by Steve76 » Fri Jul 04, 2008 09:05 am
Ok. Last year in November I was walking down some stairs in a building here in Phoenix. The handrail was loose and not knowing I grabbed it and it gave out and I fell. I had an ER visit and had some neck pain upper back pain and some left hip pain. Everything was just strain or sprain. Nothing too serious. The company had Farmers for their property insurance and they were actually very nice and the insurance adjuster was nice as well. We got everything worked out and I received my wages, medical bills and apprx. $3500 pain and suffering, which I thought was very fair. Now the STRANGE part. And I realize you do not know me from Adam but I am a very honest person. Last week just about the same thing happened at a different building. When I fell, I notified the office (property management) and they sent me an email stating they were sorry and that they'd had several calls about it but "just never got around to calling someone out to fix it!" This was a lot worse of a fall when it comes to the injuries. I had a bulging disc, nerve impingement and my right wrist sprained (I guess the wrist is not a big deal). Now the insurance sent me medical auth forms and they are going over everything. I told them, and as the medical records state, the first fall was left hip, high back, etc. and this is totally different. Much more painful, more treatment, etc.
I guess my question is am I screwed? I know it is coincidental but it is honest. From my conversation with the agent today he is not questioning the fall, but a pre-existing injury.
I kind of don't get that though. Am I in trouble here? The doc has told me I cannot work for a while. More than likely up to 6 weeks he states. Can't afford to not be able to recover that money, not to mention the doc fees, etc. I honestly did nothing wrong.
Thank you in advance for any opinions.
Steve
I guess my question is am I screwed? I know it is coincidental but it is honest. From my conversation with the agent today he is not questioning the fall, but a pre-existing injury.
I kind of don't get that though. Am I in trouble here? The doc has told me I cannot work for a while. More than likely up to 6 weeks he states. Can't afford to not be able to recover that money, not to mention the doc fees, etc. I honestly did nothing wrong.
Thank you in advance for any opinions.
Steve
Posted: Thu Jul 10, 2008 03:06 pm Post Subject: No work comp
Independent contractors have no work comp due to the fact that they have no true employer. This should be treated as a private citizen claim and should not matter if you have had 2 or 10 falls. Unless the bulging disc was a preexisting condition according to your Medical Records (ie, diagnosis or treatment) than it is going to be very hard for the owner of the building to not accept liability. One more thing, as Lori mentioned, "KEEP THAT EMAIL"!!!!! It is your secret weapon!
Posted: Thu Jul 10, 2008 05:02 pm Post Subject:
Ok thank you. I think what they are going for is just that: Pre exisiting. From what I've read on line, and I don't take it all too serious, is that I may still be entitled to something if it was a aggravation of a pre existing injury. Does that sound right? Also I have an odd question, say I miss 6 weeks of work, can thay come back and say that if I had not been hurt in the first place that this fall may have only caused me to miss 2 weeks, for example?
Posted: Thu Jul 10, 2008 11:20 pm Post Subject:
Does that sound right?
yep, as mentioned aggravating a pre-existing injury isn't 'worth' as much as causing the inital injury...but 'if' that is the case you are still due a settlement, just not as much as it would have been had THIS fall CAUSED the bulging disc...make sense? Also I have an odd question, say I miss 6 weeks of work, can thay comeback and say that if I had not been hurt in the first place that this fall may have only caused me to miss 2 weeks, for example?
Well, I personally wouldn't if I were handling the claim AND you had not missed any work prior for this supposed pre-existing injury...HOWEVER, had you been off here and there for it then yes maybe.Posted: Fri Jul 11, 2008 05:43 pm Post Subject:
Eek, I just read this thread. I hope everything works out for you!
Posted: Tue Jul 15, 2008 10:58 pm Post Subject:
Ok today I received an email asking me and I quote "I should have my review completed by tomorrow 7/16/08. I will look it over and contact you with our position on Thursday or Friday. In the interim, what are the breakdown of your medical expenses and what you calculate to be your wage loss?"
Ok. Now, I know I am nitpicking, but I read "our position" and sort of get a bad feeling. Meaning does he mean may be not covered?
BUT, then I wonder why he would ak me what my medical and lost wages are if they were not going to cover me? What would the point be?
If it is considered a "reaggravation" of a pre existing injury is it the pain and suffering that is lower? Or the wages/medical as well?
Thanks again
Steve
Posted: Tue Jul 15, 2008 11:19 pm Post Subject:
No, most of the time the pain and suffering would be all that is lowered assuming you had not been treating for the prior injury right up to the time or near the time of the new injury...by position she probably means if they are looking at it as pre-exisiting and also may just be using that term for the 'range' they put on the injury.
Posted: Tue Jul 15, 2008 11:42 pm Post Subject:
Thank you Lori. I had not missed even 1 day of work since my last injury. That is a plus obviously right?
I can deal with the pain and suffering being lower I just don't want to get screwed on my out of pocket.
Thanks
Posted: Wed Jul 16, 2008 12:22 am Post Subject:
That is a plus obviously right?
yep as far as the adjuster is concerned... :wink:I can deal with the pain and suffering being lower I just don't want to get screwed on my out of pocket
shouldn't be an issue...remember that first offer is generally at the bottom of the ''range''Posted: Wed Jul 16, 2008 12:28 am Post Subject:
Ok last question then. If their first offer is near the bottom but it is an amount I would be happy with should I take it? Or if I go back with another number will it take a lot longer and/or have them change their mind on offering anything?
Thanks
Posted: Wed Jul 16, 2008 12:33 am Post Subject:
Depends on how high your counter is...If you want to take the first offer then go right ahead....If you were my son/brother/ I'd tell you why don't you come back here and post, after they make their first offer, tell them you really thought it should be a little more, and you want to think about it....and you'll call them back in a day or so... :wink:
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