• FirefoxInstall the new Firefox »


    Can you sue workman's compensation?

    I’ve been told and read on a blog somewhere that if workman’s compensation is negligent with your case, you can sue them. What exactly constitutes neglect? My experience with workman’s comp has been horrible to say the least. They kept me from seeing a doctor on an accepted/closed claim for over a year. The reason that they closed my claim was I forgot to go to my final doctor’s appointment (I was insanely busy with a double major in college and still continuing to work..I eventually left my job because I could no longer do the lifting required because of my injury). No one followed up with me and they closed it…problem was, I was still in pain. I thought after they closed it I was screwed so I sought treatment on my own until I was told that workman’s comp should be paying for it. When I finally had permission after a year of asking, they switched adjusters on me twice. And I had to get new approval each time they changed adjusters. Once I finally saw a specialist (who said it was the same work injury), workman’s comp then said I was lying about my pain and denied any medical EVEN after I went on my own and saw a second specialist who said that the pain is related to my work injury. So that’s two doctors saying yes, it’s from the work injury and workman’s comp saying there is not enough medical evidence. Not only this, but when the claim was at first accepted, they kept me from receiving benefits after I had been approved for receiving benefits for over 30 days (so I basically had no money for food, rent, etc). I was in college, broke, so it’s not like I had any savings. My adjuster kept saying he mailed out check after check, but nothing ever came. He said they could not do direct deposit until I went around him to a supervisor and found out they could. They also failed to pay doctor bills that went to collections and on my credit report (took me a while to clear that up). So do I just get the short end of the stick here, or can I sue them?
    3 months ago 4 Answers

    Best Answer

    Chosen by Asker
    First of all lets resolve your injury first. So you missed your appointment which probably would have indicated what your rating would have been for your injury. This is called permanent partial disability/impairment (PPD/PPI). You've probably heard of this but it's your responsibility to notify the adjuster that you can't make it due to a prior commitment. However it's the adjusters responsibility to offer you another appointment, even though it's final report. If your in pain your certainly entitled to more benefits especially PPD/PPI benefits. If your unable to return back to work you also might qualify for vocational rehab benefits (VR). However based on what you say, you going to school, you might not be entitled to it due to high level education, but it's worth a shot. If you don't want to go school than you can always settle PPD/PPI and VR as a settlement and leave medicals open. You can also request a hearing with the department and request a reopening of the file and get this claim going the right direction. You might want to talk with an attorney who specializes in work comp claims. You should mention about what's been going on with the claim and how you felt you've been treated. Also you might want to mention...bad faith. If you feel that whatever you just explained could be a bad faith, the late payments, the unpaid medical bills, the fact you didn't get a chance to get a PPD/PPI rating...it could be bad faith. Talk with an attorney regarding this. Mentioning bad faith and actually making it makes the insurance company pay attention, and your claim becomes the main focus all the sudden. Fortunately I've never had to deal with a bad faith claim...knock on wood. Good luck
    a few seconds ago

    Other Answers

    • all Personal injury attorney accept WC cases on a contingency basis, yes you can sue them

      by rwa000 - 13 hours ago

    • You can sue, but your chances are slim. By your own statement, you didn't keep your appointment - the reason doesn't matter. YOU should have followed up about it. And the fact that you didn't understand the WC process won't matter, either.

      by kj566 - 13 hours ago

    • You're going to sue the insurance company? Sure you can - but your chances of winning are very slim. Whatever you read, about neglect and workers comp, I've never heard that. There's "bad faith", but that's not neglect. Bad faith, is when you have a valid claim, and they keep refusing to pay it. Your state laws determine which doctors you can and cannot see. Some of them require you to go to a panel doctor, for the first 30/60/90 days. All of them require you to go for independent exams at the insurers request. Workers comp adjusters are high turnover. They can't help it, if their adjusters quit. They have NO control over that. Typically, when you have a wage loss claim, there is a wait before it kicks in. It can be as short as 3 days, if you're in Hawaii, or as long as three weeks, in several states. That's, three BUSINESS weeks. So they don't start paying, until your waiting period is over. If you're well enough to be in college full full time, then you are usually well enough for SOME type of work, even if it's not what you were doing when you were injured. If you want to hire a lawyer, and pay $200 an hour to try to sue them, go for it. Here in the USA, you can sue anyone for anything. But half this mess is YOUR fault - for "forgetting" the appointment, treating on your own, etc.

      by mbrcatz - 13 hours ago

    Recommended Articles

    Yahoo Small Business Services