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  1. #1
    Join Date
    Sep 2009
    Posts
    3

    Default Bad Faith Employer

    I have long thoracic neuropathy caused by 3 years of repetitive overhead use. I just woke up one morning with pain in my shoulder and arm and a winged scapula. The ER doctor along with the specialist he sent me to and 4 other doctors are all in agreement it is caused by my job. Anyway I had to call in to work Monday morning to report I would be off for some time, unsure of how long and that I was being sent to see specialist. I told them The ER doctor said he thought it was long thoracic neuropathy. But could not be sure .that is what I told my employer. A few days later I was seen by the specialist, he agreed with the er doc. but said I would need an EMG done before he could confirm that. I told that to my employer. They asked me if it was work comp and I said we would know for sure after the tests. When the results came back told my employer it was long thoracic neuropathy and it was work related. They said nothing. I didn't know if I needed to do anything. I told my employer, that's all I thought I had to do. my doctor said I could come back to work part time on light duty which my employer said no I could not they couldn't let me come back till I was 100%. Well, when I still couldn't go back to work once the FMLA time was up they said they had to let me go. So I got a lawyer. My employer never filed the claim or reported the injury to their insurance company although I found out they are required to by law. Right now I can't even get any medical treatment because they are fighting the claim basing it on me not reporting it within the 90 days which is bull. My employer was informed right from the start. We can't take it to court for some reason until I reach maximum healing, but I can't reach maximum healing without treatment. It is causing me a lot of pain and emotional distress as I am not being able to get treatment or pay my bills. Do I have a bad faith claim against my employer or the insurance company or both? My employer was required by law to report it and failed to do so. The insurance company probably knows this and is just trying to get out of paying me my benefits owed to me. In the meantime I have had to file for food stamps so I can feed my kids. How can they legally get by with this?

  2. #2
    Join Date
    Oct 1971
    Posts
    5,090

    Default Re: Bad Fiath Employer

    paintergirl71
    The ER doctor along with the specialist he sent me to and 4 other doctors are all in agreement it is caused by my job.
    Did you initially inform your employer and ask to go to his doc?
    Did these docs put that in writing, did you present the doc reports to your employer?


    Anyway I had to call in to work Monday morning to report I would be off for some time, unsure of how long and that I was being sent to see specialist.
    Did you have a disability write up? did you present it to your employer?

    I told them The ER doctor said he thought it was long thoracic neuropathy. But could not be sure .that is what I told my employer.
    If they're not sure, how did they all agree it was work related?
    Why would you tell your employer anything? aren't you presenting the doctor disabilty slips to them.
    You can't just go to a doctor, have a confidential relationship with him and "tell" your employer what's going on, that's not how the system works.
    You have to keep things in order.
    A-Report your injury
    B-request medical treatment, allow your employer the opportunity to refer you to his doctor.
    C- present the written doctor statements to your employer (disabilty, restrictions, next appointment, ect.)

    I told my employer, that's all I thought I had to do. my doctor said I could come back to work part time on light duty
    That's your problem, your're telling your employer what your doc said after the fact.

    Right now I can't even get any medical treatment because they are fighting the claim basing it on me not reporting it within the 90 days which is bull. My employer was informed right from the start.
    That's not what you said, you said "I had to call in to work Monday morning to report I would be off for some time, unsure of how long and that I was being sent to see specialist. I told them The ER doctor said he thought it was long thoracic neuropathy. But could not be sure." That's hardly telling them from the start, it sure isn't the way to report an injury.

    We can't take it to court for some reason until I reach maximum healing,
    That makes no sense, you simply appeal their denial letter, do you have an attorney?

    Do I have a bad faith claim against my employer or the insurance company or both
    No, you didn't follow procedure by not reporting your injury before seeking treatment, you denied them their right to treat you.
    You put the cart ahead of the horse.
    If you don't have an attorney, get one pronto, you have one hell of a mess on your hands.
    Good Luck
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,941

    Default Re: Bad Fiath Employer

    The ER/IC is denying your claim because you did not fill out the first report of injury, within the 90 day requirement. As such, your ER is not required to file the claim wth their IC. The ER is the insured party in a work injury, not the employee. THere are no benefits ''owed'' to you.

    When you were asked directly, "Is this a work comp injury" you said, "I don't know''....
    Were the doctor reports provided to the ER/IC ?
    If it's just you calling in, then you called in 'sick'... the ER is permitted to place you on FMLA, as long as you were notified IN writing of that intent.

    There is no 'bad faith' here... LET you atty handle this for you.

  4. #4
    Join Date
    Sep 2009
    Posts
    3

    Default Re: Bad Fiath Employer

    i do have an attorny. i did notify my employer once the doctors were sure of the diagnosis and as far as treatment the HR person said she thought the DR i had was a very reliable doctor and knows his stuff. i was in to see the HR person after every DR appointment. iowa law states it is the employers responcibilty to file the paper work for work comp. i notified them that the DR said it was work related it was up to them to make the first report. i didnt know anything about work comp at the time but am getting educated about it now. when i first told them it was possibly WC they said to let them know what i found out and i did. they just didnt do anything after they were informed. that is why i got a lawyer. i am just not sure why things are at a standstill waiting for me to reach mmi. it is a really screwed up system

    my employer has never filled out accident reports for any injuries that we had to sign . i thought the safety director just filled out the reports on his own....found out they just dont fill them out period.

    I told them The ER doctor said he thought it was long thoracic neuropathy. But could not be sure .that is what I told my employer.

    If they're not sure, how did they all agree it was work related?
    Why would you tell your employer anything? aren't you presenting the doctor disabilty slips to them.
    You can't just go to a doctor, have a confidential relationship with him and "tell" your employer what's going on, that's not how the system works.
    You have to keep things in order.

    the other DR.'S CAME IN after and since the EMG test i had done where my nerve damage was comfirmed. i have been off work since OCT of last year. as far as telling my employer i mean that as relayed the info from the doctor and if they had filed the WC claim like they were required to they would have had first hand acess to my medical records.my responsibility was to report it to my employer which i did by telling them the DR said it was work related.

    it was an accumulative injury which showed its most severe symtoms on saturday morning which i went to the ER on a sunday so i couldnt really give them first chance to treat but they made no complaints on who my DR was.

  5. #5
    Join Date
    Oct 1971
    Posts
    5,090

    Default Re: Bad Fiath Employer

    paintergirl71
    i did notify my employer once the doctors were sure of the diagnosis
    Again, why didn't you notify them BEFORE you went to the docs? You yourself said they weren't sure of the diagnosis and that's what you told your employer when you called in.

    iowa law states it is the employers responcibilty to file the paper work for work comp. i notified them that the DR said
    Kind of hard to file the paperwork when you went to a docs behind their backs and notified them afterwards, ya think?

    my employer has never filled out accident reports
    That would be because you never informed him of any, you yourself admitted that.
    I'd say you have a hard road ahead, like I said, you can't go to a docs without prior approval from your employer and expect them to pay.
    If you suffered with this injury for years, why didn't you inform your employer and why couldn't you wait one more day to go to the docs?
    Last edited by tony; 09-20-2009 at 12:16 PM.
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

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