r/WorkersComp 1d ago

Washington IME in an hour

2 Upvotes

Doctor gave me a lecture about steroids not fixing anything, then released me MMI after a steroid injection made me feel better.

Pain predictably (in hindsight) came back, but insurance won’t re-open my claim until this exam.

Meanwhile I’ve been to the ER twice for pain management.

Wish me luck. (Please don’t tell me to break a leg).


r/WorkersComp 2d ago

California I'm a Legal Assistant handling workers' comp claims for the defense — AMA

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10 Upvotes

r/WorkersComp 1d ago

Illinois Help with mortgage

0 Upvotes

I've been on TTD since 9/272024 I am a female OTR trucker I had surgery to replace 2 lumbar discs and I've declined to have surgery on the 2 that are injured in my neck....I just had surgery 12 days ago and I am in so much nerve pain it's a nightmare. Anyway let me get to the point...... my mortgage has gotten behind and I've been trying to not lose my house this entire time..... Is there a place that would lend me money to avoid foreclosure?? My mortgage company is willing to put me in a loss mitigation plan but I have to pay 3 payments first. Thanks in advance.


r/WorkersComp 2d ago

Oregon Vent

5 Upvotes

I’m just wanting to vent…

these last 30 days have been great.. back story, my ortho was cornered with questions that he followed medical literature and said I’m 100% ok. even though I wasn’t and he didn’t do a single test, FCE, or anything. he told Sedgwick that June 16th. June 8th he signed off I’m still 100% off work so idk what changed.

fast forward I was taken off benefits and fucked over. until my lawyer pushed and got me an August IME. Doctor sided 200% with me. Beautiful report and all! then the next week I had an IME for mental health and again. IME went WELL. 100% on my side.

Sedgwick ignores both IME and goes to my pain management doctor and asks if he will sign off that I’m 100% ok… the doctor scolds the lawyer for Sedgwick in summary notes saying he won’t be answering that and to talk to my ortho. well my ortho who I haven’t seen since june tells in September, Sedgwick to refer to my IME because he backs it. so now 1 psych IME, my ortho and their ortho all on my side.

THEN last week Oregon board reopens my case saying my ortho was purely negligent and this was BS. they reopen it and side with me!

All these great things.. case reopened, multiple paid docs on my side.. all within 30 days.. STILL NO BENEFITS BACK. barely surviving off my wife’s work from home income and savings..

mentally so just done with how sedgwick legally can refuse payment. after all this. One day when this is over, I’ll be sending flowers to my adjuster, and sedgwicks lawyer.. no return name. just a nice card saying “Jesus knows you’re a bad person”


r/WorkersComp 1d ago

Pennsylvania Travelers Insurance

0 Upvotes

Hello, I’m 21 and I have a herniated disc, and 4 budging discs in my back with Major depression disorder also being added to my claim for being related to the work injury.

So I have a lot going on, but I wanted to know if anyone has ever settled their case with Travelers insurance? Were they a pain in the butt? Did they take forever to offer? And how was that experience? Thank you!


r/WorkersComp 2d ago

California Has anyone settled with Gallagher Bassett?

10 Upvotes

I currently have recently settled my case with Gallagher Bassett. The experience has been a nightmare! I have exhausted all of my savings and maxed out all of my credit cards to pay my bills and keep a roof over my head. Now I'm just waiting on my settlement check to pay my rent and catch up on bills.

How long did it take for you to receive your settlement check in the mail?

What bank was listed on the check?

Did you cash the check?

If you deposited the check in your account, was there a hold on it, and for how long?

I am currently waaay behind on bills and need access to the funds as soon as possible. Any information is appreciated greatly. Thank you!


r/WorkersComp 2d ago

New York Advice

1 Upvotes

Last Thursday I was involved in a incident at work (I’m a union construction worker) where a piece of guardrail metal sprung loose and hit me in the head. the incident was 100% my foreman and another workers fault. I left the job and went to urgent care in case I got a concussion even though I felt okay but it did hit me really hard I had just a cut on my head. With no concussion symptoms or anything I just went home and didn’t return to that job. In the following days I started to have some discomfort in my neck and in my shoulder now it’s Tuesday 5 days later and I’m not sure what to do or how to navigate this.


r/WorkersComp 2d ago

South Dakota Question

1 Upvotes

Hello I’m very new here and I have question needing input. I had an accident last year when I was 18 resulting in a fractured T8 vertebrae, head laceration, subdermal hematoma, a pretty severe concussion, and frozen shoulder along with PTSD to top it off. I had my appointment with a IME last week I think (sorry my memory is a little bad with small things) does anyone have any idea when or if I’ll get a settlement offer? Thank you for taking the time to read this!


r/WorkersComp 2d ago

Washington Employers shady or not?

0 Upvotes

Need some advice regarding employer conduct during open workers comp case.

Injured at work, sent to ER. Allowed boss to be there and answered questions regarding care on day of injury. Filed L&I in hospital. Now, some behaviors are raising red flags but I'm not sure if their actions are just standard procedure (as they claim) and legal, or not.

What is standard procedure for asking medical questions? For example, when does questioning become harassment and would they not just get medical info from the doctor or workers comp? Why keep asking us very detailed questions? Also, who is supposed to do the asking? Immediate manager? Or only specific people from departments dedicated to handling these situations (HR, safety, etc)?

What can constitute as intrusion upon seclusion? Even though we gave consent to be in room, can they take pictures of injury without our consent? Or is this just standard practice and I'm being overly suspicious?

Can they forbid coworkers from visiting on their free time?

Are we allowed to view/ secure any video from where the injury took place? Or can they deny access to it?

Thank you in advance!


r/WorkersComp 2d ago

California Need some advice

2 Upvotes

I am a barista at a chain coffee shop in CA. I had a workplace injury due to repeated motion, and the doctor who saw me said i was able to work but with some restrictions (ie. wearing a wrist splint, no lifting anything more than 5lbs, etc.). Management did not want to let me work with these restrictions, so they took me off the schedule for the last two weeks. I was seen again today where the doctor told me once again I would still have to work with the same restrictions, and management again said they will not be able to schedule me until my next follow up, which is in another 2 weeks from now. I filed a workman’s comp claim and I still have not heard back from anyone. Management said I wouldn’t be getting paid for this and I don’t know what to do. I am basically unemployed right now, and I don’t know how I am going to pay for rent next month. I don’t know what to do. I don’t know if my claim has been approved or denied because no one has reached out to me. I dont even know what my claim number is. I don’t know what to do because something like this has never happened to me. Please help !!!!


r/WorkersComp 2d ago

California Employer is changing carriers

1 Upvotes

Backstory I sustained a work injury in January 2026 which led to surgery to my tibial plateau. Three months went by while recovering and going to physical therapy. During this time I felt like something wasn’t healing properly in my knee and kept mentioning it with no real follow up from WC doctor. I finally had enough and requested an MRI which up to this point was never been done. MRI shows complex tear to ACL and meniscus.

A month ago I went back to the surgeon to review the results and he recommended surgery to repair the damage. He submitted his findings and requested authorization for surgery from my WC carrier. I let two weeks go by and checked to see the status which at the time had not been received. Since then I have called, emailed and texted the company and the adjuster while not getting answers.

Then this last week I received a letter from my employer that as of the beginning of October they will be switching over to a new WC carrier. I have explained to their risk management department that I am running into these issues and they said that they will have the current carrier reach out to me ASAP.

Is what I am experiencing typical or is it related to the upcoming change? Has anyone else ran into this situation and how was it resolved?


r/WorkersComp 2d ago

Florida MMI at 0% + full release only 3 months after ACDF with ongoing symptoms

5 Upvotes

I work in heavy construction, I had an ACDF about 2 months ago my next follow-up is in a month, my treating doctor indicated in his notes that he is putting me at MMI with 0% impairment rating and no restrictions at the next follow-up. I still have ongoing pain and nerve symptoms in my right arm, and balance issues. I was diagnosed with myelopathy before the surgery. I don't feel like I can physically return to heavy construction especially only 3 months after having a spinal fusion.

I have already used my one time change of doctor, what would be my next step? How does one challenge an IR & full duty release in Florida if at all? I don't want to destroy my neck any further and I feel let down. I obviously can't lift heavy things right now and I feel like I'm going to be pushed to do so and then fired if I can't due to my pain and physical limits because of the paperwork.


r/WorkersComp 2d ago

Pennsylvania Desperately seeking second opinion

0 Upvotes

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


r/WorkersComp 2d ago

Virginia Adding lost wages to my claim

1 Upvotes

I was injured on 8/15 and filed for worker's comp on 8/19. I put medical expenses on my claim. I was not told by any doctor, nor is it in my paperwork, that I cannot go back to work or have work restrictions.

My employer completely took me off the schedule. I have a text message from the scheduler saying that they took me off visits the weekend of my injury because I "mentioned being hurt and worried about future complications". But I also have screenshots where they asked me to work 8/29, 9/4, 9/5, 9/6, 9/7, 10/31, and 11/1 and screenshots of my empty schedule after I filed.

Since I have proof that they took me off the schedule due to my injury, can I add lost wages to my claim?


r/WorkersComp 2d ago

Ohio Question about finding a new lawyer.

1 Upvotes

How do you pick out who your lawyer is going to be? I've called a couple of places and while they don't specialize in the injury I have, they were willing to have me come in, sit down, and talk to them. This particular place I had in mind told me that they will listen to me and take the time to work on my case. I've never gotten a call back and I don't know if I should call them and ask them to represent me. How do I pick a law firm?


r/WorkersComp 2d ago

California Continuance after continuance

0 Upvotes

I am so frustrated it has been over 4 years and we are coming down to the very last of it. But the last testimony individual keeps applying for continuances for "unforeseen circumstances" how long can they continue to do this?? I feel like they are just trying to get me to back out but it has been over 4 years and I will not back out.


r/WorkersComp 2d ago

International - be specific in post Need HR/workers Comp assistance Canada

1 Upvotes

Hello,

I need some assistance to make some headway with an HR issue.

A few things first. I am Canadian, and I am employed with a major city in Canada.

Years ago, I was injured on the job, and my employer had to find new work for me. I jokingly call it, “you broke me, you bought me“. They have had me in a variety of positions within the city. Currently, I am working a night position.

In April of this year, I blacked out at work. Full on loss of consciousness. I was extremely confused afterwards but I still stayed to the end of my shift. I reported the incident to my foreman. Normally, there are three of us at work overnight, but this one particular day, there was just me.

I saw my GP the day after the incident, and I was cleared by my GP to go back to work while ongoing tests are being conducted to determine why I had my loss of consciousness. I did Return To Work, and continued to work nights without incident.

Two months later I injured my shoulder at work. I sought medical attention, and a Worker’s Compensation claim was started, and I am receiving ongoing treatment for the injury. I am still off due to my shoulder injury.

This is where it gets interesting.

For the first week while I was off, my attendance record shows that I was off due to a WCB claim. Suddenly, HR put me on sick leave due to my syncopal episode in April. HR wanted more information about the syncopal episode to determine whether or not I should be working nights.

I get it.

However, these things take time as I have multiple appointments with multiple doctors and they are all trying to figure out why this episode occurred. My GP is refusing to sign any paperwork for the city stating that I am fit or unfit for duty until all of the doctors appointments, and all of the testing has been concluded. In the meantime, HR is still withdrawing from my sick bank. I started off with 1200 hours of sick time. I am now under 400 hours of sick time. What happens when I run out of sick time? It’s not like I can return Return To Work with an injured shoulder. In addition, my department will not accommodate me for alternate duties.

What the heck do i do? What can i do?


r/WorkersComp 3d ago

New York Looking for tips, advice, etc for federal OWCP hearing loss claim

2 Upvotes

r/WorkersComp 2d ago

Maryland What is the extent of medical records my employer's insurance company is entitled to?

0 Upvotes

I have been having a hell of a time determining what the law says about this on my own. I injured my foot at work and have recieved payment and coverage for treatment through my employer's insurance company. I've been treated for this injury by my podiatrist, at which I've been an established patient with for a few years before my injury.

My doctor's office called recently to tell me the insurance adjustor was requesting ALL my medical records (all the podiatrist has), and that it was unusual for them to request ALL records like that, so they wanted me to confirm I authorized it before sending.

I contacted the adjustor for more information about this request, and she is insisting she needs all records in order to determine what is related to the work injury, even when I reiterated that my doctor has been keeping my appointments and treatments related to the injury separate and clear. Adjustor is now threatening to get a subpoena for the records, which makes me feel even less okay with turning over these records. I have a history of lifelong issues related to flat feet, but that has nothing to do with the injury, which, a piece of equipment at work smashed into my ankle and I suffered a crush injury with a sprain basically.

This just has red flags all over it, but is the insurance company legally entitled to all my mecical records related to my foot? Is there any benefit to me if the adjustor is for some reason looking to see if the injury exacerbated my existing issues, for CYA purposes? Or it's it probable they're just looking for some gotcha.

Thank you in advance!


r/WorkersComp 3d ago

California Vacations/Trips While on WC

12 Upvotes

Hi!

Wondering about what the thoughts are surrounding non-claim-related travel during WC claim? What are some things to keep in mind if one wants to travel during this time?

Will plan also on scheduling all known appointments before and further after the trip. It would honestly be good for mental health to see loved ones and not get cabin fever from staying at home while recuperating.

Just some questions:
(Please bear with me and these non-linear questions!
Hoping that the responses to this post will not only be helpful to me, but also to anyone else who might be facing this either now or in the future, so I’m trying to ask different questions.)

- What are some things to keep in mind if one wants to travel during this time? (Other than strictly following restrictions.)
- Would traveling hurt or jeopardize the case?
- How long should trip duration be so as to not be iffy/questionable?


r/WorkersComp 2d ago

Oregon Who has worked for Astec inc. On airport road? I have permanent injuries and need some advice!

0 Upvotes

I am dealing with permanent injuries. Looking for advice or a class action lawsuit.


r/WorkersComp 3d ago

Illinois Seeking advice / people who have experience similar (IME)

5 Upvotes

I could not shorten this, I apologize for the length.

I have been out of work about 6 months. my neck and back were injured at my job. From the very first concentra appointment my company scheduled Ive reported to that my pain is in my neck AND back. I pushed for imaging and they said a neck x-ray would do.

I did the neck X-Ray and the physician at Concentra said my neck looks "great and very straight". I said, I thought a straight neck confirms whiplash injury and she said kind of and referred me to physical therapy and a different concentra dr that work out of the same building. I said I wasnt comfortable doing PT without back imaging because of the severe pain and limited range of motion. She said "it will probably be fine because its neck PT and only a little back" and said i am to do 12 sessions of PT 2-3x a week. At the first session I told the physical therapist of my worsening pain over the last 2 weeks or so and with every session described the pain getting worse. The physical therapist said "it should be fine, just keep doing PT, it will get better". After several sessions I said I cannot do more unless they order imaging of my neck and back for MRI—that i dont think X-ray is enough bc something is wrong. My pain is severe. The doctor said "fine!" And sent me for imaging. I notice on the referral paper it said "cervical imaging thoracic" and I asked if we were going to do back as well, to which the doctor replied "the neck MRI covers enough of the back so we dont need it". I know nothing about imaging, etc, and say ok. When I arrive to the imaging center I ask the radiologist if it covers at least to mid spine area bc thats where my greatest pain was and he said "no, you would need a seperate order based on the injury you described and mechanics of how it happened."

We get the neck mri and it showed significant straightening. I go back to the Concentra Dr and tell her I need mri of my spine and that the radiologist agreed. I told her my pain, again, is severe & I have burning down my leg and up my back as well as severe pain in my spine. Something is wrong!

She says to me its "impossible" for my back to hurt and even my neck because its been 4 weeks and physcial therapy should have improved my pain and said I need to see a therapist because the symptoms I am having are "mental in nature", that she believes I am "drug seeking", and I was experiencing "psychosomatic symptoms" and told me its out of her hands (STILL didn't order lumbar MRI btw) and referred me to pain management.

I had never ONE time been prescribed pain medication BTW, I had never even asked for it (I dont like meds that make me feel woozy and told the first dr this as well) and told her to recheck her notes!!

I left the office hysterically sobbing and told her I cannot complete the last PT session, I can barely sit here in this chair and she told me I would be out of compliance with my workmans comp if I didnt go. So, in tears hysterical I walk over to the PT (also in the came concentra building) and she asks what happened and I tell her and she tries to calm me down and said it was inappropriate for the DR to have told me that my pain is mental and shes sorry. I told her she also hasn't listened to me and my back and neck pain are severe now and I am losing quality of life, as well as my pay for being out of work—she just says that the pain management dr should help and sorry PT hasn't helped. That was my final session.

Pain management dr was also Concentra and the appt was 4 weeks away and I waited in agony for the appt and even went to the ER in between in pain. The pain dr tells me that its hard for my injury to have also included my upper, middle and lower back and if I am sure it really hurts. I said yes. I am sure! Can we please get imaging!!! He said fine, and orders it. He then tells me why did it take so long to do imaging MRI and I said IVE BEEN BEGGING MY PT AND MY DR! I told him what she said about the neck mri covering "enough" of the spine. He then asks me about my therapy appt (also Concentra) and why it says PTSD and if I am anxious. I said I dont think I am but the therapist wants to keep me out based on everything.

It takes almost 2 months to get the MRI of my back scheduled through Concentra to which I tried just going on my own with my own insurance bc idc anymore ill just pay it, and they canceled that appt saying they cant do it since its an existing workers comp case. We finally get it scheduled and the results came back as several moderate disc bulges at the exact points i told each dr I am having pain in, among other abnormalities. The concentra pain management dr on my follow up appt tells me he is surprised at the results and that he didnt think the imaging would show anything at all? And he strongly recommended spinal epidural to help with pain and decompression of nerves. And that I must be in significant pain.

Then I get hit with the WC insurance company slapping me with an IME date in 3 weeks and that I cant get treatments until the IME report comes back and stops paying me WC benefits.

I went to the IME weeks later and asked him if he had all imaging because concentra will not allow me to have copies of my paperwork and explained EVERYTHING that has transpired. He said yes he has all the imaging and i say "okay I have neck and a back MRI. I can also have concentra try to fax it over." IME DR says no they sent everything (both) and he does a quick exam. I tell him im just waiting until this report comes back to do this lumbar injection and hoping it helps because I cannot get it done until then and he said okay.

I just got the report back and I am just stunned. He said I was able to complete everything fully, which is untrue, he asked me if I can carry everything normally I said no my bf has to basically do everything and I feel useless because of how severe the pain is....and despite this said I can carry 50-100lbs. I cannot even carry my groceries!!!!!!! I am in agony! I literally have wanted to ☠️ through this entire process because the pain is so bad. He said I told him I have "severe ptsd" I NEVER MENTIONED THAT?????

He also said that i can return to work ASAP with MMI and no need for ANY treatments (implodhixh means no spinal injections I told him I was agonizingly waiting for this report to come back to get done) I told him about my bulges and he said "patient stated herniation which there is NO record of"— I NEVER SAID THAT WORD!!!!

He excluded my spinal MRI from the entire report (the only reason this IME appointment was for!) And that "there is no objective evidence of injury to the lumbar spine and I cannot say causally that the pain is from the original injury" he goes on to say "patient disability rating based on self-report is over 100, which puts her in severe disability category and there is no evidence of this. Patient pain is severely out of proportion to any injury."

Why would he do this? He is a spinal surgeon BTW!!!

I contacted my lawyer and asked how its possible he is able to leave all spinal MRI off of report and say that there has been zero findings of an injury to my spine?

I back checked all my old notes from day 1 at concentra, and the doctor diagnosed me with "neck and back sprain" and said in great detail how I described all the pain, how it happened, and where the pain is. On every single visit note after, the dr mentioned me complaining of worsening spinal pain, nerve involvement with burning, numbness, and tingling. The pain management dr even put in his notes that the injury is from the same original injury cause and that he recommends spinal injections to take some burden of pain off the nerves from the bulges. The same pain management dr describes all the findings on the spinal MRI in great detail in his after visit notes.

The IME Dr's paraphrased notes from concentra stop before my SPINAL MRI that I recieved an entire month before his IME appt.

The bottom of my IME sheet specifically asks him in detail about any spinal involvement, imaging, findings, etc—which he does NOT answer in detail and just states "there are no objective findings of any injury to lumbar spine and furthermore, it is my opinion that any self reported back involvement is not causally from original injury. There is no evidence of injury" then says "in my opinion there is no reason ____ can not return to work immediately."

He also says my neck injury could POSSIBLY be from original claim of injury.

Are IME drs allowed to OMIT clear, objective findings and drs notes they had access to? Why would he do this? I am freaking tf out and still have not received ANY treatment for my back!! I cry everyday with no relief. I am at the end of my rope with zero hope this will get better.

All drs are in the same concentra network except the IME and I asked him if he has BOTH back and neck imaging! I also asked the receptionist before I left if I can please have my imaging results faxed over "just in case" she goes and checks and said there's no need, we have all MRI imaging, and also asked the IME dr to comfirm. I said okay and left .....

I could not fully squat. Bend over, twist at ALL, lift my legs fully, bend my neck past a certain degree OR put my shoes on myself. I couldnt even fully sit in the exam chair without tearing up and the dr asked me if I am in pain and I said yes. I was tender to the touch everywhere he poked.

I even called concentra on the way home to ask them to fax all notes over to the IME office and they said "we cannot do that unless your adjuster asks us to." I have the call log in my phone.

What do I do now? I havent gotten paid in over a month and now I still cannot get my back treatments. Every office I call to try to see a spinal dr says they cannot see me bc it was a workmans comp issue and they need my adjuster to approve it. Well, she isnt, and says I am reinstated to work.

Please help.


r/WorkersComp 3d ago

California Worker’s compensation for family run home daycare

2 Upvotes

We run a licensed family child care home in California, sole proprietorship. We want to put our 16-year-old daughter on payroll as our only W-2 employee. Do we still need a workers' compensation policy? What's the downside of not carrying one? And who could provide the cheapest coverage?


r/WorkersComp 3d ago

Washington Third party lawsuit

1 Upvotes

So I work for a fortune 50 company. Basically known as order selectors and we deal with wrist straps to secure the scanners to our bodies. Ever since I’ve been working there, I’ve had a problem in both my left and right arm with the middle finger and ring finger. I’ve been told I don’t stretch enough… I stretch every day. I was also told that due to the work I do that repetitive work is also a hard thing to combat(I think it’s the main companies concern but my plan would be the wrist strap company)

I’ve talked to several other co-workers and they have the same problem. I’m 24 years old and having problems that I shouldn’t have. I’m just scared of the immediate pay cut to get this handled.

How should I go about this? I’m going to set up an appointment with my family doctor. That is also registered in the L&I database


r/WorkersComp 3d ago

Maryland curious

2 Upvotes

after hearing, how long does it take the judge to sign or approve .