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Heart attack Florida

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  • ElleMD
    replied
    Spending the money on a lawyer isn't going to get you out of paying the employee/claimant.

    Leave a comment:


  • rear-ended
    replied
    TM,
    It is people like this employee who ruin it for people who do get hurt on the job. No wonder why employer's fire people, can't blame them when stuff like this happens. If I was in your position I would spend 20k on a lawyer rather then letting him have 10k, course that is just me. Hope your outcome with this is better then you anticipate.

    I recieved a phone call from the ins carrier when they found out I didn't have a lawyer wanting to know if I was interested in settling, caught me off gaurd, talked for about 5 mins and that was the end of it. Can't settle anyways right now. I guess lawyers like to settle cases, keeps them working.

    Leave a comment:


  • ElleMD
    replied
    Trust me, it isn't any easier being the "one who makes the rules" for a larger organization either. The rule that for every action there is an equal and opposite reaction is not limited to physics.

    I completely understand the reluctance to settle out with someone who is working the system. Trust me, I've been there many times. However, it does help to keep in mind that this person is not going to get rich off a 10K settlement. Neither is it going to break the bank or drive up your premiums.
    Karma does have a way of catching up to folks too.

    The cost of keeping a bad egg on principle and allowing them to spoil the workplace can be much higher. Trust me when I say that other employees are watching and probably are aware of far more than you suspect. Allowing this person to continue working the system is far more detrimental in the long run than nipping it in the bud now.

    Leave a comment:


  • TM1
    replied
    Thank you for the advice, we are a small family owned company that has never had to deal with this type of issue before. I really have to laugh when people say how lucky we are to own a company, and make all of the rules. They never seem to realize the time, commitment and stress that goes along with it. Life moves on, and the peace of mind may be worth the settlement. I just have to give in to someone who I believe is working the system.
    Thanks, TM

    Leave a comment:


  • ElleMD
    replied
    Your IC should have a lawyer on retainer if not on staff. Yes, it will cost, but personally, once you get into this kind of claim, it is worth every penny. If he is not represented, then there is some value in keeping the lawyers out of it at least on an official level. Nothing sends a pro se claiment to a lawyer faster than getting a letter from the defense counsel.

    I'm hesitant to advise you too much, and absolutely this is your decision and needs to be discussed with the powers that be, both within your organization and the IC. I would have fought paying him once light duty was offered and he declined and was off for an unrelated medical reason. However, in the grand scheme, you will spend more in litigation costs than you paid in TTD for those few weeks. I would cut it off now and have a nice long talk with the carrier about having paid it in the first place.

    If he is claiming ongoing nerve damage and missed 20 days of work, yeah, I'd say it is worth settling out. I would absolutely insist on a labor release and covenant not to return to work. That you will need a lawyer to draft but again, your IC should have a boilerplate agreement and legal counsel that can handle this behind the scenes for minimal cost.

    If you want to have this guy continue to work for you, which I would not suggest as he has already refused to work for you twice and been there less than 6 months, settlement is probably not the way to go. I'd just keep this claim going and manage it closely from here. Possibly put a nurse case manager on it.

    As for dollar amount, I hate to say what is reasonable. I will say that a lot depends on how you word the settlement and what is and is not excluded. For example, if you are picking up any and all related meds, I'd settle a lot lower than if you stipulate that no meds that have not already been paid will be, and you know that there are at least a few doctor visits outstanding. I have my own philosophy about that, but you need to talk to the IC and find out what is outstanding, what has been paid, and what they are comfortable carrying. Overall the amounts they are talking about are not far from what I've found to be typical for this sort of situation.

    One thing that a lawyer I highly respect told me which made it easier to accept when it felt like I was paying someone to just go away when there wasn't a meritorious claim behind it was that the purpose of the settlement, is to buy peace. A well drafted settlement means that you don't have to worry about this person or their claim any longer and can move on. You don't have to worry about dragging things out with him.

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  • TM1
    replied
    settlement

    The insurance company has had their lawyer call us. The employee hurt his neck/shoulder on Oct 10. He came into the office on Oct 30, and asked if we had light duty for him. We said yes and that he could start light duty as soon as he was released. That same day we received a call from w/c saying that he had been released for light duty, as of Oct 30. He did not show up for light duty and claimed that he that he was not released for light duty yet, even though w/c said that he was. He had a heart attach Nov 3rd and had not yet come back into work. He has worked for us for less than 6 months as a delivery driver and there are always two people on each truck to carry items.

    So, as far as I know he was released for light duty related to his neck/shoulder on October 30. He was released by the heart doctor on Dec 17, to take an emg/ncv test and be released again by w/c doctor. W/C continued to pay his time off during this entire time. (I do not know if they should have paid this. They did not cover these medical bills). After his second release we sent him a letter stating that we would like him to start light duty of Dec 24. He told the warehouse manager that he was not coming in. He has not called or shown up since.

    W/C and his lawyer now want to settle this case. They want to settle quickly and have convinced my controller that trying to fight the settlement or retaining a lawyer would be a mistake and cost the company more money. They think that he will settle for $5,000-10,000 dollars. Does this sound reasonable? This seems to be excessive for an injury that really should have only kept him off the job 20 days. They are coming in to speak with my employees next week. Is it a good idea for us to settle this quickly or does it seem like w/c is trying to speed this up to lessen their responsibility? About how much would it cost to hire a lawyer to deal with a matter such as this? I am not trying to keep this person form getting any w/c that he is due; I am trying to keep him from abusing my company.
    Thanks for the help
    Last edited by TM1; 12-31-2007, 08:32 AM.

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  • Pattymd
    replied
    Originally posted by Poolguy2008 View Post
    But my point here is that a job can surely give a person a heart attack.
    So can smoking, high blood pressure, high cholesterol, not exercising, etc. So?

    Leave a comment:


  • Poolguy2008
    replied
    I actually had a heart attack too and I feel it should have been covered. I drove a popular brand name bus line overnight and they work you to death. Lots of drivers die from this.
    They call you day and night and you sit for prolonged periods and the blood pools in the legs and the next thing you know you're getting chest pains. I consulted an attorney at the time and was told if it didn't happen on the job (mine happens after getting home from work) it's not covered and he didn't take the case. But my point here is that a job can surely give a person a heart attack.
    Last edited by Poolguy2008; 01-08-2008, 07:50 PM.

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  • cbg
    replied
    I don't think anyone said it couldn't be covered, just that it usually isn't.

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  • complwyr
    replied
    Patty, I hate to burst your bubble, but a heart attack at work can be covered by workers comp in most states.

    It can be an "injury by accident" if it is precipitated by unusual or extraordinary on the job exertion. Most of the compensable heart attack cases of which I am aware arose in the truck driving and law enforcement occupations. Of course, having a predisposition towards having a heart attack due to diet, family history, etc., is irrelevant in most states, as the employer must take the worker as he or she is. If the on the job accident or unusual exertion triggered it, it should be covered regardless of the pre-existing condition.

    But the OP's situation does not sound like a heart attack case that is or should be covered. Sounds like light duty for the neck injury, if that is what it was, extended throughout the time EE was out for the heart problem, which would explain why wage loss was paid during the heart problem.

    And coming to a party certainly does not mean that the person is medically or physically capable of working in any type of labor setting. Those are two completely different and unrelated issues.

    Leave a comment:


  • Pattymd
    replied
    Not that I'm adding anything important to this thread, but I've actually HAD a heart attack at work. I would have never considered filing a WC claim for it, because I couldn't fathom it being approved.

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  • Beth3
    replied
    Too ill to show up to work for light duty but able to come to the Company holiday party. Nice.

    Yes, I suggest you consult with a WC attorney. At this point, I certainly would. You seem to have hired someone who knows how to "work" the WC system so you're not dealing with a novice here. You need to fire this guy for refusing to report to work but you definitely should speak to an attorney first. I'd also be demanding that my WC carrier explain why they've been paying TTD benefits.

    P.S. You should speak to a WC attorney OF YOUR OWN. Your WC carrier's attorney is not going to advise you on any direct liability you may have for terminating this guy. The WC attorney's role is to represent the WC carrier's best interests - which sometimes are the same as their client (your company) but not always.

    Leave a comment:


  • ElleMD
    replied
    Seconding picking up the phone and calling the carrier immediately! Why they paid benefits in the first place if you had light duty available is beyond me. Same with paying benefits if he is well enough to show up to the party. Talk to the adjuster and their legal counsel asap. I would be asking why benefits were ever paid. They need to know all of this.

    He can file for anything he likes, but I can't imagine he has a prayer of prevailing. I'd get your legal counsel on board as far as the termination and such goes, but they will have little to do with the claim.

    Leave a comment:


  • Morgana
    replied
    Absolutley you need to keep your carrier informed. They dont know when he is working and they dont know that he has refused light duty unless you tell them.
    Its sometimes hard to separate out bills from one medical condition from another so you need to make them aware of everything that goes on.

    We had an employee who was charging every medication he had to WC including his diabetic supplies, cholesterol meds and his Valtrex and he had a knee problem. Luckily, they caught it but it could easily have gone thru.

    Your carrier should be your friend and you should be talking often.

    Leave a comment:


  • TM1
    replied
    The claim was filed with the carrier for the original claim as a neck injury. The problems is that after he was approved for light duty, the first time, he did not show up and the heart attack happened within 3-4 days. Workman’s comp continued to pay for his time off during and after the heart attack. They did not pay for the hospital bills. The have advised us on writing a letter, and we have sent it to the employee. The letter stated that if he did not report to work to for light duty that we would assume that he is resigning his employment.

    He told the warehouse manager (after he was released for light duty after teh heart attack)that he would not come in for duty and he has not shown up or responded. I do not believe that they should have continued to pay once he was released for light duty from the neck injury. Can we object to the fact that they continued to pay for his time off. It seems that they paid extra time to try to protect themselves? I believe that this extended pay has encouraged him to seek more money. Even though he was paid for extra time off he has hired an attorney to file for more money for his time off.

    Even though he had no intention of coming back to work he came to the company Christmas party; this is where he announced to the warehouse manager that he was not going show up for work. He heard about the party form other employees that he lives with and decided that he should be there. We now understand that he has filed several workmen’s comp claims.
    Do we need to hire an attorney for this? Can we as a company be held liable for any of this nonsense?

    Thank you for your help.
    Last edited by TM1; 12-27-2007, 11:21 AM.

    Leave a comment:

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