Old claim

mmurnahan

An employee who worked for us for 4 years, was terminated for cause in August 02. She was very unhappy about the separation. 8 months later April 2003 she calls and states that she had a WC injury in 1998! Supposedly she fell and everyone in the office saw it, but becuase she wasn't hurt at the time, she did not asked for medical treatment. She said that she reported it to her supervisor. Now 5 years later, her supervisor does not recall it, and no one has any papers about it. A few of her co-workers (who still work here) said they remember it.
The carrier we had in 1998 is no longer in business and we have another carrier.

The x-employee reported us to the Workers' Comp divison. I have been told I have to file the claim. I have no information about the accident.

Has this ever happened to anyone else?

mwild31

How long do ee's have to report an injury in your state? They have one year here in WA (for most injuries that is).

lorrie

In Kansas the ee is responsible to provide written or oral notification of injury within 10 days of the injury. Maybe she can claim she did this, but ee is also responsible to file a written compensation claim with the employer within 200 days of the date of injury (or receipt of last payment of compensation of medical treatment.)

I would think that this person is too late to file a claim now, but your current work comp company should be familiar with the laws in your state and be able to advise you.

HRQ

I have a similar situation:
- employee reported in 10/02 that she was injured 2/01, is feeling pain from injury.
- We have no documentation, employee's supervisor no longer with the company, so send injury report to w/c carrier, questioning the validity
- Claim was denied by w/c insurance company.
- 3/03 employee reports she feels pain in same body part. Silly me, I thought it was same injury, same pain - employee declined med attention. Gave employee voluntary statement, she never returned it to me. Employee told supervisor she didn't want med attention because she was having surgery on the same body part in 10 days anyway, for the injury from 2001.
- Ins adjuster advises me that employee reported "new" injury directly to Industrial Commission.
- Claim denied because employee didn't report injury to her employer
- Telephonic hearing between W/C atty and injured is scheduled later this month.

Interesting to see where this goes.

I learned from a forum post that I can run FMLA concurrently with w/c leave - she's already been off 3 mo's. I don't think I can retro her FML, but I can at least get it started now, right?

LFernandes

Start her FMLA as of now and make sure that you have proof of mailing and that you track her time carefully, especially if she is taking a reduced or intermitent leave. Also, read the regs. I think there is something in there about light duty as well.

Good luck!

Whatever

NY has special fund for when insurance companies go out of business. Does Florida? I would ask your current carrier, where to file the claim. The employer should never make the decision whether or not a claim is valid. That is up to the wc carrier, the wc board etc.

Eliant

It happens in California al the time. First you need to find out from the Industrial Commission how long does the employee have to report an injury. Then contact your current work comp carrier and give them all the information. They will be able to give you guidance.

Good luck

AnneLa

Yes - start your FMLA clock running now..................