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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 85888
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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I am a professional firefighter with the City of Kirkland and

Resolved Question:

I am a professional firefighter with the City of Kirkland and work under the LEOFF 2 retirement system. I have been on total disability for two shoulder repairs since 1/9/13. My employer has began deducting 40% for some time now from my leave balances as the RCW states if I'm on total disability for longer than 6 months, 40% will be incurred by the employee.

1. My left shoulder is now fine but my right shoulder is still needing PT to return to full duty. My claims manager "attached"my right shoulder "injury" to the left. I had right shoulder repair 5/28/2013.

2. I am trying to get my claim separated into two claims. Both are on the job injuries. my claims manager denied the reopening of my right shoulder claim stating "I re-injured
it from overuse because of the left shoulder being bad.

My question is shouldn't my 6 months start over with a new injury? What if I went back to "light duty" for a perriod of time before i was to get my shoulder operated on again? My leave balances are low and will run out as I am in need of a second right shoulder surgical repair. Please respond if any of this makes sense.

Thank you

Thomas Bach
Submitted: 7 months ago.
Category: Legal
Expert:  Law Educator, Esq. replied 7 months ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking.

Is the right shoulder injury a separate injury for which a separate workers compensation claim was filed for?

Were there two separate claims filed, one for the left shoulder and one for the right shoulder and were they both injured in the course and scope of your duties?
Customer: replied 7 months ago.

I just filed a separate left shoulder claim on 9/7/13 for injury date of 9/17/12. I did this because when i found out my left shoulder was re-torn my claims manager said he was going to disallow the reopening of the previous closed right shoulder on the job injury closed claim and just "attach' it to the right shoulder claim that was still open. he said I must have re-injured it by 'overcompensating" with my right shoulder. I have had numerous shoulder injuries at work as a 25 year firefighter.


 


I explained this to my claims manager and he said I had a year to file a accident report on the job so I did on 9/7/13 for the injury date of 9/17/12 while lifting weights at the station.


 


I am waiting to see if my claim will be accepted but feel it wont be and my leave is disappearing quickly now at 40% a pay period.

Expert:  Law Educator, Esq. replied 7 months ago.
Thank you for your response.

Your claims manager has no way to know this was a reinjury or from over use and he has really overstepped his bounds, which is nothing new because it is his job to minimize what they have to pay out on workers compensation. Whether or not these are two separate injuries would be based on the doctor's medical reports, not some insurance flunky looking to save money.

Unfortunately, you are now at the point that they have done this that you have to file a workers compensation suit against the employer and go before the workers compensation board with the medical reports showing these are two separate injuries and thus would be two separate claims for benefits and should be separated and treated as such.

The delay in filing for the second injury for almost close to a year is going to be another reason they will seek to deny the claim, so this is another reason you will likely now have to take this to a workers compensation hearing and your doctor will have to have a report detailing how these are completely separate injuries caused by two separate acts that were in the course and scope of your duty to make sure they are treated as such and to get your sick time credited back to you.




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Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 85888
Experience: JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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