Workers Comp problem

[krystalleigh1]

So almost a year ago my DH got hurt at work. He works with juvenile delinquents. He got kicked in the leg pretty hard and when his leg started to swell, he left work and went to the Dr to get x-rays. He filled out the workers comp paperwork that same day at work.

Time goes by and a year later the Dr's office sends us notice that we owe $170 for the above Dr visit. DH talks to his HR rep and they basically say, "Sorry the paperwork wasn't filed. The last HR rep who worked here must not have done it. We'll look into it."

This was months ago and now the Dr is sending us notice that they're going to file with a collection company for the bill. My DH gives in and pays even though I tell him not to-that workers comp should have paid it and his employer needs to figure it out.

What do we do now? Obviously his employer is not being helpful about this. The HR person who filed the paperwork is no longer there and we're just at a loss. Help!!

 

[krystalleigh1]

Just to clarify: He was able to work the next day and from then on. He only expects workers comp to pay for the Dr. bill since he got hurt at work.

 

[tvguy]

Sounds like you did the right thing. Paid the bill to protect your credit, now light a fire under HR to pay you back.

 

[danygirl]

You should have the dr file thru your reg insurance - this might bring your cost down- workers comp will reimburse your ins if your state has subrogation.

 

[disney1990]

If it's a workman's compensation claim, it cannot be put through your own insurance company. I know there's a Maryland Workmen's Compensation Commission and their must be one in your state also. I would contact them immediately. Your company does NOT have the option of not paying the claim if you were hurt at work.

 

[Jimsig]

If it's a workman's compensation claim, it cannot be put through your own insurance company. I know there's a Maryland Workmen's Compensation Commission and their must be one in your state also. I would contact them immediately. Your company does NOT have the option of not paying the claim if you were hurt at work.

Yep, call your state's workers comp board.

 

[Pakey]

In CA, we have to provide info to the employee when an injury is reported. Additionally, the workers comp board number is posted on the employee bulletin board, along with the name and phone number of our work comp carrier.

Your husband should be able to get this info. I bet if he asks HR for the number for the state board, his company may look into it a little faster.

It was a better choice to pay to avoid collection but his employer should now make sure reimbursement is made. When your husband reported the injury, he should have been given copies of the paperwork-he should have filled something out. If he has that paperwork, the carrier should be on that too.

 

[gracie1]

Your husband should've been given information regarding his workers comp claim. They will give him a workers comp claim # and also in Delaware the workers comp reps speak directly with the employee. Did they ever contact him?
I can't believe the dr waited a year before finally sending you a bill. Where was he originally sending them?

 

[wiigirl]

Sounds like you did the right thing. Paid the bill to protect your credit, now light a fire under HR to pay you back.

 

[southlakejr]

Well, my DH works with juvenile delinquents, and I work with HR and workers comp in a different industry so this is kind of up my alley...

Because this visit was a one time thing that did not involve medical follow up or paid time off, most employers will opt to pay the bill directly with the medical office, rather than run it through their WC carrier. This is considered a "first aid" visit. Because of this, WC paperwork (as it pertains to you receiving payment) should be irrelevant.

Are they denying that this visit was work related? If that is the case, you have an entirely different problem on your hands. Unfortunately, some agencies in the field are less than stellar, others are just less than organized.

Submit a copy for reimbursement, if it is not processed in the same timeline as a normal reimbursement, threaten to contact your state WC office. Good luck!

(On a side note- DH's most recent WC visit involved a kid that ripped out a section of his hair and scalp. )

 

[krystalleigh1]

Well, my DH works with juvenile delinquents, and I work with HR and workers comp in a different industry so this is kind of up my alley...

Because this visit was a one time thing that did not involve medical follow up or paid time off, most employers will opt to pay the bill directly with the medical office, rather than run it through their WC carrier. This is considered a "first aid" visit. Because of this, WC paperwork (as it pertains to you receiving payment) should be irrelevant.

Are they denying that this visit was work related? If that is the case, you have an entirely different problem on your hands. Unfortunately, some agencies in the field are less than stellar, others are just less than organized.

Submit a copy for reimbursement, if it is not processed in the same timeline as a normal reimbursement, threaten to contact your state WC office. Good luck!

(On a side note- DH's most recent WC visit involved a kid that ripped out a section of his hair and scalp. )

The problem is it was long enough ago that the HR person is different and they claim the old HR person never filed the paperwork. So they have no record of the injury AT ALL. DH has asked several times and so far noting. They're really dragging their feet because there is no ONE person who is accountable. It's sort of like they're saying, "Well, I'm not the one who messed up so I can't help you."

 

[starry_solo]

Did your husband keep a copy of the worker's compensation paperwork he completed?

 

[southlakejr]

Hmmm. In some ways, the paperwork should be irrelevant, as it shouldn't need to be processed through their workers comp carrier. Ask them straight out if they are denying that this injury occurred on the job. Then, ask for the visit record from the MD visit. That paperwork will indicate at some point that the injury was work related. It should also have some limited description of the injury, and if he was there during his normal work hours, that should be another indication that it is, in fact, WC related. Show this paperwork to HR and let them know that you need a response within three days. Is there another superior to this HR person that your husband can speak to? Or a president or supervisor? If not, let this person know that YOUR hands are now tied, and you will have no choice but to contact the state board. Coming from an HR person- HR folks can really suck and I'm sorry you're having to deal with it.

 

[krystalleigh1]

Did your husband keep a copy of the worker's compensation paperwork he completed?

I'm going to make him look for it tonight but it's not looking good. I don't think so: (

 

[krystalleigh1]

Hmmm. In some ways, the paperwork should be irrelevant, as it shouldn't need to be processed through their workers comp carrier. Ask them straight out if they are denying that this injury occurred on the job. Then, ask for the visit record from the MD visit. That paperwork will indicate at some point that the injury was work related. It should also have some limited description of the injury, and if he was there during his normal work hours, that should be another indication that it is, in fact, WC related. Show this paperwork to HR and let them know that you need a response within three days. Is there another superior to this HR person that your husband can speak to? Or a president or supervisor? If not, let this person know that YOUR hands are now tied, and you will have no choice but to contact the state board. Coming from an HR person- HR folks can really suck and I'm sorry you're having to deal with it.

Thank you! To throw another wrench into the mix, DH just accepted another job so he just resigned from this one. I hope that doesn't make them less likely to pay. It shouldn't make any difference but if DH isn't going in to work daily I have a feeling he'll just let it slide. But it's not right! He shouldn't have to pay!

Yes, I would think the medical work at the Dr's office would say that it's a work related injury. He did leave work to have his leg looked at. If nothing else I'm sure they can look back at the date and see he left work early and see that the date is the same as the Dr's visit.

 

[krystalleigh1]

Oh and he works for the state. So a lot of bureaucratic red tape and no one taking accountability for anything. It's a mess.

 

[plummer925]

Honestly, I'd let it go. Submit it to your own insurance since DH's work did not pay. They probably won't pay now that he has resigned.

 

[Maggie'sMom]

Honestly, I'd let it go. Submit it to your own insurance since DH's work did not pay. They probably won't pay now that he has resigned.

No. First of all, the personal medical insurance won't cover it because it is a work related injury. Secondly, the employer is required to cover it under workers' compensation law. It doesn't matter that he resigned.

As a PP mentioned, get records from the medical provider which will document this is a work related injury and resubmit the claim through HR. A call to the state workers' compensation bureau isn't a bad idea either.

 

[southlakejr]

Oh and he works for the state. So a lot of bureaucratic red tape and no one taking accountability for anything. It's a mess.

Very interesting- and now they have even less of an excuse. For some companies, they just don't have anyone experienced enough to handle WC issues. That is not the case here.

Time to start looking bigger- there should be a personnel division for your state- they are typically the ones responsible for testing, hiring, etc. They also manage the overall payroll and HR functions of the state such as benefit plans, and your worker's compensation coverage. Contact them and let them know that your husband's division is not paying a workers comp claim for an on the job injury and you would like to file a formal complaint. Hopefully that should get someone to take notice.

It may be that your husband's immediate HR department should have never handled the claim in the first place. Ugh. bureaucracy sucks.

 

[scrapquitler]

I wonder if WHERE he went to the doctor is relevant in this situation? Where I work, if we get hurt on the job we have to go to the Concentra place to have the treatment paid as a workmans comp claim. We can follow up with our doctor and they will pay for further treatment that way, but unless it requires an ER visit, our first exam is supposed to be at Concentra, and we never see a bill or have to provide our insurance information at that initial visit.