Jason’s
company sends him to a medical clinic. The doctor gives
him a note to stay out of work. Jason returns to
the clinic in three days and the doctor gives him another
note to stay out. On
the third visit, the doctor tells him only an MRI can show
if he his disk is herniated. The receptionist
tells Jason she will call him about the MRI. She also gives him
a doctor’s note telling him to work next Monday doing
light duty
.On Monday,
Jason’s boss has him sweep and pick up. Jason starts
getting strong pain going down his leg. He tells his boss,
who sends him home.
Jason has a
voice mail from the receptionist telling him the workers
compensation insurance company has not accepted his case
so they cannot schedule the MRI. In his mailbox is
an envelope with a check from the insurance company for a
few hundred dollars. The check says “Without Prejudice.”
A week goes
by and Jason is no better.
The doctor’s office tells him they cannot see
him. He
leaves a phone message with the insurance company. The hospital sends him its bill. Another week goes
by. He gets
another envelope from the insurance company but it is not
a check. It
is a piece of paper that says “Form 43” and “Injury
did not occur in the course of work.”
Jason hires a
lawyer. A few
weeks later he goes to an informal hearing with his
lawyer. The
insurance company lawyer says the company is not accepting
the workers compensation case because no one saw him get
hurt and he did not report the injury right away. Jason’s lawyer
tells Jason he will need to explain at a formal hearing
how he got hurt. The lawyer tells him there is no guarantee of winning the
case.
The lawyer
tells Jason to use his health insurance to get treatment
from his family doctor.
He also gives Jason some job search forms. His doctor gives
him a pain prescription and also tells him he needs an
MRI.
Jason and his
lawyer go to another informal hearing with the
commissioner. His
lawyer gives the job search forms to the insurance company’s
lawyer. He
also tries to get the insurance company to pay for the
MRI. The
commissioner recommends that the company pay for it. The insurance
company’s lawyer says he will let them know.
Jason gets a
part-time job driving a school bus making a lot less
money. His
wife gets a second job working weekends at a supermarket.
Jason goes to
another informal hearing.
The insurance company’s lawyer says they won’t
pay for any treatment or time out of work.
Several
months go by. Several
more months go by. His
lawyer tells him they are waiting for a formal hearing. A preformal
hearing is scheduled.
Jason’s lawyer talks to the insurance company's
lawyer before they see the commissioner. Jason's lawyer
tells him the insurance company still will not accept the
case but is offering $5,000 to settle.
Jason could
use the money. However,
his back still hurts and he still gets pain down his leg. He asks if he can
settle but still have them pay for doctor’s visits. The insurance
company says no. Their
lawyer also asks Jason’s lawyer if Jason had a car
accident case before.
Jason had an accident
a few years ago. He
saw a chiropractor for awhile but his back didn’t hurt
anything like it does now.
After
thinking it all over, Jason decides his main concern is to
get the medical treatment he needs. He tells his
lawyer he does not want to settle.
