IF YOU WANT TO KNOW WHAT MAKES A CASE INTO A LOSER, ask a NC workers’ compensation lawyer who is certified as a specialist. You might hear about a case like Katie’s.
Katie worked as a certified nurse assistant in a nursing home. She liked her job but she didn’t like her supervisor, Janet. Katie felt that she got write ups when the other assistants didn’t. Katie told Janet off after a patient’s complaint. That’s how a final written warning ended up in Katie’s file.
- Reason #1 that Katie could lose: Katie has a bad employment record. Maybe Janet is the worst supervisor in the world. Maybe Katie is the best employee. But it doesn’t look like that on paper. When someone who doesn’t know you is making a decision that determines if you will win your claim, those records make a difference.
Then came the day that Katie needed to turn over a 250-pound woman. She wasn’t supposed to do it alone, and then the woman shifted back onto Katie’s arm. Katie felt a sharp pain in her elbow right away, but she didn’t want to say anything. What if she got fired? Janet asked Katie what was wrong with her when she was rubbing her arm. Katie said one word: “Nothing.”
- Reason #2 that Katie could lose: Katie didn’t report her injury. And worse, she denied that there was anything wrong. When the insurance company is making a decision they want to see that they can get away with denying your case. Katie made it easy to say no. And when a judge has to overturn that insurance decision, they want to see that you really had an injury. A report on paper or at least to the supervisor will help.
The pain got worse and Katie used one of her sick days. Finally went urgent care. She told them that she was hurting but didn’t tell them why. The doctor told her to go to physical therapy but Katie couldn’t afford the copay. Katie called Janet and told her that she had hurt her arm three days before and needed workers’ comp to pay for
- Reason #3 that Katie could lose: Katie failed to tell the doctor about the accident at work. Doctors write your medical history into your electronic medical record. The medical records follow you whenever you go to a doctor. The insurance company will ask for those records. The fact that Katie didn’t report an injury to the doctor will hurt her claim even more.
Within a week, Katie had a denial letter and form sent to her. Workers’ comp refused to pay. She went back to work and tried but couldn’t do the job. Janet called her at home and told her not to come in anymore because she had too many unexcused absences.
- Reason #4 that Katie could lose: Katie did not continue to get treatment for her injury. Katie didn’t follow her doctor’s orders to get therapy, and the doctor didn’t give her any restrictions. Katie doesn’t really know what is wrong with her arm; without restrictions, she wouldn’t qualify for compensation for her time out of work even if she won. Because Katie, like every other person claiming workers’ compensation, has to prove that her injury caused disability. Right now Katie can’t do that.
What should Katie have done? The same things that every injured worker should do.
- Have a good work history. People mess up. But a good work history always helps.
- Report the injury. Do it in writing, and get the names and numbers of witnesses.
- Tell the doctor about the injury. It will help.
- Follow the doctor’s orders. You want to get better, so follow instructions.
- Make sure any restrictions are in writing. It is part of the proof you need.