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Old 11-14-2011, 04:56 PM
 
15 posts, read 13,226 times
Reputation: 16
Default workers comp question, please help!

I am an EMT with an ambulance company. On August 8th 2011 I lifted a patient, and immediately felt a sharp pain in my lower abdomen and groin region. I went to the emergency room as soon as my shift was over and was relieved to find out I had mild epididymitis, an infection of the epididymus, and not a hernia. I filed out all the paperwork with to have my ER visit covered under worker's compensation, and returned to work the next night knowing there was no reason I could not injure myself worse.

A few weeks later I found out the claim has been rejected because it is not "a workplace injury diagnosis." The insurance company refuses to pay, and after telling them I went to the hospital to rule out a hernia, they simply stated its not their problem, and I am responsible for the bill. I refuse to pay 3000 dollars for an ER visit stemming from work. I had no pain before lifting, but pain and swelling for weeks afterwards.

Anyone have any ideas on what I can do? I went through the workers compensation laws and information on the state website and it seems that they should be paying for this. I'm fairly broke and cannot risk legal fees unless I am positive I have a court case. Any ideas or information would be heavily appreciated.
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Old 11-16-2011, 03:02 AM
 
19,618 posts, read 13,718,307 times
Reputation: 8809
I would lawyer up.
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Old 11-18-2011, 02:16 PM
 
832 posts, read 1,015,816 times
Reputation: 627
You're gonna lose the case. The injury is not work related, it just happened to flare up at work, but it was not because of the lifting it's infection. Should have went to your doc. not the hospital, bad idea.

No lawyer will take your case except a scammer who will take your money.

Also, the min. you felt the pain you should have stopped working, waiting to your shift finished is gonna go against you.
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Old 11-19-2011, 06:18 AM
 
825 posts, read 1,341,971 times
Reputation: 561
Quote:
Originally Posted by jerseyisfallingapart View Post
I am an EMT with an ambulance company. On August 8th 2011 I lifted a patient, and immediately felt a sharp pain in my lower abdomen and groin region. I went to the emergency room as soon as my shift was over and was relieved to find out I had mild epididymitis, an infection of the epididymus, and not a hernia. I filed out all the paperwork with to have my ER visit covered under worker's compensation, and returned to work the next night knowing there was no reason I could not injure myself worse.

A few weeks later I found out the claim has been rejected because it is not "a workplace injury diagnosis." The insurance company refuses to pay, and after telling them I went to the hospital to rule out a hernia, they simply stated its not their problem, and I am responsible for the bill. I refuse to pay 3000 dollars for an ER visit stemming from work. I had no pain before lifting, but pain and swelling for weeks afterwards.

Anyone have any ideas on what I can do? I went through the workers compensation laws and information on the state website and it seems that they should be paying for this. I'm fairly broke and cannot risk legal fees unless I am positive I have a court case. Any ideas or information would be heavily appreciated.
Sorry, but you can't have it both ways. You just said you returned to work because you knew work wasn't affecting it.... so how can you then say work was to blame...?!?
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Old 11-20-2011, 07:34 PM
 
Location: PA
3 posts, read 2,732 times
Reputation: 10
I certainly appreciate your screen name as most injured NJ workers do who have only basic WC benefits. NJ is an employer friendly state when it comes to WC.
]There is only one way that I can think of that would meet the criteria to be eligible for WC benefits but if that were the case you would have more serious problems than filing a WC claim! I understand you 1st felt pain while on the job and like many injured workers they tough-ed it out till end of day and sought medical attention. However feeling a symptom while at work is not the criteria necessary to be eligible for NJWC benefits.

Being in your profession I would think you would have some kind of health benefits through your employer as if so you can just submit this claim there for payment, but in the most employer friendly state in the nation I imagine your employer doesn't give you the hours needed to be eligible for health ins thus you bust your butt lifting patients all day/night and will never get ahead in that situation?? I hope that I am wrong but I have been a NJ injured workers advocate for many years and know better.

You can consult with a NJWC lawyer for no cost as most only get paid when you get benefits, and this is not a difficult case as there really is no case from the info provided, which I am sorry to say.
If you have other medical ins that's the way to go, but if not you can consult with a lawyer who works on a contingency, but you will be told same.

I wish you a speedy recovery and hope you are back on your feet by now??

BUG
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