Q: Open WC case at current employer from an injury 3 years ago and now need surgery.
I herniated my back almost 3 years ago. My company accepted my claim and it remains open. I been back to full duty after being off for 3 months from the injury that happened 3 years ago. I have pinched nerves that suddenly appeared around this injury in October of last year. I been treated with my Dr with multiple injections with no avail and I used my own insurance to pay for it. The company never wrote up an incident report from the re occurrence in October but I reported the treatments and Dr appointments through e mail. The Dr is also the WC Dr that treated me and she put me on light duty for 2 months. Now I'm back to full duty and my problems are worse. Mid March will be 3 years to date of the injury. Can my open claim cover surgery to get me back to normal? Can I still be denied even though it is still open? I am currently working and at full duty but need this surgery because of the issues I am dealing with.
A: Assuming this is truly an open claim for an accepted injury than yes it can be used to cover the surgery and related lost time. With the gap during which you returned to work combined with the potential new injury in October and your doctor billing your private insurance instead of WC, it is very likely that entitlement will be disputed. If you have a lawyer, you should give them a call to discuss your options. If you do not have a lawyer, you should consider retaining one.
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