Re: Knee Damage

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On 1/26/02, Craig Grimes wrote:
> In October of 1998 I hurt my knee while at work, I was
> getting up from my desk and somehow my chair slipped out
> while my shoe got caught on some wires running underneath
> my desk resulting in an ACL tear in my right knee. The day
> before my scheduled surgery I was notified by my workers
> comp insurance that they were denying the claim, claiming
> that the injury was an ideopathic injury, my personal
> health insurance denied the claim stating that the workers
> comp was crazy, and they are totally liable. What resulted
> was a three year ordeal going to an arbitrator who claimed
> workers comp was liable. Needless to say during the three
> years my knee continued to deteriate. I just finally had
> surgery and had to have a complete ACL replacement as well
> as alot of other work. I am now out of work again and
> wondering if there is any liability on anybodies behalf....
> If so what. Thanks for any help.

Craig,

Work.Comp. has to pay for this recent surgery right? Every
state has different Work Comp. law. One thing that is
forgotten in the Work Comp process is the reason employers
have insurance.....unlike regular tort/personal injury
claims, you cannot sue for "pain and suffering". Your
employer is protected under the law against this. Basically,
if they've paid your lost time from work and medical bills
and are offering something for permanent damage to your knee
then that's about all you can get.

However, after the fact.....Why didn't your insurance company
offer a "subrogation agreement" to you so that you could go
ahead and get the medical care you needed? Under this
agreement, your insurance could have been re-imbursed for
what Work comp insurace was found liable for. Did you have an
attorney?

How did the medical professionals/doctors handle the delay?
Was it their opinion that you wait? I'm just guessing....but
depending on the treatment scenario maybe someone was
medically negligent. Talk to medical malpractice experts.

Good Luck - Rhonda Humphry

Re: Knee Damage, 2/05/02, by Rhonda Humphry.

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