Let's say you are hurt on the job. You tear your shoulder while lifting a large box overhead.
Worker's compensation doctors say you'll need a shoulder operation and you should be good as new. Your company's workers' comp insurance agrees to pay for the operation, all medicines, medical treatments, and any therapy resulting from that shoulder injury.
You breathe a sigh of relief
But a few weeks later that sigh of relief is interrupted. You're having trouble breathing. A lot of trouble. Your wife calls 911, and an ambulance rushes you to the hospital. There's a blood clot in your lung. If the doctor determines this clot was likely the result of your shoulder surgery (a known risk of any surgery), workers' compensation insurance is responsible for paying all medical expenses related to the blood clot too.
Seems black and white.
Yet unfortunately, these situations are not black and white. They can often be grey. Very grey. More often than not we've found that some insurance companies may deny payment of these common complications, which will leave you - the injured worker who just wants to heal and go back to work - in the red. Paying bills out of pocket or just not able to afford the care the doctor says you need.
Denials and Delays! Why You May Need a Workers' Comp Lawyer
Proving that secondary injuries are the result of the initial workplace injury can be particularly tricky. Especially for someone who is not familiar with workers' compensation law.
Some insurance companies may be more likely to question secondary injuries or delay payment. If they get their way, this strategy could potentially save them money.
Moreover, the law allows the workers' comp insurance company to pick your doctors. If you're not comfortable with that doctor's diagnosis, you have the right to request a second opinion from a doctor you and the insurance company agree on. But sometimes we have had cases where we've had to fight tooth and nail for clients to exercise that right.
And then there have been cases where we've seen the insurance adjuster stand in the way of authorizing treatment. Sometimes treatment can be delayed or may not get paid on time or appropriately. Prescriptions may not be reimbursed, so some of our clients have had to pay for prescriptions or expensive equipment out-of-pocket. Some began to spiral into debt trying to keep up with medical bills. Until they hired us, many didn't realize these secondary medical expenses, which were directly related to the initial workers' compensation injury, should typically be covered by workers' compensation.
Life can careen out of control quickly just trying to keep up with medical bills, let alone arguing with your insurance company day after day.
Let us do the arguing for you. It doesn't matter what type of injury you have, we have probably dealt with it. As a matter of fact, these secondary issues have often been some of the most hotly contested litigation during my career in workers' compensation law.
Can You Afford a North Carolina Job Injury Attorney?
Don't worry if you think you may not be able to afford us. We work on contingency, which means that you don't pay any attorney's fee unless we get you compensation.
Click here to take the first step toward taking your life back. The link will take you to our short but empowering booklet, How to Take Control of Your NC Workers' Comp Claim (before it controls you).
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Let one of our workers' comp attorneys - six of whom are North Carolina Board Certified Specialists in workers' compensation law - evaluate your situation for free. Click here to contact us or call 1-866-900-7078. We're available 24/7 to try to get you the answers you need.