Medical care for workplace injuries contested for year &

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Medical care for workplace injuries contested for year &

Postby daraio » February 22nd, 2008, 10:57 am

I was injured working at WPIX, a Tribune Company TV station in New York, when I fell into an unmarked open hole made in the floor of the newsroom.

I have seven herniated disks and one extruded disk in my lower back and torn meniscus on both sides of both knees.

Tribune's worker's compensation insurance carrier has denied proper medical care for over a year and a half. I've had six hearings before the Worker's Compensation Board Judge and won every point at every hearing.

In spite of this, the insurance company continues to refuse to authorize all the necessary treatment, nor pay for prior MRIs and X-rays. They keep filing groundless appeal after groundless appeal.

My lawyer says that while what they are doing is wrong, it is not illegal and I have no recourse.

Are the Worker's Compensation insurance carriers in New York State regulated by any government agency?

Can they be held accountable for knowingly filing groundless appeals?

Do I really have no options here?

Bob Daraio
Posts: 2
Joined: February 22nd, 2008, 10:34 am
Location: Ossining, NY

Postby Webmaster » February 22nd, 2008, 1:43 pm

A private email was sent to address the questions.

For those in workers' compensation systems other than Oregon, please check to see if there's an advocacy group in your state. Since state laws vary, they'd be in the best position to have answers.

Injured Workers' Alliance
Site Admin
Posts: 133
Joined: February 23rd, 2005, 10:39 pm

Postby daraio » March 25th, 2008, 9:18 am

Okay, so I finally had the first knee surgery to fix the torn meniscus in my left knee. It took over a year and a half to get the surgery approved by the Worker's Compensation Board here in New York.

The judge did not specifically list the pre-operative physical therapy evaluation in his ruling, so I was unable to get that important benchmark range of motion test done before the surgery.

They also sent me for an IME right before surgery. Their doctor told me horror stories of knee surgeries gone wrong and pushed me not to go ahead with the operation. Of course he didn't even look at any of the x-rays and MRIs I brought with me.

My left knee is much improved post surgery. I'm going three times a week to physical therapy and look forward to having the other knee repaired.

Of course I haven't heard from my Worker's Comp lawyer since right before the surgery on March 6. I've left five messages at his office.

So, having made my short story long, today's question is: Who pays the lawyer? Will I be billed for legal fees?
Posts: 2
Joined: February 22nd, 2008, 10:34 am
Location: Ossining, NY

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