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  1. #1
    Join Date
    Jul 2019

    Default Re-Injury 6 Months After Workers Comp Claim

    So I fell at work in December 2018. Opened a claim and had surgery in Jan 2019. Surgery was Meniscus and cleaned up scar tissue from ACL repair 10 years ago. Fast forward to July 2019, I was walking down stairs at HOME and my knee suddenly gave out. The meniscus repair failed and now surgeon wants to repair ACL which he contemplated doing in first surgery in JAN. 2019 but decided not was not needed.

    Workers comp told my boss they closed my claim a week prior and that they would not cover this since it happened at home. And that I could call them if I had any questions. Iíve been trying to get ahold of my claim adjuster, leaving voicemails she will not answer or call me back. I had my surgeon give them a call and explain everything with MRI results.

    Workers comp told my surgeon they are willing to re open it but they need to do an investigation. Knowing that will take awhile, they said if I go ahead and have surgery done under my own insurance once everything is settled and they decide to re open my claim that they could re-Imburse my insurance and cover anything else involved.

    My questions, should I wait to have surgery until they decide whether to re open my claim or not?

    Is it even possible for my claim to be closed so soon? I never recieved anything stating it has been closed.

    If denied what actions should I take?

    Since it happened at home do they even have to re open it?

    Thanks in advance.

  2. #2
    Join Date
    Oct 1971

    Default Re: Re-Injury 6 Months After Workers Comp Claim

    Comp is responsible for any injury occurred during the course of employment, nothing more.
    I'd say the odds of them covering an off work injury is just about zero - you better consult a lawyer before having further contact with the carrier or employer.

    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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