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sakuraj

workman's comp

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I had a really bad fall at work (hospital ) tripping over an employee and dislocated my hip and tore my labrum. I had to have surgery and was in the hospital for two weeks.

I will not be able to return to work for 3 months. Do I have a case?

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A case for what?

 

WC should have been paying all your medical bills and 2/3 of your wages.

 

Beyond that you don't get anything else unless you have a permanent disability of some sort and then there are additional benefits.

 

Please explain what your goal is here.

 

And what state you are in.

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Did you ever file a claim for WC? If not, you are way behind the 8 ball here. If your own insurance covered it, they may reject the charges if they find out it happened at work. That means you will be billed. If you haven't filed a claim, you need to do so, but expect this to not run as smoothly as if you had followed the proper procedure all along. You may not get wages for the full time period or have everything covered as you filed late. WC only ever pays 2/3rds of wages. That is set by law and the case in all 50 states. You can not negotiate a better deal with the carrier. You can ask your employer if you can supplement wages with your own leave, though most will not. If you have a disability policy, it *might* cover some of the difference.

 

The only way to ensure you are covered for the medical premiums is to file for leave under the Family Medical Leave Act. If you do not qualify, or have already exceeded the 12 weeks of leave, you can be held responsible for the full premium. A hospital likely has more than the 50 employees required, but have you been there at least 12 months, and worked at least 1250 hours in the past year? This still only covers you for 12 weeks. if you are off for longer, you can be charged the full premium.

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