Posted on 11/28/2020 9:36:55 AM PST by kingu
I had a traumatic injury at work, a broken bone which hopefully I'll eventually be permitted to see a specialist so I can begin my healing. In the meantime, it has been a tremendous upheaval in the household as I was the only person who drives. Thankfully I've got two people at home who can help me around.
I'm wondering what or if ECOMP reimburses for needed equipment like a hand shower and transfer bench or if that just comes out of my pocket. I'm still trying to puzzle out how to get to their approved doctors who are over 45 minutes away since local facilities no longer accept federal worker's comp cases (even though it'd be covered by my insurance.)
And reading through Doctor Google, it appears that my facture will mean about 7 months out of work from the time of actually treating the injury instead of the palliative care I've had to this point.
If anyone's gone through this process, some advice would be great. I've already apparently broken a major rule by filling the prescription from the hospital with my insurance and paying the $1.30 co-pay. I am a federal employee, this was an on the job injury. Scary part is had I done this in the off hours, I'd probably be in a much better situation, or so it seems at this point.
If they can not then they should be able to refer you to someone who can.
All the best for you.
$1.30 copay. lol. I have a $8000 deductible and no R/X is covered until deductible is met.
Do you have short and long term disability insurance?
I can only address it generally. If you have a work injury, file a workman’s comp claim, and get a worker’s comp attorney. The attorney will send you to a doctor and that doctor will prescribe what you need to function. The fees paid to the workman’s comp attorney are paid by your employer.
As a former Health, Safety and Accident Prevention Manager that dealt with Worker’s Comp as part of my job on a daily basis, it would help to know which WC System you fall under.
I can assure you that most employers work very hard to avoid paying as their WC Lost Time Accident Frequency Experience drives up the insurance costs.
As to what it pays for, if a physician prescribes it, you are entitled to it, but that does not mean that the insurance carrier will not require a second opinion from their own physician. Frequently they tend to be the best opinion money can buy.
You may end up hiring a WC attorney to force the issue.
Hopefully this helps, mend well FreeperFriend,
Gunner
Federal employees have access to the best insurance on the planet. I would make use of that instead of getting jerked around by workman’s com.
I'm having a tough time visualizing this.
ML/NJ
No, I don’t have long or short term disability insurance, and wouldn’t qualify now for it. It was something I was actively working on investigating - should have pulled the trigger, but, well, it is 2020.
I’ve got a $3k deductible, most of it was the automatic discount off of retail prices (HDHP HSA plan.) I’ve been extremely impressed by the overall plan, but wish that mental health was included in the telehealth coverage. Then again, that’s probably now injury related... Soo confusing.
I plan on leaning on her heavily come Monday to make sure everything’s been forwarded to ECOMP appropriately now. They broke a lot of speed records in getting the case to them complete with the agency reviewer report and management approval (less than 24 hours from the incident) which I think utterly confused ECOMP.
There are some of us who actually work every day.
FECA, it’s under ECOMP from the Department of Labor.
If You need a shower chair DO NOT GET/USE THE PIECE OF &H!T ONES SOLD AS SHOWER CHAIRS !!! THEY COLLAPSE AND YOU RISK MORE INJURIES.
Go to Home Depot/WallyWorld/etc and get a New 5 gallon bucket with lid and get a Square Boat Seat cushion that is a Flotation Device. Fill the bucket with at least 4 gallons of water (for a no tip over weight and safety) and a splash of Bleach (to prevent nasty growth inside the bucket), snap the lid on it and put Float Seat Cushion on top. Way SAFER and costs less.
I don’t know about fed WC but get a nongovernment Advocate because the insurance scum only care about themselves and saving money !!! The ins co will blame You for everything and also accuse You of faking injury/committing fraud so watch Your 6 All the time day/night. They will have a PI of some kind following You around.
I went through a freaking hassle and things you can’t imagine and that was on the State level.
An interesting viewpoint, especially considering you can view all the options for federal employees online here - https://www.opm.gov/healthcare-insurance/healthcare/ While I'm really satisfied with my insurance, most states offer low (or no) income residents coverage that far exceeds that.
Thank you for the great solution there. It’ll probably be not as useful for getting me in and out of the tub, but we did have questions on how to support the leg once I’m in there, and there’s the solution we needed. Though I’ll probably use a gel pack instead since it’ll keep the leg immobilized since I’m just in a soft brace until I’m finally approved to see a specialist.
Normally you will be dealing with a claims adjuster from the WC Carrier. If you are union, you should be able to have them involved. I am more familiar with the Long Shore and Harbor Workers Compensation Act. (USLH) Was an investigation conducted into your injury? OSHA may become involved depending on the type and extent of the injury. Employer is required to conduct an investigation.
For the most part WC is WC. A WC attorney usually works on a contingency flat rate.
Gunner
Investigation was concluded within 6 hours of the injury. Signed off by the OIC for the plant. OSHA was filed; I’m sure that’ll result in further investigation on plant practices.
Since it’s Department of Labor who handles the claims, talking to the people there is, well, yeah, much more entertaining talking to walls since they don’t stupidly repeat the same things and probably walls listen better.
I may just have to break down and consult with an attorney, I know I have a long recovery arc for this injury and I can’t imagine weeks worth of waiting would improve that in the slightest.
With OSHA conducting an investigation, depending on severity, they may issue citations to the employer. Not so sure how that is going to work with DOL citing the government.
As to an attorney, find the most feared WC attorney, just takes asking around, or if you are union, they will know which rat bastage is the best.
I was the employer representative on such things and was the person fought to keep costs down. I know how the game is played.
Gunner
Be aware that WC claims are put under a microscope and they are looking for every excuse they can not to pay.
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