Injury During Post Op at Home

[keven252]

My workers compensation claim was made in the State of: Illinois
I injury both shoulders at work .....which both need surgery on ....had surgery on my right shoulder and just had surgery on my left shoulder 2weeks ago....iam a single father raising a four year old boy ....well 2 weeks after post open my son was throwing a fit so just out of habit I went to pick him up and retore everything the doctor just did and now I need surgery to fix it again.....well workers comp says they don't feel they should have to pay for the second surgery cause I didn't follow the doctors post open orders ...but they did say they really don't know the law on this and I do have a lawyer and he did say the same thing so we are all on hold with this ......has anyone been thought this before.....I feel being a single dad that I can't stop being a father cause I was injuryed at work and they should have to pay for this it wasn't my fault that I was injury at work so that donest mean I shouldn't comfort my son when he needs it ....any please help with this

[BvIA]

.....I feel being a single dad that I can't stop being a father cause I was injuryed at work and they should have to pay for this it wasn't my fault that I was injury at work so that donest mean I shouldn't comfort my son when he needs it ....any please help with this

If you had reinjured your shoulder DUE to the org injury, or post op condition... it would be compensable.

....well 2 weeks after post open my son was throwing a fit so just out of habit I went to pick him up and retore everything the doctor just did and now I need surgery to fix it again.....well workers comp says they don't feel they should have to pay for the second surgery cause I didn't follow the doctors post open orders

That's a reasonable arguement... you didn't injure yourself DUE to the injury/surgery, but due to your own actions. Following the Dr restrictions post-op is your responsibility...that you didn't have extra help with your child during your recovery is not your ER/IC responsibility.

IF on the other hand, your Dr/surgeon had requested inhome assistance post op... that may have been approved and this would not be an issue.
Listen to your attorney...this will likely take a hearing/judge to make the final determination on what benefits may be due.

[keven252]

The doctor did bring up to my case manager that my son was a concern for him......but besides that nothing was done about it ......by my doctor saying something to my case manager would that qualify as a major concern and should have they acted on that concern

[.SH]

it's confusing when you make duplicate posts under different Member IDs.

[BvIA]

The doctor did bring up to my case manager that my son was a concern for him......but besides that nothing was done about it ......by my doctor saying something to my case manager would that qualify as a major concern and should have they acted on that concern

No...only your Dr can make a request for prior authorization for treatment, or in home services. The carrier isn't going to "offer" child care. Listen to your atty.
And, like SH said... keep to one screen name and thread. Multiple threads won't change the answers.

[keven252]

I did....only have one user ID and just started it today

[.SH]

it's been corrected.
it had a copy of eagle eye's post under your ID.