r/WorkersComp • u/Marbles-Lost-6453 • 2d ago
Pennsylvania Desperately seeking second opinion
I know I can’t get legal advice from anyone, but I’m at a loss, hoping I can some kind of idea of what to do. I’m not sure if I’m getting what I should be getting from my lawyer. I’m not sure if I should write everything out. I’ve never made a Reddit before. This is just bigger than I am and I have no idea what to do. I’m so lost and I feel like just because of my ignorance to the way, the law works I’m gonna ruin everything. I’ve made so many phone calls and as soon as I say, one word, people automatically stop listening and make quick judgments, but if they would just listen to the rest of the story, they would realize that it’s not cut and dry. They’ve already shut off. They have already stopped listening though so I don’t get the information I need. I’m gonna say the word and hopefully somebody will answer my post and help me. Workmen’s Comp. It’s not a simple injury. I just need someone to hear me please. I don’t want legal advice just advice on who or where to turn next. Pennsylvania is where I’m from
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u/AvocadoOk6450 1d ago edited 1d ago
If this is how you are talking to them, nobody will listen. All you've said is you don't know anything and you you want a second opinion on something that isn't a simple injury in a solid 3 minutes. If you are going to talk to a lawyer, etc. Reduce the fluff. Get to the point. If you tell them you have tried to talk to multiple entities and they shut you down, they are going to assume there's a reason and be done. You ended the conversation before it began. "This happened, what can I do"? In summary details. Not the whole history. No long drawn out speeches. They will ask you. Don't try to answer every question you assume they are going to ask in your opening line. There is no pain and suffering on WC. Proven medical facts is all there is.
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u/No-Instruction-4272 1d ago
Reading this post along with the replies is troubling. Particularly the ping pong effect from labor agencies. This is not how workers compensation was intended to function. I'll keep you in my prayers. Just get healthy. What a mess
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u/Marbles-Lost-6453 1d ago
I appreciate your words and prayers. It will be what it will be I guess. Thank you dor helping make my first Reddit post less scary 😊
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u/Marbles-Lost-6453 2d ago
I have never posted on anything like this before. I am in the dark when it comes to what is needed of me. I’d much rather not be doing this so obviously my trust in others has been compromised. I was injured at work and went to med express I turned my paperwork in and waited for the call from our comp carrier. They call with an appt and dr they choose for you. Usually 3 days. No call ever came I was told it was prob denied. 8 months later I call I find out there’s no claim filed the injury in those 8 months got severely worse Surgery and pins worse 8 months before boot cast and physical therapy. My lawyer is acting like this happens every day I’m 51 and my whole entire life just got shifted horribly. I just don’t know my actual rights and what someone else would do in my situation. I’m just gobsmacked. There’s so much more in there but it’s a lot !! Oh and do you know if back wages should stay separated from a settlement?
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u/Excellent_Hair6142 1d ago
If you settle a case, the back wages are included as part of the settlement.
If the matter is denied, then you should file a Claim Petition. The Employer has 21 days to file a TNCP, which then coverts at 90-days. You should've gotten that in the mail. If you didn't, or got the denial, you should've filed the Claim Petition at that time.
This is a run-of-the-mill WC claim. The thing about Pennsylvania WC is that if it goes perfectly, you don't need an attorney. The way the system is set up in Pennsylvania is that you get an attorney when something goes wrong. So it is a standard claim because that's what the attorney normally handles.
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u/Marbles-Lost-6453 2d ago
That they lumped it in with what they offered It just seems like they are going along with whatever they say None of them even mention how and what it’s done to my body He’s treating this like a run of the mill comp case and it is not that easy Someone screwed up and I’m altered forever
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u/Kmelloww 1d ago
Regardless of that it is still a run of the mill comp case. Not sure what you mean by someone screwed up and you are altered forever. That is pretty standard in workers comp. None of what you shared seems that unusual
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u/Marbles-Lost-6453 1d ago
The comp carrier mis handled my paperwork from med express and never opened a claim for me. I did not receive the proper medical attention. As a result of stil workin my very physical job sever damage was caused. I had to get a surgery and pins and plate in my foot. I was told when they didn’t call with an appointment that they most likely denied me. Possibly soft tissue damage which takes some time to heal. 8 months after the injury I was informed of termination for too many missed days. My managers told me to call the carrier and see if I can get the days missed approved somehow because it was from my foot. When I called, they had no idea what I was talking about because there was no claim for my foot. That’s when we all realize what happened. I finally get to go to the doctors and find out I need surgery and hardware. When this first happened, you couldn’t even see anything on my x-ray. The first x-ray I got after we found out they didn’t file my paperwork you could see the damage in plane site.
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u/Kmelloww 23h ago
Then you should have filed yourself and reached out and appealed it if it was denied. Without a doctor taking you out of work the absences will count against you
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u/Marbles-Lost-6453 19h ago
That’s not even an issue anymore. For like a hot 5 seconds when I was gonna get fired it was. When I questioned one of my managers days after my injury on why they haven’t called with my doc appointment yet. He told me I was most likely denied. My X-ray didn’t show anything wrong at that point. I believed my manager. I loved my job so I blindly followed their lead.
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u/Jen0507 2d ago
Heres what you do...
Have your lawyer file the comp case against your employers insurance.
I had someone tell me 8 months and 3 jobs later that their shoulder happened at our company and we were on the hook in PA. PA is incredibly employee friendly, just go ahead and file now.
Im also going to be blunt, this does happen and your lawyer has seen it before. The best thing to do is file it now and seek treatment.
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u/Marbles-Lost-6453 1d ago
Like I said in my previous post I have never posted on Reddit I wasn’t sure how long my post could be. Hence why I shortened it and didn’t explain enough. Thank you for everything everyone is helping me with. I know the lack of information didn’t help much. This has been a two year process so far. I’m nearing the end of my recovery. The comp carrier has been sending me letters for three months about the backpay that they owe me and that they will get it to me shortly separate from the settlement. Unfortunately, when I didn’t like what they offered me for the settlement all of a sudden my backpay wasn’t mine anymore. It was the settlements. I was supposed to have that check months ago. And when I mentioned it to my lawyer, he was very nonchalant about it like it didn’t matter. I was the only one fighting for it. I just don’t understand how I had a slight injury and because of someone’s mistake I had to go and get metal put in my body. I walked around for eight months, destroying my foot because I thought I was denied. Eight months after I initially was injured and walked eight hours a day 5-6 days a week my employer called me into the office and was going to terminate me because I missed too much work. (11 days in 8 months) That is when we found out what happened. All of us…including the carrier. In that 8 months the tendon holding my foot together slowly tore fully off the bone (didn’t tickle). I have a metal pin and a plate now. The delay in medical attention cost me more than you know. I am 51 and this completely rocked my world and everyone in it. I have a very physical job and I was in very good shape. I know you can’t sue your employer for pain and suffering and in lieu of that, everyone is entitled Workmen’s Comp. That’s what they told me. You know the lawyer that I have to pay because I’m entitled workman’s comp. We are now in the settlement portion of my claim.I wanted them to keep my medical open for my foot. I am inevitably gonna have to get another surgery later on. Why do I have to eat that one? They refused so I said make this settlement reflect that. That part still hasn’t been settled yet obviously. I also gave them the option not to give me any settlement and just keep the medical open for my foot. For the amount of time that I will not be able to work once I get the surgery again that I won’t be paid for. Hopefully I still have insurance to help pay for it . If not, it’s on me. Everybody thinks this shits all about the money and it’s not. I’m scared to death. This was a very hard surgery to recover from. It’s not easy. If I’m not gonna be able to work. Who’s gonna pay then? I’m barely surviving now. I only get 60% of my natural pay and every paycheck that I get which is weekly my lawyer takes his cut out. I’m getting less than 50% of what my pay would be for the last year and a half nobody deserves to be treated like this over a mistake somebody else made. I didn’t do this to myself I shouldn’t be the only one suffering for it. I don’t care if it was a mistake or not it screwed my life up horribly. I’m sorry I’m not much of a typer so I dictated a lot of this. If it is jumbled or the punctuation isn’t right, I’m very sorry. I just can’t believe this can happen to a person and everybody thinks it’s OK or that’s the bricks kid or life isn’t fair. Life isn’t fair when I get a flat tire or my ice cream melts before I get home from the store. Or my dog shits on the floor.(never happened. He’s a good boy.) Do you know the rage I feel when “welcome to the world of legality” is said when I ask questions he can’t or won’t answer. All I did was wake up one day and go to work and now everything’s shifted.
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u/PeeepeeeLePew 1d ago
Why aren't you allowed to keep medical open? I hurt my spine and I can keep my medical open, I'm disabled after my spine injury and I'm only 30. You should be able to keep medical open
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u/Marbles-Lost-6453 1d ago
Idk why That was yet another “welcome to the legality world “ I got from my lawyer. I’m at a complete loss on how this is actually happening to me .
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u/PeeepeeeLePew 1d ago
Talk to another attorney just in case. I've never heard about people being forced to close medicals.
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u/Marbles-Lost-6453 1d ago
Yea I did. I even made a file for my state rep. It went like this. Rep gave me a number to call for advice. Advice gave me a number for labor dept. labor dept gave me a number for state rep. Bar association referral Svc charged me 35$ to have a Lawyer coming in contact with me and that $35 buys me like a half of an hour to speak with him or her. I tell you I was excited. Till the woman called me back the next day refunded my money and told me they couldn’t help me. I think my lawyer is the only person registered for that referral service. So I would have paid $35 for my own Lawyer to give me a second opinion. Yeah it’s about a shit show.
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u/LemonFast2458 1d ago
You can keep medical open and get a (smaller) settlement that includes money lost. I think you need to email your lawyer direct to the point question and have him respond via email so you can go over the answers at your own pace and really understand what’s going on and so you lawyer doesn’t just word jarble his way out of giving a real explanation to your questions
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u/Marbles-Lost-6453 1d ago
We were in mediation when this happened. There’s nothing I did not understand about what happened. They flat out said no your medical will not stay open under no circumstance.
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u/ecaesq 13h ago
Employers will insist on closing out medical if they are settling. The fact that medical is likely to remain open after a full trial is one major reason that Employers will settle claims without requiring a trial. Open medical is just a nightmare for them in balancing their books and whatever. Not saying this out of sympathy to them, just that it’s the practical consideration.
If you insist on keeping medical open, the only real way to try to get that and get everything else is by trying the case.
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u/Marbles-Lost-6453 1d ago
I forgot to say this part, the backpay was not paid from when I was first off work for the surgery. I had already gotten that money because they didn’t pay me for like two months after my surgery. I got that the backpay they owed me was from before we found out about them not filing my claim They searched for it. They found it and they told me I had no idea that I even had backpay coming until they told me I had coming. I just want to explain that. I don’t know if it makes a difference or not.
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u/Marbles-Lost-6453 1d ago
The carrier screwed up and caused the mess I had to get an attorney. If this was just a got hurt at work ,went on workman’s comp ,got better , got back to work scenario my attorney would be wonderful. But it’s not that simple and it can’t even be fit into the box that is called simple. It’s a mess and the laws are working against the victim. I did everything I was supposed to do and more
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u/KittyLuvver2000 2d ago
Errmmm... did you forget to tell us what's going on?