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  1. #1
    Join Date
    Oct 2010
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    3

    Default Understanding Work Restrictions

    My spouse received a head injury on the job. No mTBI according to MRI and Neuropsychological tests, but has chronic headaches and dizziness. Lost job due to absences and RN case manager informing employer/self insured that there are no work restrictions. I am confused over what defines a "work restriction" vs what defines an "accommodation" to employment. First appointment with a neurologist said to try to work and be able to take more breaks. Appointment yesterday MD says that basically spouse does not have "physical restrictions" (and clarified stating such as lifting no more than 10 pounds), but that can remain at home to work towards MMI. We do not trust the RN case manager assigned to the case, as this is the individual manipulated the appointment. Is a MD's note stating needs to be able to take frequent breaks to manage headaches a work restriction?

  2. #2
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Understanding Work Restrictions

    yes, frequent breaks is a job modification due to injury limitations.
    your husband should also look at his rights to reasonable accommodation under federal ADA laws.
    http://www.ada.gov/

  3. #3
    Join Date
    Oct 2010
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    3

    Default Re: Understanding Work Restrictions

    My spouse was fired for "unauthorized absences" two of the three included medical excuses. The neurologist wrote the recommendations for "try to work with extra breaks." Our primary MD wrote the specific note based on the neurologists' recommendations.The RN case manager said the neurologist (verbally, because it is not in writing) said 8 hours, no restrictions. My spouse is under going visual de-escalation therapy for dizziness. This specialist was concerned about the continuing headaches and the interference with the therapy. This is how the RN case manager wriggled in another appointment with the neurologist.
    In the meeting yesterday, the neurologist addressed return to work because of the RN case manager request. It was in this conversation that the neurologist said he did not see any "physical restrictions". He however continued to talk about recovery being very slow.
    I know that I need to help my spouse file a formal discrimination/possible workplace harassment with the Nebraska Labor agency, as well as the federal government (they were who I called when this was happening).
    I am still concerned if we have been duped and workman's comp will now be denying coverage since he does not have any legal "physical restrictions" per the most recent appointment.
    By the way- the last professional who made this recommendation (no restrictions, 8 hours a day), was ignored by workman's comp. This was the neuropsychologist who did the initial testing before my spouse was diagnosed with post-traumatic migraines with dizziness.
    My biggest fear is loosing income and our house and way of life.

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
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    18,018

    Default Re: Understanding Work Restrictions

    Is a MD's note stating needs to be able to take frequent breaks to manage headaches a work restriction?
    Yes, but the Dr should define that some... ie, 15 mins out of every hour etc.
    Appointment yesterday MD says that basically spouse does not have "physical restrictions"... but that can remain at home to work towards MMI.
    If the Dr is saying he should stay home, then he should remain TTD. Not returning to work yet. The NCM/RN does not control the benefits in the claim, or determine when the IW reaches MMI. Or what restrictions there may be once MMI has been reached.

    Restrictions are determined by the treating physician.
    Accommodations are provided by the employer.

    Some info on "Reasonable Accommodation" under ADA/EEOC is here http://www.eeoc.gov/facts/fs-ada.html

    Do you have an atty handling this claim ?

  5. #5
    Join Date
    Oct 2010
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    3

    Default Re: Understanding Work Restrictions

    Restrictions are determined by the treating physician.
    Accommodations are provided by the employer.

    Thanks, I understand. And no, we don't have an attorney yet. Personally, we have been too busy trying to stay on top of getting the care he needs. Have been in touch with ADA and still need the time to complete their paper work. Will see our primary physician and get a better work ability report sent out.

    unfortunately TBI specialist botched the diagnosis (and continued to do so even after another specialist found he had post concussion migraines with dizziness), and we can't find a headache specialist willing to take his case.

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: Understanding Work Restrictions

    no, we don't have an attorney yet. Personally, we have been too busy trying to stay on top of getting the care he needs.
    Talk to an attoreny. You will be FAR ahead if you do. The reason you are having so much difficulty is due to your not understanding the process and how to get the necessary treatment.

    Not all Dr's accept industrial/occupational injury claims. And, they dont' have to. The process, extra work involved, which is not compensated for, and the intervention of CA's with no real medical expetise, as well as NCM, or "RN" getting involved telling a "doctor" how to treat an IW is reason enough for most providers to stay away from treating IWs.

    An attorney would be a tremendous help to you. Please consult with a few.

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