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NH workers comp New Hampshire

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  • NH workers comp New Hampshire

    I was injured at work in NH on July 1. My company is based in Mass. and is self insured. I have been out of work since July 4th. My physical therapy doctor needed confirmation from the insurer to begin treatment on the 16th. They could not get hold of the WC contact at the companys main office because she had gone on vacation. They were given the number for the law firm that handles the WC claims however, they have not recieved any reports from the main office. I called the main office to see if I could get any information so that we could get the confirmation we needed to start the rehabilitation. I was told that they can't find any paperwork or reports on me and won't be able to do anything until the lady gets back from vacation on the 23rd. I was wondering what the time constraits there are for my employer to file my reports with the insurer. I checked the states WC laws and know that the insurer has 21 days to pay benifits or deny a claim. It's been 18 days since my injury and nobody seems to know where my reports are. Even though my employer is self-insured do they still need to file the first report of injury with the state within the 5 days? On top of all the medical forms that I have been recieving it states that they must be filed with the WC insurance carrier within 10 days of treatment. I was on WC last with this company 10 years ago and they were very fast at paying weekly benifits and I am a bit discouraged at the fact that nobody seems to know anything about my claim. I hate to say moneys getting tight but at the rate they seem to be going I'll lose my house before they even see my reports. My doctors ended up starting treatment anyway in hope that this will get cleared up when the WC lady gets back on the 23rd, however if they are letting her case load pile up over vacation I think she might be a little overloaded. Any help or advice is greatly appreciated. Thanks

  • #2
    Get a lawyer now, you should have been recieving checks after you missed 3 days of work. It may be different in your state, not sure, but at least go for a consultation, it sounds as if you do not force them to pay, if you are supposed to be getting unemployment checks, you will lose your home. My husbands attorney works on a contingency basis, so it may not cost you a thing if you do not get a thing.

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    • #3
      Workers comp is VERY different from state to state. The waiting period differs, the plan structure differs, it is NOT the same everywhere.
      The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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      • #4
        I called the NH Labor Dept. yesterday. The first report was filed with them on July 1st. They said the lawyer firm should have a copy. I told them that I had spoken to them four times and that they had stated they have 21 days to look at it and decide but they don't have the reports yet so they couldn't help me. I just don't think it seems right that the lady at the main office shoved it aside for a week without filing it, then went on vacation for another week. Nobody else down there will touch it or send a copy to the law firm until she gets back. They just keep saying "well, shes on vacation...", like thats supposed to clear everything up. The state said they would call them and get back to me. The laws do seem very different state to state.

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        • #5
          The state just called me back and said that the lawyers told them that they would look into it. The labor dept. said that the insurer does have 21 days to do their investigating. It seems to be the only fact that they can tell me. I am aware they have 21 days, but it would seem that filing the report 23 days after the injury is wrong. They have 5 days to file it with the state of NH, which the state had on file the same day as the injury, but apparently no constraits when filing it with their insurer? Does their 21 day investigation period start whenever they feel like it? It just seems asinine that it took them 23 days to file the report, and now have possibly another 21 days to decide whether I'll be covered or not. I'm a little frustrated.

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          • #6
            Originally posted by cbg View Post
            Workers comp is VERY different from state to state. The waiting period differs, the plan structure differs, it is NOT the same everywhere.
            Thanks cbg, is there a site that goes into detail about the differences in Workers Comp for the different states? I am glad you brought this to my attention, sorry poster!

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            • #7
              Originally posted by Chandler76 View Post
              The state just called me back and said that the lawyers told them that they would look into it. The labor dept. said that the insurer does have 21 days to do their investigating. It seems to be the only fact that they can tell me. I am aware they have 21 days, but it would seem that filing the report 23 days after the injury is wrong. They have 5 days to file it with the state of NH, which the state had on file the same day as the injury, but apparently no constraits when filing it with their insurer? Does their 21 day investigation period start whenever they feel like it? It just seems asinine that it took them 23 days to file the report, and now have possibly another 21 days to decide whether I'll be covered or not. I'm a little frustrated.
              I wish I had an answer to that, hopefully a member with experience with this in your state will chime in.

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              • #8
                This is a link to State of NH WC laws if it helps anyone out. I've read through them but some of the wording is confusing.


                http://www.gencourt.state.nh.us/rsa/...XIII-281-A.htm

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                • #9
                  I'm not sure what to tell you. People go on vacation and there just isn't anything you can do to prevent that. I doubt she scheduled her vacation just to make your claim more difficult. Yes they should have a backup plan in place but I don't know how the office is set up and how feasible that is. She comes back on Tuesday and there isn't anything you can do before then. You aren't missing out on treatment which is good so unless they decide to contest the claim in which case I'd advise a lawyer get involved, continue as you have been for a few more days.
                  I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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                  • #10
                    It's not that I was injured while she was on vacation and she wasn't there to file it. She had the report for two weeks and didn't file it, then went on vacation. They have 10 days from the date of treatment to file the doctors reports which hasn't been done. It's not exactly my problem but these doctors will use my insurance when the bills are not paid on time because it took them 23 days to give the reports to the insurer. I don't get how there are strict time requirements to file these reports with the state, 5 days or $2500 fine, and 10 days for the doctors reports or a $2500 fine, but when it comes to filing my report so maybe I can recieve a check to buy the kids food nobody seems know. No, she didn't schedule her vacation to make my claim more difficult, she didn't do her job for two weeks to make my claim more difficult. Her job was to gather the reports and my history, throw it in the fax machine and hit send. Anybody that doesn't see the problem with them waiting 23 days to even submit my claim to the WC dept. has more problems then me. I was told there was nothing they could do until Monday until I called the state. Now, magically, someone figures out how to use the fax machine and the lawyers get my report. My question was simply how many days an employer has to file the First Report of Injury to the insurer. I don't care whose on vacation, where they were going, or what they were planning to do when they get there. The law doesn't get put on hold because this lady was in vacation mode 2 weeks before she went.

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                    • #11
                      The law doesn't address how long they may take to inform the insurance company, only how long to file it with the state and how long they have to controvert the claim if they choose to. A delay in reporting it to the insurance company does not extend the amount of time they have to do these things. It may be unfair but seriously, there just isn't anything you can do about it until this woman returns. You can't hunt her down on vacation and ask why she didn't file it, you can only go forward from here.
                      I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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                      • #12
                        There was something I could do. I called the state and within 2 hours my reports found there way to the carrier with the lady still on vacation. This means that either they were just being lazy or they realized it should have been filed when they recieved my report. Does it make any sense at all that my doctors bills related to treating my injury must be filed with the carrier and paid faster then they would recieve the report that the injury even occured? The only reason why they would not stipulate a time constrait with filing a First Report of Injury with the carrier is because it defies common sense that they would wait so long to do so in the first place. I guess this is a question I will never know the answer to. It seems to me that the first report of injury is the most important one to get filed as soon as possible, as everything else is dependent on the validity of that claim. Thank you for your input.

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                        • #13
                          The day the lady is to return, contact her, if you get her voice mail, leave a message that she is to call you immediately. Tell her if your claim is not handled in a timely matter from this point on, she will be hearing from your lawyer, even if you don't plan on getting one. It may prompt her to take your claim more seriously, or at least in a timely manner. They usually do not want someone to get a lawyer.

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                          • #14
                            Actually, in WC it isn't really a threat to get a lawyer. Most employees do at some point. It is expected so it doesn't really work as a threat. Heck, I tell my employees to seek the advice of one, especially for significant injuries as does the union.
                            I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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                            • #15
                              Originally posted by ElleMD View Post
                              Actually, in WC it isn't really a threat to get a lawyer. Most employees do at some point. It is expected so it doesn't really work as a threat. Heck, I tell my employees to seek the advice of one, especially for significant injuries as does the union.
                              Darn, it sounded like such a good idea lol! I am really glad you are here ElleMD, you teach me and others so much! Just wanted to tell you that, I respect the fact you set the record straight when needed. It sounds like you give your employees solid advise also! I wish all bosses would recommend things such as this.

                              Comment

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