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worker comp law?

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Old 08-14-2006, 05:16 PM   #1
Join Date: Aug 2006
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wrenching94 HB User
worker comp law?

have a question for anyone? i got hurt at work . the diagnosis is spondylolithesis and i'm a surgical candidate at .5 mm of slipping forward l-4,l-5. they are telling me that it's been there since i was teen but i've never had a problem in my life. lawyer says has to be major cause to do anything if i have to change careers . the dr's says it was unstable all this time with no pain and that bad . this doesn't make sense to me and if i have to take this hit and start over i would like to sue them and try to salvage what i can because i won't make this money anywhere else? don't know what my options are if they say pre-existing ?

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Old 08-14-2006, 06:24 PM   #2
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Backinthesaddle HB User
Re: worker comp law?

How in the world does the doctor know you had this since you were a teen? I had two work related injuries and cervical surgeries and never was I told I had any issue prior to. How bad is your pain? Did you go immediately to the doctor after your injury? And even if it was a issue you had for some time it wasn't bothering you until you got hurt at work. As I understand if your injury at work aggravated a previous injury then it would be covered. Hopefully someone else has some insight.

Old 08-14-2006, 08:12 PM   #3
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wrenching94 HB User
Re: worker comp law?

I guess this is common from what i'm reading online but not sure where i stand . Thought I just pulled muscle and worked right through pain has gotten unbearable and had to see dr and on to this point . Just not sure how they ( workers comp & employer ) would pursue . Then if i can no longer do this type of work should i pursue with laywer ? Anyone ever win a case similar to this ? I'm new to this never gotten hurt at work in my life and now i may have to change careers.

Old 08-14-2006, 09:21 PM   #4
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Re: worker comp law?

Hi, I am currenty on workers comp. Its a real struggle. The employer has to do an investigation to see if they feel the accident is their fault or if you were violating any company rules at the time. Once that is done the company should accept responsibility and then it gets interesting because you are stuck with whatever doctors w/c wants you to see. You have to really fight to get anything done. My advise is as long as you feel like you are getting positive results and not getting the runaround keep a laywer out of it. If you state having problems then find a laywer. My reasoning for this is laywers are really busy and you may have a question you need an answer to and if your represented by a laywer you can't even talk to w/c. It may take a week just to get a call back from your laywer.If you want to know more about where my case is I'd be happy to share it with you. What state or ins co. aree you dealing with. Hope this helps. TEXASCRITTER

Old 08-14-2006, 10:52 PM   #5
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Re: worker comp law?

A few things to consider:

-Spondylolysthesis is typically viewed as a congenital problem (that which one has from birth). What may have occured is the problem you had since being young may have been aggrivated by a work related injury. Have you filed for WC and are you able to describe the incident/activities that led to the pain/symptoms? Keep in mind WC is different in each state - so the laws, processes, requirements etc are different for each state.

-Also, many companies offer Short Term Disability (STD) and Long Term Disability (LTD) benefits which can provide youa % of your annual earnings for work-related or non-work related injuries or illnesses. You should check your HR/benefits department to see if these benefits are offered. Sometimes employees have to enroll and pay all/part of the premiium and sometimes the company automatically enrolls and pays the premium. In either case you'd have to have been enrolled before the illness/injury occured. (So for anyone reading this, never turn down STD or LTD when you join an employer - you never know when you may need it and you can't get it after the fact).

In both cases, often WC is offset (removed from) any STD or LTD benefit payable. For example, lets say your normal income is $60,000 per year which is $5000 per month. The typical LTD policy offeres a benefit of about 60% of your income to a pre-determined maximum. So, again for the sake of example, let's say your LTD plan offers 60% to a max of $2500 per month. With $5000 per month in earnings you could get 60% on LTD which is $3000. But if the max LTD benefit is $2500 - you would be eligible for $2500 less any other income benfits. So to further the example, if you do get Workers' Comp at $1500 per month your LTD would be $2500-$1500 = $1000. If your WC claim is denied, then you can get $2500 per month (less any other income or wages). STD and LTD are also applicable for non-work related medical conditions such as cancer, stroke, surgery, mental illness, etc).

I've been in the disability insurance industry (STD and LTD) for a long time and in my opinion, if you think the aggravation of the condition is work related you should pursue WC, find a WC attorney and follow the pursuit all the way through all appeal stages. However, if after full review WC says it is not compensable there is usually no other legal recourse to have the employer accept liability and to pay you for being unable to do your job.

-Lastly, if you are denied WC and do not have STD/LTD but you are truly incapacitated from any type of work you can apply for Social Security Disability (SSDI). The definition of disability is very stringent and requires you be unable to do any gainful work (so if you are in construction and were making $40 per hour, but you could be a receptionist at a company at $8 per hour they would consider you able to work and not eligible for Social Security. But, just as in my previsous examples, if you are indeed out of work and totally incapacitated it is worth pursuing, through appeal stages, etc.

I was found to have Spondylolysthesis in 1987 at the age of 21. I had a fusion at L4-S1 and later in 1993 had it re-done with hardware from L5-S1. I used to work in social service and am now in the insurance industry so I have not been incapacitated for long for either of the back surgeries or my recent ACDF C5-C7 (each time taking 6-8 weeks off of work only, but then again I don't have a physical job).

Sorry if this is long, but I hope it helps.

ACDF 5/18/06
Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

Last edited by SpineAZ; 08-14-2006 at 11:03 PM.

Old 08-14-2006, 11:43 PM   #6
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Re: worker comp law?

Hopefully, you have disability insurance and can take the steps outlined above.

WC is a no-fault system. Basically, you give up the right to sue an employer for negligence in exchange for a defined set of benefits. Of course, the injury must arise out of the course and scope of your employment.

WC lawyers work on volume because the payoff is minimal.

I feel guilty opening up pandora's box here. But...

You should always examine the potential liability of third-parties in the case of a workplace injury.

An employer is insulated by WC law, and the benefits are clearly defined and very, very limited, relatively speaking.

Liable third-parties, however, are fair game for legitimate lawsuits.


--Were you wearing any kind of safety gear?

--If involved in a vehicle accident, did the safety equipment work correctly?

--Were you unloading cargo from a third-party carrier's truck?

--Did the injury occur on a third-party's property?

Those are just a few simple examples.

Certain types of employment - Police/Fire - waive many of these rights. However, not product failures (bullet-proof vest).

None of the above should be taken to be legal advice.

You need to speak to a competent attorney in your state to determine what rights you may have.
"Use your health, even to the point of wearing it out. That is what it is for." George Bernard Shaw

Last edited by ThoreauFan; 08-14-2006 at 11:49 PM.

Old 08-15-2006, 04:21 AM   #7
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Re: worker comp law?

in my state when you are injured on the job you must first notify your supervisor who in turn must give you the info on their WC insurance for you to file a claim. employer must also notify WC. i have had 5 comp injuries with the same employer and always went back to my job full responsibility because i was afraid to lose my job and benefits. not this time. i hired an attorney immediately. i feel if the attorney takes the case he must fell it is worth it since they only get a % IF you win and that % is different in every state. my attoeny picked my case up immediately after reading all papers on the 5 injuries and how they were handled. attornies will not charge you for a consultation. as far as pre-existing injuries go my neck must have been going on for years (never claimed it) becasue it bothered me and was quite painful. i used to come home and ice several body parts. my back and knee are re-injuries of previous WC claims that i never signed off on. If your job aggravates a pre-existing condition it is still considered to be an occupational injury. different by still falls under WC. get yourself some good medical attention and some advise from an attorney. it is an uphill battle all the way. best of luck.

Old 08-15-2006, 05:28 AM   #8
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Location: ma
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wrenching94 HB User
Re: worker comp law?

Thank You to all responders appreciate the help . I really would like to go back and do the same job the pay & bene's are a good package but all the dr's have said is you may have to consider a change . Have already gotten lawyer because they have a nurse coming to my dr appointments didn't think that was right ,now going to their dr tommorow . Just don't understand how this couldn't be work related . Do not want to sue but will take a huge hit changing careers . I've been a mechanic for 16 years so all my backround is mechanical and it's all bull work. Just starting to think I'm getting railroaded here . Lawyer says the injury has to be the biggest cause for you to really pursue and dr's say it was like this all the time since teen years the verbage was unstable . So it sounds like it has been this bad for this long with no signs does not sound right to me . Have 3 kids so can't take painkillers til night, can't walk around the block with family to painful , can't stand for to long . All pre-existing ? and now i'm done . Again thank you all for your advice and waiting for more .

Old 08-15-2006, 06:55 AM   #9
Join Date: Jul 2006
Posts: 3,263
Re: worker comp law?

wrenching94-----------same here. love my job. have had it for 20 years. kept going back injury after injury because i also make good money adn have a great benefit package. it's breaking my heart but i know deep down if i went back this time i would be permanently and completely disabled. no money is worth what i have done to my body for a job. take your time and let the dr.s and attorney advise you step by step. attorney's are a pain in the butt to get in touch with but they do call back. sometimes you have to be very persistant.

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