Q: My cousin injured his hip on his job in the company’s car last year. Follow all the workman’s comp protocols has denied
Since his injury happen, 6 months had to lawyer up. Now my cousin needs a complete hip replacement and is at risk for AVN disease and Crosis if not taken care of. He’s been handicap like this for a year and 2 months now and now other injuries are occurring due to his hip not being fix. He’s been denied since day one by workman’s comp, and still continuing along with his lawyer is also denying him to see any doctor of his choosing and keeps telling him about the “list” and no matter what he chooses he’s denied. Workers comp, keeps blaming it on arthritis! Arthritis does not disintegrate the hip bone just aggravates it. Never was symptomatic til he injured his hip, he’s is suffering tremendously and is in horrible excruciating pain dealing with this bare & raw while still working a full duty schedule! Please need help on this! Options do we have?! His lawyer is Just denying his options!His lawyer knows the risk & he’s SUFFERING! There is more to this want to reach me send me your email
A: Thank you for your work comp question. you seem to be in the dark about the reasons the case is in the position it is in. if that is the case, either your attorney is explaining things or not and /or perhaps you still dont understand? work comp is complex but a good attorney makes it simple to understand. perhaps a consultation with an experienced and thoughtful attorney is needed. you can change attorney if necessary.
A:
Here are a few suggestions on how your cousin can proceed with his workers' compensation claim for his hip injury:
- Document everything. Keep detailed records of all injuries, symptoms, treatments, conversations with the claims adjuster, etc. This documentation will be key evidence.
- Get a second opinion on the injury. Have another doctor examine him and determine if the injury is work-related or aggravated by work duties. This can counter the claim that it's just arthritis.
- Review the denial letter from workers' comp. Make sure the denial is valid and that proper procedures were followed. If not, appeal the denial.
- Consult with another workers' comp attorney for a second opinion if his current lawyer is not advocating strongly enough. Find one who specializes in these cases.
- Consider getting an orthopedic surgeon or hip specialist to examine him and write a letter of medical necessity for the hip replacement surgery. This can help justify the need for treatment.
- File a complaint with the state labor board if the workers' comp insurer is unreasonably delaying treatment. This can prompt action.
- As a last resort, consider filing a personal injury lawsuit against the employer. This option involves more time and expense but can get results if workers' comp continues to deny care.
The key is diligently documenting everything, getting medical opinions that support the work injury, and continuously appealing each denial. I hope these tips help your cousin get the treatment he needs.
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