Have I handled wrong?

An ex-employee called last week and told me she was in pain from carpel tunnel. She was diagnosed with it when she worked for us when she went to the doctor on a different matter (not work-related). She felt no pain at the time and didn't see any need to act. I knew nothing of HR matters then, and though I was her supervisor I also did nothing. Our department manager handled HR issues, and as far as I know, did nothing either.

She then went to work for another company, and later, moved to another city 70 miles away to work for that same department manager who was working elsewhere by this time.

When she began to feel pain she complained, and eventually went to her boss about it. The boss (our ex-department manager) told her to contact us as it originally occurred while working for us.

I have never handled a work comp claim before, and so spoke to my CEO and we called our agent. A claim form was faxed to me last Friday, and I have not completed it yet. The agent told me that an investigation would be made, and probably the 3 companies the ex-employee worked for would share a part of the costs.

I spoke to the ex-employee over the weekend and she indicated that she has not been seeing a doctor. She had been told by someone that work comp won't pay unless you see their doctors. I told her if work comp didn't pay, then her insurance would probably pick up, but she has a high deductible and couldn't afford it at this time.

Today her current employer called me (not our ex-department manager, but someone else). She said the employee is in a lot of pain and wanted to know the status. I told her how things stood, and then spoke to the employee. I told her to get to a doctor as there is no claim if she doesn't and they won't have anything to investigate or work with until she does.

She soon called me back and told me she found a work comp doctor but they would not see her until we authorized it. I called my agent, but as unbelievable as it sounds, the entire claims department for this large agency is closed for the day and my agent will not be back until 12/3. I left a voice mail for a back-up person who supposedly is covering and checking voice mail. I have not heard from her, and my CEO is on vacation this week.

SO...I called the doctor and gave them the information to send bills here, and then called the ex-employee and told her to get into the doctor's office. I hope I did the right thing. It just seems to me that we cannot let our employees or ex-employees suffer while we wonder what to do. But, I am confused about this entire scenario. It seems to me that her current employer, who has now put her on light duty, should have made a claim. Their carrier would have had to coordinate with ours and the 3rd employer, but her pain started there. Am I wrong here?

To make matters more complicated, this ex-employee is now a very good friend of mine. I need to walk a tightrope here between my obligations to my employer and my friendship. But if my company is doing the right thing, that shouldn't be an issue. Right?

Someone out there please give me some confirmation that I am on the right track, or tell me where I went wrong and what I can do to fix it.

Comments

  • 7 Comments sorted by Votes Date Added
  • I think her current boss's advice to contact you was wrong. Obviously, if she's in pain now, whatever she's doing for the current employer is continuing to aggravate her carpal tunnel. That employer would be liable, perhaps exclusively, perhaps with contribution from you, depending on the facts and Kansas workers' comp law. But more importantly, the workers' comp process should start with that employer. They should turn it in to their insurer, they should do any medical authorization that's necessary.

    Brad Forrister
    Director of Publishing
    M. Lee Smith Publishers
  • Brad

    Thank you for your response. EE went to the doctor and a work status report was faxed to me. EE also sent me an email asking for our current address (we moved last December) as the doctor told her she needed to give us a form he sent with her.

    I am glad you think her current employer should be handling, but how do I get them to take over? Should I just tell EE that she needs to have current employer file also?
  • When you finally make contact with your w/c carrier, they will ..without a doubt... contact the current employer for carrier information. The two insurances will figure it out, along with the doctor.
  • Thank you! Thank you! Thank you!
  • If she was not having symptoms when she left you then you should be able to get your insurance company to deny it. Did she have to take a physical for her new job? If so that would indicate if she was having problems then. If she indicated she was fine and able to do the work without accomodation I would also say this helps get you off the hook. She says she has carpe tunnel but has not been to the doctor? In Kansas you have to pay unauthorized medical up to ($500?) I could be wrong on the amount. I would contact the insurance company, file a claim have them investigate and hopefully they will deny it. New job is causing the problem.

    Good luck.

    Dennis
  • UPDATE:

    Our carrier indicated that they would deny since no treatment has ever been initiated until now. Ex-employee called yesterday and said she went to bosses and requested a work comp claim be filed and she was terminated. I asked her why and she replied that they would not tell her why. She has never been terminated from a job before (in late 30's) and was very upset, but did tell me she has an appointment with a lawyer Monday. Her job, by the way, was in Kansas City, MO. I am in Kansas and don't know MO law, but I am sure something is rotten in Denmark (or somewhere).
  • Sounds like you life will be easier..........and her most recent employer is going to have some issues to deal with, as you cannot fire someone for wanting to file a claim. That is basic stuff!
    DJ The Balloonman
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