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  1. #1
    Join Date
    Sep 2019

    Default Knee Injury at Work

    Background Info:

    - Registered Nurse, knee injury at work, reported to manager same day. Workers in early 30s, has bachelor degree.
    - Injury date ************ State of California.
    - Manager never completed paperwork, injured worker sought treatment on her own using private insurance.
    - Injured worker had physical therapy, but pain and knee locking continued and was informed b*************(Dec, 2017).
    - Workers' Comp Insurance reached out to worker 1st week of **********, initially sent worker to their own doctors who then denied the case, saying it's "an old injury, go see your own primary doctor". Worker then appealed decision and informed CA department of labor division. A QME doctor was appointed.

    - Worker went back to initial/privately paid doctor who then refused to take her back because worker switched doctor.
    - Worker saw a different doctor who then thought the issue with the knee was a meniscus tear, cortisone shot was given.
    - Almost a year after the injury, after being evaluated by QME doctor and medical records were reviewed, the reported concluded it was indeed a work related injury and the Employer had to take care of me.
    - Insurance accepted the QME doctor'findings and started to pay for medical services in January 2019, worker is now seeing a new provider from the insurance authorized orthopedists.
    - Physical therapy completed again. MRIs and x-rays (3) were taken, it was concluded I had arthritis. QME doctor was not satisfied and wanted to know how a young person ended up with arthritis.
    - A CT scan was ordered last month by the QME doctor (treating physician was against it, believed I did not need it because the scan would show that I have arthritis). The scan result revealed " meniscus tear, cysts, and swollen areas in the knee).
    - I am currently waiting for insurance authorization for the knee arthroscopy (Lavage and removal of torn meniscus etc...).
    - I was taken off work in March and went back to work "light/desk duty" since May 2019 as I cannot go back to the floor yet.

    QUESTION: Do you think i need a lawyer at this point (My plan is to leave my option open for future medical treatment as the treating physician told me I may need a knee replacement in the future).

    *** I just discovered this website, at this point I did not want to get an attorney as I have been dealing with most of the drama along and I am no longer fighting with the insurance to accept liability. If I am wrong about certain things, please let me know. All polite comments/suggestions are welcomed. Thank you.
    Last edited by tony; 09-13-2019 at 10:50 PM. Reason: Dates removed

  2. #2
    Join Date
    Oct 1971

    Default Re: Knee Injury at Work

    I removed the dates that could be used to identify you.
    The carrier won't settle with open medical, that defeats the purpose of settling which is to get you off the dough and close your claim.
    Retain a lawyer at the first sign of problems, it wouldn't hurt to consult one before hand and have him on standby.

    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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