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Allen M., Esq.
Allen M., Esq., Attorney
Category: Legal
Satisfied Customers: 17922
Experience:  Lawyer and legal specialist.
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I have a very bad knee injury sustained at work. I am a month

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I have a very bad knee injury sustained at work. I am a month out and my doctor says with the damage I have and the longer I wait the greater the loss will be to the knee. I am waiting on workmans comp(which I wish I would of just skipped and just paid for my surgery) because now they will not release me from my claim and just let me go get my knee fixed. Withouth them releasing my claim my personal insurance won't pay for my surgery either. We are coming to the end of the medical year and I would like to just get this surgery done since ive already met my out-of-pocket max. Rather then pay 5,000 this year and 5,000 next year..WHAT DO I DO?? my leg is going down hill fast I can't even walk.. This is so inhumane!
Submitted: 2 years ago via LegalInfo.
Category: Legal
Expert:  Allen M., Esq. replied 2 years ago.
Hello, my name is XXXXX XXXXX I look forward to assisting you today. I bring nearly 20 years of experience in various legal disciplines.

Regrettably, the only thing you can do when WC is dragging its feet on an issue is to hire a local attorney that does WC law, and threaten to file or actually file suit.

Otherwise, WC has no external entity to force them to act more quickly. Any complaint to an agency or court on the matter would have to be brought by a WC attorney.

You might consider first contacting the WC carrier, telling them that you need to do this surgery now and, if they do not respond in 24 hours, you'll be hiring a WC attorney. That may get them to move on this issue for you.
Customer: replied 2 years ago.

I have done the threatening and that's when they said they would step up and give me the release to have surgery without an approval to just have it ran against my personal until everything gets solved.. But then my personal won't budge? So, there is no way for me legally to tell workmans comp to just back out of it and let me pay for it?

Expert:  Allen M., Esq. replied 2 years ago.
No, once there is a claim filed, they have a legal obligation to give a determination on that filing. This is because WC is a state required insurance....which is why it is such a problem. It is half private and have government run. This is also because your employer is legally protected by WC against claims directed specifically at them.

So, once you've filed the claim with WC, the only way they will release it is if they make a determination that the injury is not workplace related. Then, they can release it without subjecting the employer to an external lawsuit, because it will have been determined that the issue was not work related.

You don't want to now state that the injury wasn't work related (to try and force them), because then you would appear to have been lying the first time, an offense that they could use to terminate your employment.

I'm so sorry that you're in this situation. You need to go ahead and immediately contact a local WC attorney, who can get this issue resolved more quickly that WC will do it on their own.
Customer: replied 2 years ago.

I never told them it wasn't work related I just told them they are making everything way more difficult and I just had a baby and I need my leg and they are doing me more damage then good. I'm afraid I am going to end up going in for surgery and they are going to tell me the tissue is to far gone and I am going to lose % of my ability with my leg and never be able to play football with my son, dance with my gf, or ride my Harley. I am not getting as much pay as I was before and I can't be spending the money we have saved up on a lawyer or my family will end up even worse off.

Expert:  Allen M., Esq. replied 2 years ago.
No, I'm not saying that you said that.

I'm cautioning you against saying that. That would certainly be a way to get them to release your claim, but it would also not work out so well for you.

WC lawyers work on a contingency fee, meaning they only get paid if they recover something for you (aside from minimal fees), so again, this is the only advice I can give you. You can't force them to release the claim and you can't force them to work any faster. The most rapid way to get this surgery done is to get a WC attorney involved.

I want you to be able to do all of those things too, which is why I am strongly suggesting forcing their hand with a WC attorney. If there were any other path, I'd tell you, but there isn't here.
Allen M., Esq., Attorney
Category: Legal
Satisfied Customers: 17922
Experience: Lawyer and legal specialist.
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