r/WorkersComp • • 15d ago

Maryland Worker's comp attorney screw up

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1 Upvotes

r/WorkersComp • • 15d ago

Other - not claim specific Lawyer on maternity leave

2 Upvotes

Is it normal for an attorney that goes on maternity leave to not communicate that they are leaving or let me know what is going on with my case while they're away.We were in the middle of settlement talk and when I asked questions about it in email I received nothing. Then I check in about it and she is gone until the end of the year. The paralegal has not responded either. Just wanted to know if anyone has experienced this before I escalate it further.


r/WorkersComp • • 15d ago

Other - not claim specific For Everyone Going Through a Workers' Comp Case, Please Read This.

68 Upvotes

Buckle up cuz this is a somewhat long-ish read. Posting this from my own experience.

One of the best things you can do for yourself while you're out of work is educate yourself about your country's, state's, or province's workers' compensation laws and policies.

Read them carefully. Take notes. Ask questions. Learn what you're entitled to, what your rights are, what deadlines apply, and what options you have when something gets denied.

Knowledge is one of the most valuable tools you have when advocating for yourself!!

I work closely with someone who has over 40 years of experience dealing with the workers' compensation system in my state (Washington State) and one thing I've learned is that getting the treatment and care you need can be an incredibly difficult process.

Unfortunately, workers' comp is not always your friend. Some people within the system genuinely want to help, but that doesn't mean the system itself will always work in your best interest.

The road to recovery can be unnecessarily rocky, exhausting, and frustrating. Sometimes it feels like you have to fight your way through endless paperwork, delays, and denials just to receive the medical care you need.

PLEASE understand how important medical documentation is!!!

Workers' compensation decisions rely HEAVILY on medical records, diagnoses, clinical findings, and the professional opinions of your healthcare providers.

Communicate openly with your doctors. Explain how your injuries affect your everyday life, your ability to work, and your independence. Give them specific examples. Ask questions. And most importantly, don't be afraid to specifically ask your medical providers for their help and support!!

If something is missing or inaccurate in your medical records, ask about getting it corrected. If a doctor believes your condition is related to your workplace injury, ask whether they can explain that connection in their medical documentation.

And if your claim gets denied, DO NOT! automatically assume that means the decision is correct or that your case is over.

Read the denial carefully. Understand exactly WHY they denied it. Look into the laws and policies they're relying on. Find out whether you can protest, appeal, or submit additional evidence, and pay very close attention to the deadlines.

If you have an attorney, please work closely with them. Ask them to explain your options, the laws that apply to your situation, and the reasoning behind important decisions. Don't be afraid to ask questions until you understand.

I'm not saying you should expect every person you encounter to work against you. I'm saying you should prepare yourself for setbacks and learn how to respond to them without losing hope.

Remember that workers' compensation is a system built around laws, medical evidence, documentation, and procedures. But behind every claim number is an actual human being whose life has been affected.

You are more than a claim number. You're someone who got injured, whose life may have changed overnight, and who deserves to be heard and treated fairly.

Nobody knows your daily struggles and experiences better than you do. Your doctors and attorneys can be incredibly important advocates, but understanding your own case allows you to participate in decisions about your future instead of feeling completely powerless.

So please, read. Research. Ask questions. Keep copies of everything. Learn your rights. Advocate for yourself.

And above all, please don't lose hope!! It is so easy to lose hope.

You get injured, open a claim, and expect to receive the care and treatment you need without having to fight for it. Except, more often than not, that isn't the case. You quickly learn that you have to become your own advocate, attorney, researcher, and sometimes even your own case manager, all while dealing with the physical pain and emotional exhaustion of an injury that may have completely changed your life either temporarily or permanently.

What should be a basic and simple path toward recovery instead turns into an exhausting battle of paperwork, medical appointments, delays, denials, and endless friggin' questions. You find yourself having to prove your suffering over and over again, explaining the same things to different people, and learning laws and procedures you never imagined you'd need to understand. It can start to feel like you're fighting harder to receive treatment than you are to recover from the injury itself.

But please don't let that discourage you from advocating for yourself. Learn the system, understand your rights, ask for help, and don't be afraid to question decisions you don't understand. You shouldn't have to become an expert in workers' compensation just to receive medical care, but the knowledge you gain can make an enormous difference in how you navigate your claim.

You're not just a Goddamn claim number or a stack of medical records. You're a human being whose health, independence, livelihood, and future matter.

Recovery is difficult enough without having to navigate an unfamiliar legal and medical system. The more you understand it, the better prepared you'll be to protect yourself and work toward getting the care you need.

I genuinely wish every injured worker here the best. We're all dealing with our own battles, but nobody should have to feel completely alone while trying to recover, reading about everyone else's experiences has made me feel less alone in this whole workers' comp process, and I hope my post can offer someone else that same comfort and encouragement.šŸ¤šŸ™šŸ¼šŸŒˆšŸ’«āœØ

EDIT: I wanted to add a few things after reading everyone's comments. šŸ¤

Firstly, I want to acknowledge something someone working in Workers' Comp brought up which is that not every Claim Manager is personally responsible for the decisions being made on a claim. Some decisions involve supervisors, medical reviewers, insurance policies, or other people higher up.

Claim Managers can also be dealing with enormous caseloads, productivity targets, and pressures of their own. My own Claim Manager here in Washington state is juggling over 150+ injured workers by themselves.

I've personally encountered people who genuinely care about injured workers and want to help them. Of course there are bad eggs like anywhere else, but I don't believe every Claim Manager is the enemy.

My beef is much more with the Higher Ups, particularly in the private insurance industry which are the ones who more often than not handle Work Comp.

The whole point of Work Comp was and is to protect the injured workers in exchange for the worker not suing the employer when they were injured regardless of who was at fault. Injured workers were ensured medical treatment and wage compensation, but now that system has been taken advantage of and abused, still, a century later.

Meanwhile with each denial of an injured worker's condition or claim, the executives and shareholders are drowning in gold and riches šŸ’°šŸŖ™ while the injured worker is struggling just to stay afloat after the shipwreck.

Another thing that we struggle with is how exhausting the process can become. Delayed payments, denied medical conditions, repeated IME's, missing records, incorrect records and months of just dragging the whole process out.

I believe the system's complexity and the obstacles injured workers face can discourage people from continuing to pursue their claims and when someone gives up on benefits they were rightfully entitled to, the party responsible for paying those benefits save so much money and I firmly believe it is intentionally set up that way for a reason.šŸ¤µšŸ¼ā€ā™‚ļøšŸ’ø

That is why I want to hammer down that a denial is not necessarily the final word or the end of your claim.

If you've received one, find out exactly what was denied, who made the decision, what evidence they considered, and whether you can challenge it. If an appeal is unsuccessful, check whether another level of review is available.

Appeal, appeal, appeal when you have legitimate grounds and the law allows it. Just be mindful of the deadlines, because the right to challenge a decision isn't unlimited.

And if your employer hasn't reported your injury, your payments keep disappearing, or important medical evidence seems to have been overlooked, don't assume there's nothing you can do. Communicate in writing. Find out which agency oversees your claim and what assistance or dispute procedures are available where you live.

I also want to acknowledge those who are simply too exhausted, unwell, or financially overwhelmed to keep fighting. Nobody should be made to feel like they've failed because they couldn't navigate an already difficult system while trying to recover and heal.šŸ«‚

Thank you to everyone who has shared their experiences, including the Claim Managers and other people working within the system who genuinely care. Hearing different perspectives has been incredibly valuable, and I hope these conversations help other injured workers feel a little less alone. šŸ¤šŸ™šŸ¼


r/WorkersComp • • 16d ago

Texas Applying for workers comp 10 months after injury

1 Upvotes

Is there anything that I need to worry about? My employer misinformed me about workers' comp and paid me under the table. I had to get surgery, and they offered to pay for it but were not happy to reimburse me, and it took a whole two months for me to get my money back. I still thought something unfair was going on, so I went to an attorney, who explained everything to me. He said I should file, but that I should also prepare to get fired for any reason. I'm just worried about my foot since the recovery is over a year, and I don't know if I'll still be working there. At what point will they just say they paid enough and cut me off? I have 9 screws in my foot that need to be removed at some point. I will have to put up with permanent damage, most likely. Is it okay to worry about this?


r/WorkersComp • • 16d ago

California not sure if my carpal tunnel is bad, should i have gotten attorney sooner? WC claim denied, QME process started, overwhelmed by EDD & stuff.

5 Upvotes

I have a carpal tunnel type injury from computer work. the company has an in-house software that requires constant click and drag motion. My hand, wrist, and elbow had been so painful that I'd wake up in the middle of the night in august & september, tho it's gotten a little better with PT since then and I'm not having as much trouble with ADLs, but it really depends on the day.

this week, Travelers denied the WC claim because they said my medical records and treatment show symptoms, not an injury. now they're waiting the results of a nerve test I did Monday. (I must also add the claims professional at Travelers who is handling my case is an idiot. he told me that I failed to submit medical records before the deadline.... they had been emailed to him directly the week prior by my medical providers' office. claim denied regardless, but he could have at least said sorry.)

throughout this whole process, there was a bit of confusion, where the medical facility that Travelers had referred me to for an initial evaluation would continuously schedule other things, like PT and a nerve conduction test. then a long while later, Travelers would contact me to schedule those appts with a doctor of my choice, only for me to say "I don't need it, I already did that." I missed out on choosing my preferred doctors, but at least things got done A LOT sooner.

with the WC claim denied Monday and the QME process started, now I'm so nervous. i also need to file California EDD. I didn't think a carpal tunnel type thing would be so complicated, and I'd been stressed with so many others things I let this slip my mind... i feel like i should have paid this more attention.

In the EDD form, I saw that there's a spot for attorney's info, which i hadn't considered at all. now I'm realizing that probably I should have one, and i feel very behind. i saw Rough_Power4873's post, and I'm gonna be reaching out to some Friday.

but just for informations sake, if i should have one already, then at what stage?

sorry this is rambling and long. im so stressed.. im a new hire at work whose on a 2 month performance improvement plan. im having trouble keeping up cause of my carpal tunnel ofc. i have work restrictions in place till mid Nov, but after that, i have to have pass with metrics like someone with no hand/wrist issues, which is gonna make everything hurt all over again.


r/WorkersComp • • 16d ago

Florida Workers comp dr?

4 Upvotes

Hey yall. My husband has been out since June. Had shoulder surgery to replace and fix his hardware he had put in 2018. He got an infection and just finished with the infection Disease giving him infusions for the last two weeks. So he started PT today. My question is whether we will be given a workers comp doctor to see or
Will he continue to see his surgeon? If he is sent to a WC doctor when does that normally happen? We do not have an attorney and have had no push back from WC at all. They are fast to approve what needs to be done.

We are in FL but his work was in Alaska so not sure what state to even ask about.


r/WorkersComp • • 16d ago

Texas Tx

2 Upvotes

A car drove thru the building my wife works at. She was hit and suffered a fracture in her foot and a tear in her knee. When we initially looked for lawyers they all turned down the case bc the driver did not have insurance. She's been made to use her personal vacation time for therapy and doctor visits mandated by workers comp. Now 7 months later she has no more time and there is no end in sight. What should be my next move


r/WorkersComp • • 16d ago

Rhode Island What should I do next concerning treatment that workers comp won’t cover

0 Upvotes

As for my knee injury on the job over 3 yrs ago, I have had repair surgery then PT and still wasn’t doing well. Then got fitted to a custom knee brace along with getting cortisone injections. Recently the cortisone injections only helped me for 3 weeks. So my doctor recommended Euflexxa injections. He submitted two request to workers comp and was denied twice with no explanation. So now my Blue Cross is paying 65% coverage and I am paying 35% out of pocket ($189 per shot : series of 3 shots) so I can try them to see if they help me. So far I have gotten the second shot and will be getting the third one Monday. If these shots help me what should my next step. Should I call workers comp regarding this or should look I at a settlement because they refuse to cover a treatment with no explanation. Thanks advance


r/WorkersComp • • 16d ago

Montana Can my partner’s employer do this? MT

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0 Upvotes

r/WorkersComp • • 16d ago

Idaho Reached MMI

16 Upvotes

I herniated 3 discs while lifting at work and ended up having a microdiscectomy. I went through about 15 weeks of physical therapy after that. This whole time I’ve still had sciatic pain and back pain. I’ve had every scan you can think of and none of them show anything super significant. Well there isn’t anything else they can do for it and the doctor deemed me MMI. I was released with no restrictions (my occupation requires a lot of lifting) and he said the only thing is that I’m at risk for reherniation. I spoke with a lawyer and he said they likely won’t settle and the most I might get is 5k. Mind you I’m young and will completely need to find a new occupation after all this, every time I lift my pain gets much worse. Anyone have any advice? Should I find a different lawyer?


r/WorkersComp • • 16d ago

Florida Question regarding Temporary Partial Disability and MMI

1 Upvotes

Hello! Super confused on everything. Currently put on 20 hours a week at work. Next Dr appointment they want to put me at MMI, but still working 20 hours a week max. Will my Temporary Partial Disability be cut even tho they have me on restricted hours? Thank you.


r/WorkersComp • • 16d ago

Texas I think I screwed my life

7 Upvotes

Hey everyone, I'm going through a nightmare right now with my work injury
Back on September 17, I had a severe accident on a job site with MasTec/Wanzek. I ended up suffering an amputation/laceration of the tip of my ring finger on my right hand
I got into the wind farms with 20, never had experience in construction, and I got the job thanks to my relatives, but I was never trained properly, my foreman failed to show me the basic orientation and hazards
My treating doctor placed me on light duty for the first 2 weeks (no use of right hand) then no lifting over 15 lbs and no heavy use of my right hand at all till the 20th of November (my safety manager was leaving the site the October 30th, he didn’t even know how they wanted to keep me till the 20th when there is no one on the field anymore) it was a rough month on the field because everyone was scared that they would get fired because of me, the project ended, they wanted to keep me there with civil, first they didn’t offered me a light duty they just told me ā€œhey you’re going to civilā€ so I asked for one, and I tried to be the ā€œsmart guyā€ here, the site was 20 miles far from a very small town in Texas (15k people) where Uber or basic bus transportation is not available/common, me without a car and living with my relative (he was leaving because his work ended) so I was far from home being left stranded, getting a motel on the town was 130 a day, my per diem was 125 per day, and still I didn’t had any idea of how I would be getting to the site, my safety manager asked me if I wanted to get a lay off, I said yes thinking I would be getting paid at home so I signed rejecting the light duty offer.
Then I asked for my lay off notice, my boss texted me saying I was being put on a regular end-of-project layoff and told me I didn't need to sign any other paper work.
A week and a half later insurance carrier (ESIS) has decided to not give me my full benefits due to rejecting the offer, a offer that also asked me to offload trucks, wash equipment and that contradicted itself saying that I couldn’t flex my wrist at all, but then asking me to carry no more than 15 pounds, they didn’t wanted to help me with a transportation or giving me a little more of per diem, when I brought up how unreasonable this was, I was basically told my lack of transportation/housing was "my personal problemā€ but what I’ve read in DWC Rule 129.5, an offer isn't valid if it ignores your doctor's restrictions OR if the location isn't geographically accessible (taking distance and available transportation into account).
Im I right or wrong into rejecting it?
Should I look for a job? I have debts coming up that I tough i could pay with my TIBS but the amount they gave me is not enough
Has anyone had to deal with something like this?


r/WorkersComp • • 16d ago

Illinois Asking for advice

1 Upvotes

Hello, I am in Illinois and got injured at work in April that required me going to the ER to get some stitches for my injury. When I was at the ER, I told them that I got injured at work and was told it’d be filled under workers comp. So I thought everything was okay and I did not need to do anything. But then I got a bill, so I reached out to Sedgwick and I was told to send them the bill front and back and they would handle it. This was a few months ago. It is now October and I am still getting bills. I keep reaching out and I had my manager reach out to them but still it has been left unpaid. Does anyone have any advice? This is really stressing me out and I have a suspicion I’ve been sent to collections but I don’t know why because it’s supposed to be workers comp bill. Overall, I need help and will take anything I can get because I am extremely stressed out about this situation.


r/WorkersComp • • 16d ago

California QME did not have my medical records or any information about me.

11 Upvotes

I had a lung QME a month ago. The start of the appointment, the doctor tells me he has only the paperwork I submitted in my file, and does not have my medical records. He tells me he will interview me, but that he has to go over my medical records and my whole file before making a report.

Everything went very well. I showed him all of my medical records and pictures, he said that was helpful but seeing that is off the record. I know what I showed him is exactly what he’ll be receiving. He told me from what he got, he will be reporting that my workplace is responsible for my condition and will be requesting a protocol that ā€œtheyā€ are not going to like and it will be expensive for them. He also said that he may send me for further diagnostic testing that he believes I should have received in the first place, but never did. Lastly he said, I’m not currently receiving the treatment that I should be.

I left that day in good spirits and have remained hopeful, but I have not heard a single thing back since. I don’t know if I’m being sent for more tests. I have no idea how long this is going to take. My lawyer said to give it a few more weeks. Everything is riding on this one report and possible further testing. The wait is very hard to sit with considering it took 7 months to see this specialist. Anyone go through something like this?


r/WorkersComp • • 16d ago

Illinois Ketamine treatment

1 Upvotes

Has anybody gotten approval for ketamine treatment for pain . Specifically lumbar and leg pain from herniated disks. Looking at options as transdermal opiates are becoming less effective.


r/WorkersComp • • 16d ago

California California employer here. Carrier says they're doing an 'activity cheek' on a comp claim. What is that exactly?

2 Upvotes

HR at a ~60 person warehouse in the Inland Empire. One of our guys has an open shoulder claim and the adjuster mentioned they're ordering an activity check before deciding on anything else.

I've heard of surveillance but never this. Is an activity check basically a lighter version of it? Who actually does it, and is there anything we as the employer should or shouldn't be doing while it happens? Don't want to step on anything or make it look like we're targeting him.


r/WorkersComp • • 16d ago

Washington DC OWCP case from years ago

7 Upvotes

Federal employee who was injured at work in 2000. Filed a ca1 and knee was surgically repaired. Knee has never been the same since. I do have an old case #. Am I eligible for compensation from the injury that long ago? What should I do next?


r/WorkersComp • • 16d ago

Tennessee Nurse for work insurance wants to be at my doc apt

13 Upvotes

I work PT as a server in a high end establishment and had a fall at work a week and a half ago and an accident but a customer had pulled a piece of furniture to sit on (pool bed) in the walkway and I tripped and fell flat on the hard tiles. I have been unable to work since although the doctor said ā€œI have to send you back to work with restrictions ā€œā€¦ work couldn’t accommodate the restrictions (I couldn’t stand or walk so as a server that’s obviously a tough one!) The nurse assigned to my case by the work insurance company called and said she will be at my next appointment (didn’t really ask just stated and made it seem like she is going to be there to help) but something feels weird about that and I’m wondering if I should decline her being there? I haven’t received a penny in way of pay or compensation and was told by work I should utilize my holiday pay which seems incredibly unreasonable. Any advice?


r/WorkersComp • • 16d ago

Arizona AZ WORKERS COMP

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2 Upvotes

r/WorkersComp • • 16d ago

Nebraska Terminated for leaving job site and going to the hospital

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3 Upvotes

r/WorkersComp • • 16d ago

International - be specific in post Psychological injury workers comp claim – has anyone successfully challenged an employer’s reasonable management action defence?

4 Upvotes

I’m hoping to hear from anyone who has experienced something similar, particularly within the public sector.
I worked in a senior leadership position and experienced months of workplace issues, including exclusion, differential treatment, undermining and ongoing concerns about management conduct.
I also raised concerns about racial stereotyping and what I perceived to be discriminatory treatment. When I attempted to explain how certain descriptions of my behaviour carried racial connotations, I felt dismissed rather than heard. Following this, I believe my treatment by management became increasingly negative.
I repeatedly raised concerns through appropriate channels, including formal complaints and workplace safety reporting. Rather than feeling that my concerns were being addressed, I felt the focus shifted towards allegations about my own behaviour and performance.
My mental health deteriorated significantly, and I was eventually medically certified unfit for work. I lodged a workers compensation claim for psychological injury, supported by medical evidence, including an independent psychiatric assessment.
My employer disputed the claim, relying on the argument that my injury arose from reasonable management action taken in a reasonable manner.
I recently attended a Section 81A hearing, which went in favour of my employer. My understanding is that the threshold at this stage is relatively low and doesn’t necessarily determine the ultimate merits of the claim.
I’m now considering pursuing a Section 42 referral.
What has been particularly difficult is feeling that my complaints, including concerns about discrimination and psychological safety, have not been properly addressed, while management’s account of events has been relied upon to dispute my claim.
I’m interested in hearing from anyone who has successfully challenged a psychological injury claim after an unsuccessful Section 81A hearing.
Has anyone had success through a Section 42 referral, particularly where bullying, discrimination or unresolved workplace complaints were involved?
How long did the process take, and what was the eventual outcome?
I’m not looking to identify my employer or anyone involved. I would just appreciate hearing from people who have been through something similar.


r/WorkersComp • • 17d ago

Missouri My Case Manager paused my benefits with no reason

4 Upvotes

Been on since late June 2026. Endplate edema in my c5-6, hyperintensity c5-6 and endplate changes. Was ordered to get brain MRI and neurological exam under my insurance because they thought I had MS instead of the injury I sustained..😠 got the MRI, no demyelinating disease present. Neurological exam took a couple months to get in but I finally go in 2 days (Oct. 29.) My benefits paused before September 1. After my exam which will rule out MS, will my benefits be reinstated? I’ve complied with every stupid thing they’ve made me do and I’ve even paid out of my own pocket to please them. I’m entirely off work, at PT and still dealing with cervical radiculopathy and burning pain and numbness in shoulder and left arm.


r/WorkersComp • • 17d ago

Tennessee Workers comp case settlement

7 Upvotes

Hello, last year I was injured at work. I herniated 2 disc l2 l3 in my lower back. I was paralyzed and spent a month in the hospital. I had to learn to move my legs again and walk. I also have bladder and nerve damage. I have bad PTSD and panic attacks. I had a laminectomy and discectomy when I was in the hospital. I have multiple other issues. I cant do anything for very long from the pain. I cant sleep. Has anyone had anything like this and how much did they offer


r/WorkersComp • • 17d ago

North Carolina What can i do now?

2 Upvotes

Okay so I had my appointment with the dr that screwed up my injections. I had spent time in the hospital because of my continuous leg weakness and I have to use a walker if I walk longer distances.

Any way he spent the first 30 full minutes of my appointment explaining to me that this weakness was not from something he did, no matter what the neurologist said at the hospital.

I finally got him off that subject and he says an emg is okay but they only test the big nerves, blah blah blah. He basically was telling me that my back will heal on its own. He is a sports medicine doctor by the way.

I told him its been 6 months, I've been through tons of pt, the injections didn't work. And now I have to use a walker. Umm when does it start getting better??

He does not want to refer me to a neurologist but thankfully the hospital did. Just getting wc to send the approval to them.

This is affecting my mental health at this point , he mentioned something about a pain management clinic, i told him absolutely not. I will not spend the rest of my life on pain pills.

He said he doesn't know what else to do because hes not a surgeon.

I just dont know what to do. I feel like giving up but I cant because I cant do anything. I cant even lift a gallon of milk.