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  1. #1
    Join Date
    Nov 2011
    Posts
    3

    Default Assault by a Patient

    Came across this forum after searching for days looking for real and actual information regarding dealing with Work comp issues.
    So I will try to brief and concise with the description of what is going on.

    Workplace accident: My wife worked as a CNA in an assisted living memory care unit. She was assaulted by patient A who was arguing with patient B in B’s room. While trying to convince A to leave, he became violent and punched her in the face, sending her over a bed and knocking her out. After the incident she notified her manager on duty who refused to let her seek medical treatment at the time and had instructed her that she (wife) could not miss the next shift either as she (wife) is the only 1 certified to pass meds. Next shift she was instructed to leave 3 hrs into shift and seek medical (after seeing how bad her injury was).

    Has been diagnosed with TBI and post concusive syndrome. Has been receiving treatments entailing injections to reduce swelling in her head as well as visits to neuro psych for evaluations. Suffers from short term memory loss, cannot sleep due to pain and nausea, (only sleeps after 2-3 days of no sleep when she collapses from exhaustion).
    We have since obtained a work comp attorney and has been doing his best to help. Wife had previous head injury 5 years prior and work comp covered initial Doc visit. Was released to work 2 days later with no restrictions. We were informed that insurance company will use that against her. After meeting with attorney recently we were informed that IC is calling this a black eye and will be dropping her medical treatment soon. She has been receiving TTD for the past 4 months.

    We know for a fact Doc’s will argue this and will back wife with diagnosis. My issue with all of this is that wife was injured due to unsafe work environment (I notified OSHA when I found out that Patient A and B were not being given proper dosages of meds and were too high lvl to be in facility).

    Now after 5 months of Doc visits with no relief, we are faced with her dealing with a “black eye”. Have been told on numerous occasions not to give and to keep fighting, as she (wife) WAS in fact hurt and deserves to be compensated medically as well as loss of wages.

    I don’t know what to do anymore as the stress of all of this is wearing us down. Me for having remember things for her, and for her just because of her injuries and the fact that she may have to put off nursing school till she gets better.

    So… does the fact that employer was in violation of OSHA rules have any bearing on her case?
    Is it normal for IC to downgrade an injury as much as they did?
    Does the fact that she won’t be able to attend nursing school factor into her potential wage loss?
    And lastly should she continue to fight this?
    Only reason I ask is I have to make most of her logical decisions for her and I don’t want to put her through any more stress than she is already dealing with.
    Any help or input would be greatly appreciated.

  2. #2
    Join Date
    May 2010
    Posts
    629

    Default Re: At the End of Our Ropes.don't Know What to Do

    You should have been or by now been in contact with a lawyer!!! Please dont wait any longer!!!

  3. #3
    Join Date
    Oct 1971
    Posts
    5,201

    Default Re: At the End of Our Ropes.don't Know What to Do

    Quote Quoting airdale View Post
    You should have been or by now been in contact with a lawyer!!! Please dont wait any longer!!!
    The OP said "We have since obtained a work comp attorney"

    sdwolf
    Wife had previous head injury 5 years prior and work comp covered initial Doc visit. Was released to work 2 days later with no restrictions. We were informed that insurance company will use that against her.
    That's fine, if they want to reopen that claim, let em do it.
    I would think this is a second injury, I fail to see why they would want to reopen the past claim.

    After meeting with attorney recently we were informed that IC is calling this a black eye and will be dropping her medical treatment soon. She has been receiving TTD for the past 4 months.
    Her past injury is irrelevant and has no bearing on this claim, this is a second injury. This attorney should be reassuring you, these games are typical and nothing to worry about.

    does the fact that employer was in violation of OSHA rules have any bearing on her case?
    No, worker comp is no fault. All that is required is that she was injured during the course of employment, the details are irrelevant.

    Does the fact that she won’t be able to attend nursing school factor into her potential wage loss?
    No, the only factors are her average weekly wage, her actual wage loss and her final impairment rating.

    Is it normal for IC to downgrade an injury as much as they did?
    Yes, in fact it should be expected. Just because they say they will deny, doesn't mean they will prevail, 99% of the time benefits are reinstated.

    should she continue to fight this
    There's nothing to fight yet, your attorney has informed you of a possible low ball tactic that may be used.
    If or when they deny benefits, your attorney should respond accordingly and have them restored.

    My advice would be to relax and quit trying to predict the future, take it as it comes, you'll be fine.

    Tony
    Last edited by tony; 11-06-2011 at 04:20 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.

  4. #4
    Join Date
    Nov 2011
    Posts
    3

    Default Re: At the End of Our Ropes.don't Know What to Do

    These answers helped. We were informed through attorney that they have a statement from " the company kiss-ass" denouncing her injury, but we are in the process of obtaining statements from others who were on shift as well as her old supervisor. So we CAN come up with our own ammunition if needed.
    Next step that I know of is getting her % rating. Is there a chart somewhere that lists the settlements based on % ratings that can be looked over. I know it is based on a formula involving her PPD rating when issued, but I cannot find one for the state of Montana. Like I said most sites I've visited are lame excuses of Lawyers posting exuberant claim settlements to drum up business, and state work comp office is now help.
    Wife is concerned that even if they offer future medical, the settlement will not be close enough to cover our losses. (had to sell a vehicle and some of our possesions to cover her loss of wages to offset our monthly expenses). Actually she said it more like IS THIS EVEN GONNA BE effin WORTH THE FIGHT???!!!! yeah she also suffers from depression and severe mood swings since the injury.
    Again thank you for the input. My mind can now take a little break from the worry.

  5. #5
    Join Date
    Oct 1971
    Posts
    5,201

    Default Re: At the End of Our Ropes.don't Know What to Do

    Is there a chart somewhere that lists the settlements based on % ratings that can be looked over. I know it is based on a formula involving her PPD rating when issued, but I cannot find one for the state of Montana.

    Workers' Compensation Summary - Montana

    Medical Benefits
    A claimant copayment of 20 percent of the cost of each visit to a provider (up to $10) and $25 for each subsequent visit to a hospital emergency department for treatment is required, unless the employee uses the managed care or preferred provider organization requested by the insurer.
    Benefits for Temporary Total Disability (TTD)
    The percentage of worker's wage paid is 66 2/3. For weekly payments, the minimum is payable, but not statutorily prescribed, and the maximum is $633, 100% of SAWW. The maximum period of payments is the duration of disability, or until the worker is released to pre-injury job or similar employment. WC benefits are subject to Social Security benefit offsets.
    Benefits for Permanent Total Disability (PTD)
    The percentage of worker's wage paid is 66 2/3. For weekly payments, the minimum is payable, but not statutorily prescribed, and the maximum is $633, 100% of SAWW. The maximum period of payments is the duration of disability. WC benefits are subject to Social Security benefit offsets.

    Benefits for Permanent Partial Disability (PPD)
    The percentage of worker's wage paid is 66 2/3. For weekly payments, the minimum is payable but not statutorily prescribed, and the maximum is $316.50, 50% of SAWW. For non-scheduled injuries, the maximum period of payments is 375 weeks and the maximum payment is $118,687. Ratings for compensation purposes are determined as a percentage of permanent total disability. Wage loss benefits are determined by multiplying the percentage of impairment by 375 weeks not to exceed a permanent partial disability rating of 100%. WC benefits are subject to Social Security benefit offsets.


    Contact Information
    Claims Assistance Bureau
    Employment Relations Division


    Department of Labor and Industry
    PO Box 1728
    Helena, MT 59624-1728
    Phone: (406) 444-6534
    Internet: http://erd.dli.mt.gov/wcca-bureau.html

    Additional Information
    Montana Workers' Compensation laws are available online at:
    http://data.opi.mt.gov/bills/mca_toc/39_71.htm
    The Department of Labor and Industry Administrative Rules are available on the Secretary of State web site and include these chapters:
    · Chapter 28 Workers' Compensation Mediation:
    http://www.mtrules.org/gateway/ChapterHome.asp?Chapter=24.28
    · Chapter 29 Workers' Compensation and Occupational Disease:
    http://www.mtrules.org/gateway/ChapterHome.asp?Chapter=24.29
    · Chapter 33 Contractor Registration:
    http://www.mtrules.org/gateway/ChapterHome.asp?Chapter=24.33
    · Chapter 35 Independent Contractors:
    http://www.mtrules.org/gateway/ChapterHome.asp?Chapter=24.35
    The Montana Workers' Compensation Court website is at:
    http://wcc.dli.mt.gov/


    Tony
    Last edited by tony; 11-06-2011 at 04:42 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.

  6. #6
    Join Date
    Nov 2011
    Posts
    3

    Default Re: At the End of Our Ropes.don't Know What to Do

    Beautiful. Tried this info a week ago and received the dreaded 404 error when trying to access the page.
    Much appreciated.

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: At the End of Our Ropes.don't Know What to Do

    Wife is concerned that even if they offer future medical, the settlement will not be close enough to cover our losses. (had to sell a vehicle and some of our possesions to cover her loss of wages to offset our monthly expenses). Actually she said it more like IS THIS EVEN GONNA BE effin WORTH THE FIGHT???!!!! yeah she also suffers from depression and severe mood swings since the injury.
    The "worth the effort" question is ...'yes, because as WC is no fault, she is not liable for medical care. Whether or not she is eligible for benefits is based on medical evidence, not how many people may be witness to the injury. WC is not about a big cash settlement, there is no money for pain/suffering, or what you may have lost. But the medical, ...basically. Your own health ins won't pay for treatment to a work injury. Nor should you have to pay deductibles/co-pays for medical care. The other "worthwhile" benefit if the weekly wage replacement...TTD. Future medical is also a significant dollar value...once you take a cash payment to close a claim, you pay out of your pocket for medical care.
    Wife had previous head injury 5 years prior and work comp covered initial Doc visit. Was released to work 2 days later with no restrictions. We were informed that insurance company will use that against her.
    As she rec'd treatment, and was released WITHOUT restrictions, and no PPD was paid, there would be no reason for the prior injury to have any affect on this claim.

    IF... IF that were to be the case, once she was rated for PPD due to this injury, any % of PPD from the prior would only go to reducing any PPD indemnity award in this claim. You can only be 100% PD... the ER is only liable for PPD due to this occurrance. Apportionment to cause of impairment. Since there was no award in the prior, can't affect this claim.

    Relax...let your atty handle the claim issues. You/your wife concentrate on her recovery, and your family issues. Don't let the claim rule your life.

    BTW....Does the fact that she won’t be able to attend nursing school factor into her potential wage loss?
    No... she is likely (hopefully) to see a complete recovery from this injury, and go on to complete her education. Good luck to you/her.

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