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  1. #1
    Join Date
    Dec 2011
    Posts
    1

    Default Pre-Existing Condition and On-The-Job Injuries

    Recently I was injured while working. I work at a large retail store as a cashier-- or at least normally I do. My injury happened when I was going back to the register with an item number. I have a shallow trochlear groove, or in layman's terms, the groove where my kneecap sits is too shallow. As I was walking, my kneecap dislocated, moving to the outside of my leg. My manager called an ambulance for me and I was taken to the emergency room, where the kneecap was replaced.
    This happened two weeks ago. I am still unable to cashier and must do light duty, but I can work. The knee is not yet healed. It had indeed dislocated before, but it always went right back into place when I straightened the leg. I did not know that I had the structural defect in the knee, however, as previous doctors had laughed at me for being concerned.
    Do I have anything resembling a workman's comp case? My family is pressuring me to fight the recent denial of my claim, despite my having health insurance. They and my doctor insist that because my injury happened during the course of my regular duties, on the clock, I am entitled to workman's compensation. However, it was a pre-existing condition. I'm not sure I do have a case. And I'm a little afraid to voice my concerns to the HR personnel or the workman's compensation group because I'm worried I'll say something that's legally 'wrong' and ruin any chance of having a case.

    So, do I have a chance of getting compensation... or should I just use my insurance already to pay the hospital bills? I'm very confused, and have never done anything like this before.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Pre-Existing Condition and On-The-Job Injuries

    my doctor insist that because my injury happened during the course of my regular duties, on the clock, I am entitled to workman's compensation.
    The Dr's supply the medical evidence/reasoning. When a claim is filed/denied, you litigate through the WC court...appeal process.

    Do I have anything resembling a workman's comp case? My family is pressuring me to fight the recent denial of my claim, despite my having health insurance.
    No one can tell you one way or the other whether the claim is compensable... for legal advice on the merits of your claim, consult with a competant WC attorney.

    WC is about the liability of your ER...you are presumed "as is" on hire...there is no such thing as "pre existing" condition in WC. The only way your own health coverage will fully accept liability, which is yours, is if a judge finds the injury not compensable.
    There's no reason for you to pay for treatment where your ER is liable.

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