in need of is the prescription-strength ibuprofen.
    Who are you getting RX for this medication from...and who is paying the bills...?
    I am unable to perform the same job functions w/o risk of further injury.
    Then change jobs. Because you don't want to risk injury is not reason for filing a claim "for/of injury".
    How can anyone "know" if the injury is job-related? That's one of my questions. There's no way to say for sure, but it is very likely
    You file the First Report of Injury with your ER. The ER files with their WC carrier. You go to the Dr as directed by ER and/or IC. A CA is assigned to administer the claim. If there is MPN in place, you select a PTP in the group/MPN. The DR hears your complaint, and makes a medical decision as to causation. Dr's make medical determinations, not IW's.

    As I said, it would appear you are attempting to claim CT/Cumulative Trauma injury... that is a condition that develops over time. Some resolve on their own over additional time. Some don't and require intervention. Again, a Dr makes that decision, not IW.
    It's been several months since the first day of time lost. Am I SOL?
    You have ONE YEAR from the DOI to file a claim. That SOL (Statute Of Limitations by definition here ) clock begins once a reasonable person has the knowledge the injury is industrial/occupational. In a CT claim, the DOI is the first date there is time loss.

    Are you "SOL" ?... Don't know. Get a DWC-1 form. File the claim. It would be investigated and a decision to accept/deny.
    Expect a denial at this point due mostly to your time frame in filing... and litigation of the denial.
    Now, having been laid off 6 months ago, I have a hard time finding a job that doesn't require lifting of boxes, and I am taking 2400mg of ibuprofen a day to combat pain.

    Can I file a claim? Which employer? What info would I need?
    As I said... based on the information, and reason you wish to file a claim for WC benefits, IMHO...because you can't find a job within any restrictions or abilities you may have is NOT sufficient reason to file a claim, or be granted benefits.
    Over the past several years (6 years ?) you have done nothing to even explore your eligibility for benefits under any ER's plan for work injury. There are red flags all over this one. (for potential denial)
    IF you choose to file a claim today, you file with your most recent employer. File as a CT injury/claim and see what happens. You need the ER info, and probably the WC insurance carrier.
    Back doctor had sent note to more recent employer, stating that I was able to resume all duties, but if I were to get another job doing the same things, I am sure my back would get worse again.
    As I said, going forward with your ability, or inability for work isn't reason for claiming injury. You must ''have suffered'' injury in the performance of your job duties/functions to claim benefits.

  5. #5
    Join Date
    Sep 2010
    Posts
    3

    Default Re: Injured Several Years Ago, and then Again More Recently. Too Late to File Claim

    "Who are you getting RX for this medication from...and who is paying the bills...? "

    My doctor. I am.

    "Then change jobs"

    If only it were that easy.

    "ER" Is that employer? So, I can file the claim with my (former) employer now, even though I didn't originally, correct? As long as it hasn't been a year since I was injured?

    Thanks.

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Injured Several Years Ago, and then Again More Recently. Too Late to File Claim

    You can always file a claim... doesn't mean you are eligibile, or you are within the SOL.
    The One year SOL is from the date you have knowledge the injury is AOE/COE... Arose Out of your Employment, and in the Course Of your Employment.
    This is generally a specific onset injury, a CT/Cumulative Trauma injury, or a Dr advises you of industrial causation.

    IMHO... I would forget about the 6 or 7 year ago incident. You have no recourse there.
    And, as I said, you are waving a huge red flag here.... you didn't file a claim at the time you were injured. You have not sought treatment under WC process/system for months. You are now laid off from your ER where you claim injury.... and apparently have no health coverage.

    And.......because you can't find a job within any restrictions or abilities you may have is NOT sufficient reason to file a claim, or be granted benefits.
    , I'm not sure you have basis for filing a valid claim. You haven't said anything about an actual ''injury'' you have at this time. Not one you can attribute to your employment/job functions with any certainty.

    But, go ahead and file with your most recent employER...yes, ER is 'employer'.
    Good luck with this one.

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