Re: Worker's Comp Denial-HELP!

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On 4/08/07, David wrote:
> Any advice? I injured my knee in a student/faculty
> basketball game and need ACL surgury. The workers comp.
> has denied the claim and says it was not an accident. I
> have filed an appeal but can they get away with this? I
> have lots of witnesses including my supervisors and a
> photo. What should I DO?
> Is a lawyer necessary?

Here is an excerpt from the labor code which applies to your
issue. Not enough detail has been provided in you query to
allow me to provide you a firm opinion on whether the injury
is or is not compensable under workers compensation laws.
"Where the injury does not arise out of voluntary
participation in any off-duty recreational, social, or
athletic activity not constituting part of the employee's
work-related duties, except where these activities are a
reasonable expectancy of, or are expressly or impliedly
required by, the employment. . . ." (§ 3600, subd. (a)"

If your injury occurred during the game and that game
constituted a part of your work related duties or there is a
reasonable expectation express or implied that participating
in the game was required then it would be a compensable injury
and workers comp would apply. If this is the case then you
should retain an attorney to represent you as the carrier has
apparently decided to fight the compensability issue.

Make sure to save whatever witness lists you have, get as many
statements about the issues of injury and the position on
whether others on staff thought the game was wholly voluntary
on their part as you can signed by them and dated if possible
and keep hold of any videos of the accident. Take all of this
with you to the attorney you decide to retain.