Injured and Employer Let Workers Comp Lapse

[kachinatracy]

I work as a non certified companion caregiver with a caregiving agency that sends their caregivers out to clients homes. I was never formally trained and do not have even my CPR or first aide certification. I was suppose to just do things such as run errands, clean house, keep company, assist with meds, etc. My clients health has severly deteriorated and I now have to help transfer him from bed to chair, etc. I have been doing fine for months and my boss knows the status change of my client. A week ago I threw my back out throwing away a piece of trash when I bent over (small can on floor).

I called my boss within 30 mins of it happening to inform them that i hurt my back and said it was not from transferring client but from throwing away trash. I told her I did not clock out and told her what time it happened. I was very clear about being on the clock. I told her I was going home to take a muscle relaxor and pain pill i had left over from my recent broken arm (not work related). She said to let her know how I felt later and if I needed someone to cover my shift the next day. I called her and said I could barely move and there was no way i could go to work and that as soon as my friend could come get me in the AM I was going to go to urgent care. She said just keep her updated. She said nothing about where I should go, nothing. I went to urgentcare and filed out workers comp paperwork but had no case number to give so they called my employer directly. They told them it was NOT a workers comp issue as I was not on the clock. I called them and because I told my boss (there are 2 sisters that co own biz) it was not from transferring client she took it as it was not a work issue and preceeded to yell at me that I didnt go through proper channels, etc and that their fees were going to double because the time frame they had to file the claim expired.

She then called back and informed me that their workers comp insurance had "accidently" lapsed when they did an overhaul of their payroll system (they fixed it now that they found out with my claim) so that they would pay out of pocket any expenses I accrue. So they would reimburse me for urgentcare visit. Urgent care didnt help me because I could not get out of the wheelchair without serious help and said I needed to go have an MRI done and I needed to go see my regular dr to get the referrel (was working with my real insurance which is ahcccs). Later same day boss called and said to meet her at the ER and we could get it all taken care of. I had no one to drive me so had to drive (very very very painful as i have a standard). Both bosses showed up and the one i had originally called had me fill out paperwork about what happened, time, etc. The other boss stayed with me and proceeded to follow me into the er and stuck to me like glue and was there for the whole examination (i was informed by my mom that was a violation of HPPA?). I was told by ER that they could not preform MRI because its not a life threatening event and I needed to follow up with my Dr in 3 days. I made sure the ER did NOT charge my insurance and boss was there to claim responsibilty. They gave me some scripts and gave me 2 pain shots in the rear and asked who my designated driver was, my boss said she was. When we were done my boss wheeled me out to my car and told me I was fine to drive home. I went to my DR appt yesterday, boss was suppose to go to pay and was a no show. Again made sure it was not claimed under my regular insurance and had to pay $80 out of pocket. DR examined me and said no work for at least 2 weeks, go to physical therapy, and no driving unless unavoidable (single parent have no one else to drive). The paper only stated no work for 2 weeks, didnt say anything about PT or driving. Gave me more scripts to fill (one was $239). I had to max out my credit card to fill my meds. Boss is saying submit all payments to them and they will put them on my next paycheck. Boss is also saying she will go with me to next dr appt and then PT will be discussed even though DR said I needed to go now. I offered to get DR to put in writing but she said to wait till after 2 week checkup.

By putting my reimbursed money on paycheck wont it be taxed? I am being seriously put out by having to do all this and Its putting a serious finanancial strain on us. I only work roughlly 10 hours a week as it is and was barely making it. Ive been with them for about 14 months. Is everything they are doing legal?

Injury itself sounds so stupid how it happened. Hearing it I would judge it as someone lying or milking the system. Especially after a week (this happened on the 3rd). Yet I still cant stand in one place for more than a few minutes, cant sit straight on my bottom as it really hurts, cant lean over sink to do things like brush teeth or wash dishes. Pain is centered mostly between tailbone and as high as the hipbone directly on my spine. Only time i get relief is with all the meds they have me on which make me sicker than a dog. Dr says he has heard of people taking up to 6 months to completely heal but that is total not acceptable. My boss wanted me back to work last week. I can tell by the way she talks to me that she thinks im making it up.

Im sure I left info out but any advice would be appreciated. I dont want to piss my boss off and get fired as I need this job, well A job. I cant be without a job but at the same time I feel like im getting stiffed.

[.SH]

file a claim here
http://www.ica.state.az.us/Claims/Cl...of_Injury.aspx

[complwyr]

You need a lawyer as soon as possible. Your claim is not insured. Your employer has probably committed a criminal act by allowing the insurance to lapse. It was probably not an accident, either. It really has nothing to do with payroll. It has to do with the employer getting the bill from the insurance company and deciding it costs more than they want to pay. You will have a hard time collecting a dime on your claim for either yourself or the med providers, so get an experienced work comp lawyer tomorrow.

I just re-read your post. Man, you are getting screwed. Your employer is not going to take care of you. That is already obvious.

In NC, the single biggest work comp fraud problem we have is non-insured employers.

You don't buy your own drugs or pay co-pays in work comp cases.

In future doc visits, make sure the out of work note includes all the restrictions before you leave the office.

[kachinatracy]

David I will be calling lawyers tomorrow and see if I can find one that will give me a free consultation to get started. Thanks!!

.SH how would that work if there is no insurance company for the ICA to send to? Or just let the ICA deal with that part?

[complwyr]

WIth no insurance carrier, your employer will probably be personally liable to you.

[kachinatracy]

Complwyr:

I am going to the doctors office tomorrow and harrass them until I can get him to put everything in writing that he told me in the office. I am also going to ask him for his medical opinion on how not going to physical therapy will impact my injury or if he can state it was a requirement. Who knows if he will do it or put it in writing. I do have insurance I can use but ahcccs will boot me off in a heartbeat if I use it for a workers comp issue. I have to go back to the first urgentcare and try to pay cash so they will drop the claim to Ahcccs.

I do have emails from them stating where they will reimburse my costs that im accuring so not sure if that will be of help for future legalities.

[BvIA]

I do have insurance I can use but ahcccs will boot me off in a heartbeat if I use it for a workers comp issue. I have to go back to the first urgentcare and try to pay cash so they will drop the claim to Ahcccs.

Do not pay any more out of pocket. If your health carrier has paid for treatment....notify them, they will place a lien on your comp claim...and/or go after your employER.

WC attys don't get paid a fee until your claim resolves, there is no fee for consultation.

[kachinatracy]

I called a WC lawyer and they told me to contact the industrial commission and see if a claim has been filed, though it doesnt sound like my boss or the ER did it, and to file one if it has not. I have a call into them but got voicemail so left a message. She said that in AZ my boss is required to have workers comp insurance and it was a big no no to not have it and even if they didnt they still should have told me how to file the claim because they have a fund set up specially for this situation. She said from now on to keep my employer out of it. I submitted the receipt from the meds I filled (all this was before lawyer and was what was the final breaking point causing me to call the lawyer) and asked that they cut me a seperate check instead of waiting for payroll. She called me yelling at me for filling such an expensive med and asked what I was thinking filling it. Because the DR told me to take it. She then said she needed to make arrangments to get me started on clerical work from home so I can do my 2 hours a day I was missing out on. I said no the DR said no work for 2 weeks, she got pissed and hung up the phone. That is when I called the lawyer.

Thank you everyone for your advice. I am the type of person that does not like confrontation and does not like to upset anyone so I would probably of kept doing stupid things trying to keep the peace. I know I will get fired over this and as its a right to work state I have no recourse but at least my medical will be covered.

[tigris]

Hi just to let you know in AZ you don't get covered for any workers comp related injury if you missed less than 7 days of work. So I mean they won't pay you 66% of your pay check. If you missed over 2 weeks of work they have to pay for the entire time missed. Either way they should have had WC insurance and if you filed a injury report to ICA the ICA would notify your employer/insurance. I think the ICA would fine your employer for not having the WC insurance. If the Dr said no work then don't work I know money is tight but my husband did that mistake he worked with pain and his employer didn't care about his restrictions so he got worse and turned out to have other issues (a herniated disc from a slip and fall that wasn't discoverd till a month later). plus my husband has no health insurance so he had to wait for the WC insurance to get back to him to see a specialist and when they took too long he went to see a chiropractic who discovered he had discs after seeing the MRI they ordered. Anyhow 7 months later we are still waiting for the insurance to pay him WC so it went to court.

Good luck