Legal Question in Workers Comp in California
I fractured my ankle at work (11 pins and a plate), and the claim was accepted. Went back to work (non weight bearing). Got a slight fracture on wrist on 3rd day back. Claim was accepted. While off work, my knees are hurting (especially on fractured ankle knee). My ankle surgeons office believes the knee problems are due to the atrophy (2 1/2 months non/limited use recovering) in the knee joints while starting partial weight bearing therapy for ankle. My employer has told my ankle surgeon that they can't treat the knee issue as Workers Comp. the underlying cause of the knee problems is obviously the ankle, my employer must cover the knee problems, right? Obviously, I would like to go to the same physicians that are handling my ankle/wrist (underlying injury responsible for knee)
2 Answers from Attorneys
Sorry to read that you're now in the comp system. You're going to have to consult with a lawyer, but unfortunately you're not in my neck of the woods. I'm in the Los Angeles area and by the zip, I think you're up north somewhere.
Good luck.
David
YOU MUST write on the Workers Compensation Claim Form you are claiming "Both Knees" as a body part. Unless and until the body part is claimed the insurer need not authorize anything (yes even if the treating doctor, Mohammed, Moses and Jesus Christ tell them you have an industrial knee injury). If there is an Application for Adjudication of Claim, that Application must be amended. Get the AMENDED Workers Compensation Claim Form (and the Amended Application, if appropriate) delivered to the adjuster (fax with fax transmission report would work fine) and then you can insist the INSURER treat the knees. I would NEVER use an ankle specialist on my wrist, I would only use a Wrist/Upper extremity specialist... insisting on the same guy may not be your best choice. All are orthopedists / ortho surgeons, but some just do knees, some ankles and some hands/wrists.
Related Questions & Answers
Looking for something else?
10,200 active attorneys ready to answer your legal questions today.
Featured Attorneys
Earn additional revenue and grow your business.
