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

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.

A: Dealing with a workers' compensation claim that has been denied can be extremely challenging, especially when facing a serious injury like your cousin's. In New York, workers' compensation is designed to cover medical expenses and lost wages for work-related injuries, but sometimes claims are unfairly denied.

If your cousin's claim has been denied and his current lawyer is not providing satisfactory assistance, it might be beneficial to seek a second opinion from another attorney. This new attorney can review the case details, including medical reports and the reasons for the denial, to determine the best course of action. It's important to act promptly, as there are time limits for challenging a workers' compensation denial.

Additionally, if the injury is worsening or causing other health issues, it's crucial to communicate this to the legal representative. Exploring all medical options, including seeking evaluations from other doctors, may also be necessary. Remember, the right to fair treatment and adequate medical care is fundamental in these cases.