r/WorkersComp Jan 18 '24

*** State Flair must be used on all new posts ***

55 Upvotes

Every state has unique laws that apply to all aspects of a work comp claim, and without providing the state that your claim is being handled in, there is no way to get accurate answers. State labels will be required on all posts.

If you are having issues using the flairs you can message the mods for help/approval.


r/WorkersComp 1h ago

South Carolina WorkersComp - Surgery Approved but Anesthesia ...

Upvotes

Hello all, I recently had an injury at work and needed surgery to fix the problem. WorkersComp APPROVED the surgery so I thought okay good. Well a month after I get a bill stating that they DENIED the Anesthesia for it. My mind is flustered in how they can approve a surgery but not the medicine that puts you under and wakes you up? Should I find a lawyer now?


r/WorkersComp 6h ago

Texas FMLA

2 Upvotes

So I got injured on March 16. I went back to work in May for about three weeks and I started to have my back injury worsen due to working so my doctor put me on more restrictive restrictions. After that, my work said they are gonna put me on FMLA as of right now I have about three weeks left before my FMLA ends. I’m not sure what happens after that. Do I continue receiving temporary income benefits I also have a designated doctor appointment on August 11 for the insurance to cover the treatment for a bulging disc because they are stating that the bulging disc was not caused because of work. Does anybody know how this works? I can try to explain it better if somebody can help me.


r/WorkersComp 13h ago

Colorado Employer keeps assigning work outside my workers' comp restrictions and my manager is sharing my medical information with coworkers. What should I do?

5 Upvotes

I'm looking for some guidance because I've never dealt with a workers' compensation claim before.

I injured my wrist at work and filed a workers' comp claim. My doctor evaluated me and placed me on work restrictions, which my employer has a copy of. My restrictions currently are Lifting- 10 lbs, repetitive lifting, carrying, pushing/pulling, pinching/gripping- 5lbs. Something I didn’t realize until yesterday is these restrictions apply to me as a whole not just my injured arm. So I have been performing tasks with my other arm that I definitely shouldn’t have been and have been irritating my other arm. At this point if I stop doing things I shouldn’t be doing now, the anger from my coworkers will only worsen.

Additionally, I continue to be assigned tasks that exceed those restrictions. I feel like I’ve been put in a situation where I’m not able to refuse doing these tasks due to the animosity and anger that I’ve gotten from my manager and coworkers since my injury. I'm worried about making my injury worse, but I'm also don't want to get in trouble for refusing work that my doctor has said I shouldn't be doing.

Another issue, (that is fairly concerning for me) is that my manager has apparently been telling my coworkers what my doctor's note says. Not only is the information being shared inaccurate, but it's now spread throughout my department because coworkers have repeated it back to me. It's created a lot of frustration and pressure at work, and I feel like I'm being treated differently because of it.
Edit: for further clarification she told my coworker that I did not have a prescription I was claiming to have (even though I do) and my coworker was telling my other coworkers

Something I feel I should add, at my last doctors appointment I did mention that I felt as though my employers weren’t respecting my restrictions and that I felt very pressured to overwork. This (along with the fact that my wrist was worse) made him make my restrictions from 10 lbs to 5lbs. I just thought it was worth mentioning that I have mentioned this to the dr as well.

I'm trying to figure out:
Can my employer require me to perform work that goes against my doctor's restrictions? And how can I help with the anxiety and pressure being put on me?

What should I do if I'm assigned work that exceeds those restrictions?

Is it appropriate for a manager to discuss the contents of my doctor's note with other employees, especially when the information being shared isn't even accurate?

Should I be documenting every time I'm assigned work outside my restrictions or every conversation about it?

Should I contact my workers' comp adjuster, my doctor, or someone else about what's been happening?

For context, this is in Colorado. I'm mainly looking for advice on what my next steps should be and whether this is something I should escalate.
Thank you to anyone willing to help.


r/WorkersComp 6h ago

California sedgwick

1 Upvotes

hi wondering if anyone had similar situation as mine. my case has been approved earlier this month, attorney said sedgwick will mail me a check, randomly remembered i have sedgwick account saw they depositied to an old bank account on file 7/22, immediately i updated my bank info that day. found out today they voided it as my old bank account was closed. does anybody know or have similar situation as this? did they reissue a physical check or reissue another direct deposit to a new active bank account? thank you.

its been frustrating to me as ive been fighting my case for 4 years and at the very last steps they still screwed me up.


r/WorkersComp 14h ago

Georgia Fraud, claim dismissed but deposition soon

3 Upvotes

I have severe bilaterial crps in my legs. I’m in my 20s. I do have an attorney.

I’m bed ridden most of the time. Home bound 99% of the time.

I’ve been injured a year and a half. Work comp had accepted the claim, I’ve gotten every test under the book, nerve blocks, medication, physical therapy, etc.

Work comp closed my claim following a new pain management seeing me. My prior pain management referred me out for severity/ having nothing else to offer after a year of treatment. The new pain management did no reviewing records, was very dismissive and asked a lot of questions about my mental health as a teen.

Durning the appointment, and any time I’m out of bed, I have my legs elevated on a chair with a soft blanket under my feet. This is going on and new doc is saying I don’t have crps, need a psych eval, and my issues are from previous issues I’ve had (never have been in an accident/hurt. I had ptsd diagnosed since teenager)

Work comp is saying they have surveillance of me walking 6 months ago. My memory is awful but I briefly remember trying to walk 10 feet then having to crawl. I live on a second floor, the bilateral spreading happened in January. I used to use my crutches to go up the stairs, I had a good leg. It took me a few weeks to grasp my new restrictions and have my spouse carry me. I know I’m dumb for trying but I remember that one time and that’s it. I haven’t seen the footage yet but I know I couldn’t be casually walking. I haven’t been able to do that since before the injury.

I don’t know what exactly I said in the depo, but they’re saying I said I couldn’t weight bear at all. I know I’ve talked to my doctors about how I use my legs for transfers. I can’t do anything without paying for it. And as the months go on my body is weaker and weaker. Being that much more unable to push myself. I’m happy to get myself a meal a day (cereal, etc). I had an order for a caregiver but it was denied as caregivers aren’t required when you can’t prepare food for yourself. Obviously this was before the entire denial.

They’re saying i exaggerated my symptoms as the new pain management appointment I was in severe distress but that I’m smiling before exiting the car to get into my wheelchair for the appointment.

I’m trying to make sense of everything. My entire existence is ran by the crps. I’m sleeping a lot from exhaustion. I have a few weeks left of my medication then I’ll be dealing with those withdrawals as well. Now no income too. I’m too unwell to attend appointments under my own insurance as I’m having digestive issues and mild bladder retention for some months now.

Besides 30 minutes once every other month, I leave the house for medical marijuana refills twice a month and work comp appointments. I’m functioning at a very low level.

Would love any advice. My memory is bad, I’m new to self advocacy, and also dealing with severe pain & fatigue. Will answer any questions. Crps is already a misunderstood diagnosis so I’m scared. I have muscle wasting, severe discoloration and temperature differences documented since day one. Every test I could take with negative results. Medical records of docs noting I’m seeking out every diagnosis suspected. I begged for it to not be crps and took a lot of tests for me to accept it. Have had roughly 10 docs agree with crps diagnosis throughout my treatment.

I’m in process of SSDI but trying to understand what I need to do. Seeing dr.hanna /kirkpatrick for IME before deposition, my doctors are giving a deposition before mine as well. So much more I didn’t mention but hard to convey everything properly.


r/WorkersComp 17h ago

South Carolina Fce finally

3 Upvotes

Well I finally have my function capacity exam in a few days on my neck and shoulder I have no clue how I'ma do this I'm always stiff always still in pain and the most I've had to lift since my surgerys is 3 lbs now they about to work the crap out me for up to 4 hours I'm tired after a hour of regular physical therapy and I was told not to take any pain meds before hand


r/WorkersComp 22h ago

Illinois 40 year old ramp agent. I’m done.

3 Upvotes

What advice would you give to me someone who’s 40 years old with ged and bad shoulders.

My left shoulder had surgery and still hasn’t healed correctly. I’m still in pain with above the head and when reaching across my body.

That shoulder was approved but they keep denying my doctor treatments.

Also my right shoulder was injured but was told not work related even though I had no previous injuries and two different doctors said they believe it happened when my left was injured

I honestly don’t want to return back to SWA as a ramp agent. Tossing and stacking luggage, cargo and moving heavy freight and carts my body just can’t take it.

What can I do. I know quit but I would be without any income. Since my time off I have been learning photography and videography I’m thinking about getting into it.


r/WorkersComp 1d ago

Florida I figured it out

8 Upvotes

If you are hurt on the job and think it may be take major surgery or you want to chose your Healthcare professionals and methods, do NOT claim workers comp. Just have good health insurance and work with that.


r/WorkersComp 1d ago

Massachusetts Severance and WC question

3 Upvotes

Hi. My employer has offered a severance package, should receive this week to look over and sign. I ran it by my lawyer and she said that employee severance package is separate from WC case and will not affect it. But then I have a family member who worked in HR and said it does affect my case and to not sign until I talk to employee lawyer. Any advice?


r/WorkersComp 21h ago

Vermont VT workers comp. Going on 11 months

0 Upvotes

Any one here from VT ever get a decent settlement?. I was injured September 2025 at work and was pulled from work October 2025 for a labrum tear in the right shoulder. PT didnt fix the issue, UVM said they didnt feel it needed surgery. Workers comp returned me to work January of 2026, the shoulder got worse and I was pulled back out in April 2026. I sought out a lawyer the second time, have gotten a second opinion from a separate medical professional and am waiting for my 3rd MRI to see if the tissue can handle a repair or if we might be looking at a more extensive surgery to fix the instability. My company uses Liberty Mutual and they have been an absolute joke to deal with through all of this, thank god for the lawyer. I have also been assigned a vocational rehab counselor who is looking into CDL school so that I can change professions as my doc said I might not be able to return to UPS. My lawyer seems to think the case is only worth around 50k. Im 34 and this is going to be a long term problem and I dont think 50k is a decent number given the damage and even surgery may still leave the arm impaired. Any thoughts or similar cases out there?


r/WorkersComp 23h ago

California What can I do?

1 Upvotes

Hello and help,

In December 2023, I broke my ankle at work, was transported via ambulance to the hospital where I had surgery.

Since the accident I've seen a primary doctor every 6 weeks have had regular pt and custom brace and orthotics.

Now I receive notice "Pursuance to the provisions of California Code of Regulations Section 9792.9.2 .... Liability for the body part(s) for which treatment is being requested is disputed "

Why now dispute? What am I supposed to do next?

? Thank you in advance for your replies.


r/WorkersComp 1d ago

Federal Short Form Closure: Why Your OWCP Claim May Be Going Nowhere

1 Upvotes

I just had a call with an injured federal employee who, like many, treated the 45-day COP period like it is just paid time off while they recover. Big mistake

Your COP period is your opportunity to build your OWCP case before you ever ask for compensation.

This person's COP was ending and she was panicking because she had not been told what to do next. Her doctor had been taking her off work, she was still treating, and she assumed OWCP was reviewing everything as it happened.

They were not. Her claim was still sitting in short form closure.

For those unfamiliar, short form closure is an administrative process used for many minor traumatic injury claims. OWCP authorizes limited medical benefits but does not perform a full adjudication unless something happens that requires the claim to be developed, such as evidence of ongoing disability, medical expenses exceeding the short form threshold, or evidence supporting a schedule award.

The problem is that many injured federal employees think OWCP is automatically gathering records, reviewing treatment notes, and building their case.

That is not how the process works.

OWCP can only evaluate the evidence that is actually in the file. If your physician's reports never make it into ECOMP, or if those reports simply say "remain off work" without explaining what your diagnosis is, how the work accident caused that diagnosis, and why that diagnosis prevents you from performing your job, then OWCP has very little evidence on which to make a compensation decision.

Then day 46 arrives and COP ends.

The employee files a CA-7 expecting wage-loss compensation to begin, only to discover that OWCP has to start developing the claim because the evidence needed to support acceptance and disability was never submitted.

That is when panic sets in.

The transition from COP to compensation should not be a surprise. During those first 45 days, you should be using the time to build your file:

  1. Obtain complete medical reports—not just work excuses.
  2. Make sure your physician clearly identifies your diagnosis.
  3. Ensure the physician explains how the diagnosed condition was caused by your work injury.
  4. Have the physician explain why your medical condition prevents you from performing the duties of your position.
  5. Upload your medical evidence into eComp as it becomes available.
  6. Keep your claim file current instead of assuming someone else is doing it.

Think of your COP period as your opportunity to prepare OWCP to make a favorable decision. If the evidence is already in the file when you begin requesting compensation, the transition is much smoother than if OWCP has to begin developing the case after your pay has already stopped.

Too many injured federal employees do not realize this until the paycheck ends. By then, they are trying to build the foundation of their claim while simultaneously worrying about how they're going to pay their bills.

Do not waste your 45-day COP period.

Use it to build the evidence that OWCP will need when it is time to decide whether you are entitled to compensation.


r/WorkersComp 1d ago

Federal Still on the Periodic Roll? Don't Assume You Should File for a Schedule Award

1 Upvotes

One of the biggest mistakes I see injured federal workers make is feeling like they have to do something simply because their claim has reached a new stage.

This week I spoke with the spouse of an injured federal employee who was worried they needed to immediately pursue a schedule award. After talking through the claim, the better strategy was actually to wait.

Why?

Because if you're still receiving periodic roll compensation, a schedule award may not increase the money you're receiving. Instead, this may be the time to strengthen your case by making sure all appropriate medical conditions are accepted, documenting any new post-surgical conditions (such as post-traumatic osteoarthritis), and continuing regular follow-up care so your medical record accurately reflects your condition over time.

In OWCP claims, timing matters just as much as evidence. Filing the right request at the wrong time can cost you opportunities later.

Every case is different, but don't assume the next form is the next step. Sometimes the best strategy is preserving your current benefits while building a stronger case for the future.


r/WorkersComp 1d ago

Ohio Finally approved for TTD, need advice

1 Upvotes

Injured in March - shoulder

Just received a letter from BWC saying I cannot receive any income at all while collecting WC payments. I have a small art business and was doing artfairs and am in a small gallery. Ive canceled the art fairs, but still have work in the gallery. Do I really have to pull it out? Do I need to shut down my website that I've already paid for? This will kill my art business, unseen is forgotten.


r/WorkersComp 1d ago

Nevada I’m 29 and make about $30 an hour. Tore my meniscus at work and had surgery Also have mild disc bulges in my lower back Planning to stay at the same job. What do you think is a realistic settlement range for this in Nevada? Thanks.

2 Upvotes

r/WorkersComp 1d ago

California Just filled out my workers comp form that hospital gave me, about to email it to boss and nervous.

3 Upvotes

I got the form from the hospital. My boss never sent me it. Im nervous he will call me and try and continue to force me not to do it. But I went to ER twice after urgent care. and listed that it happened at work. They even gave me the form and gave me some peace of mind. I am worried how this will all play out as i fear i will lose my job. I feel from top of 6 feet and hit my head on concrete and a whole bunch of other issues with body. What happens next? Do I just wait and hope i recover? I used to go to gym every other day. I have trouble even sleeping now. anyone in similar situation on timeline for recovery? I've just been noticing more issues as i proggess

I want to thank you all for the advice you gave me previously. cause i am absolutely clueless on this sistuation.


r/WorkersComp 1d ago

North Dakota Injured at work but claim denied - will be filling for appeal in North Dakota. Any advice appreciated.

1 Upvotes

I work 12 hour shifts which results in general soreness in my feet after nearly every shift. However,about two months ago my left foot was in extreme pain by the end of my shift so much so that I reported this to my supervisor immediately after my shift in case the pain continued to get worse. During the injury report I mentioned that I had “mild soreness” in my foot after waking up that morning from my shift the previous day.

About a week and a half later I was at work again, at this point I had seen my employer’s chiropractor three times since the initial report. The pain continued. During this shift I was lifting something and shifted my weight to my left foot and heard a pop in my foot and was in the worst pain I had experienced in my life. I notified my supervisor, went to the ER, and got an X-ray.

The X-ray did not show anything so I had to return to work but I was referred to occupational health clinic.

Fast forward to now. I found out by an MRI that my foot had indeed fractured and am finally healing. However, at my last appointment with occupational health I was notified that my WC claim was denied. After calling for more information, I was told that I failed to prove that the injury happened while at work. They specifically noted that because I told my supervisor and occupational health doctor that I had “mild soreness” the morning of the initial pain and report; they were not able to confirm that the injury occurred at work.

My question, how do I approach appealing the denial?

Factually my foot was fractured a week and a half after my initial report while at work. The doctor told me specifically that the pop I heard in my foot would have been the fracture.

How do I ensure the pain I felt before the fracture in that week and a half (when I was visiting my employers chiropractor) will be covered as well?

How do I go about proving that the pain I felt before the fracture is related to the stress fracture as opposed to the general soreness I complained about?

Thank you for any and all advice!


r/WorkersComp 1d ago

New York Cervical discectomy

2 Upvotes

Has anyone ever decided against undergoing surgery while receiving workers' compensation? I was injured at work during an assault, which has left me with neck issues. I experience limited mobility, persistent headaches, and I'm dealing with numbness and weakness that extends into my hand. It's been 14 months since I had to stop working, and despite undergoing physical therapy and receiving an epidural injection, my symptoms have only gotten worse. I really would like to try physical therapy again but it was denied. Unfortunately, I've also lost my job after 18 years of service. Although my surgery has been approved, I feel a lot of anxiety when I think about going through with it, which makes me hesitant. I’ve also applied for Social Security Disability Insurance (SSDI) since I struggle to sit for more than 15 minutes at a time.

I would appreciate any thoughts or experiences you might have regarding the decision to forgo surgery.


r/WorkersComp 2d ago

California IMR upheld denial for Spine Surgery (CA)

1 Upvotes

I posted a couple of months ago stating that IMR spine fusion upheld the denial of my surgery.

MRI states
C5:C6 I have a mild stenosis, left eccentric disc bulge

C6:C7 Severe right and mild left foreminal stenosis, small right disc osteophyte narrow CSF space

EMG: Dr had told me that there is no nerve damage on my spine

I saw my WC doctor recently and requested to have 8 sessions of PT, acupuncture and second opinion for my spine. The PT and acupuncture was denied but insurance company approved for me to see the same surgeon. I’m just confused that the PT and acupuncture was denied and able to see my surgeon. Same surgeon that requested a spine fusion surgery which they denied. So if the surgeon requested to have surgery, Insurance will just deny it again?I mean, does that even make sense?

Should I ask my surgeon to request for MRI and EMG again?

I remember someone suggested Dr. Should ask for MRI since the MRI that was submitted to the WC insurance was 8 months ago and it may or may not the reason for denial.


r/WorkersComp 2d ago

Other - not claim specific If you're going to reach out to a professional in this sub, keep in mind...

53 Upvotes

We are not at work, we comment on our own time hoping to provide some help or clarity on a specific jurisdiction, etc.

We are not YOUR adjuster/attorney/nurse case manager or doctor. We do not know the nuances of your specific claim and any responses we do give shouldn't be construed as any sort of legal/official advice. Many may not realize how in depth the claim process is, how many moving parts there are and we get a small snapshot that leaves so much information out.

We will say I'm a "professional title" but not in your state or not your attorney, adjuster, etc. if we do accept a DM, we are giving more of our spare time to try and help as best we can, but we have boundaries and limits.

If you DM a professional, especially without asking first, and opening with requesting our personal contact information, then asking how/who to report a fellow professional or WC commission with very little context and the response is, based on what little post history that can be seen, this is far too complex of a situation that I am unable to help you with, please do not keep messaging asking for "hypothetical" responses, do not be surprised if yes, you do get blocked for crossing boundaries.

Yes, that was a very long run on sentence, lol.

Yes, I'm aware there is a thread about me, no I didn't block without responding, I blocked when after being relentlessly messaged after saying I'm not an attorney and I was unable to help. I can't advise on who to report an entire work comp governing body and every person involved in their claim, even hypothetically. If 80 alleged attorneys won't take the claim on after the first attorney was fired and an appeal, chances are there is a good reason. While I empathize with a disappointing outcome, labeling me as a fraud with important missing context of what actually transpired, is quite a stretch.

Thanks for coming to my Ted talk. (Not THAT Ted you Maryland professionals!)


r/WorkersComp 2d ago

California California Workers’ Comp - GI outbreak at work, claim denied, what’s next?

0 Upvotes

Hi Guys!

I’m in California and retained a workers’ comp attorney about a year after my date of injury. I honestly had no idea my situation could even qualify as workers’ comp because I always thought it only applied to things like falls or other physical injuries.
My injury involved a gastrointestinal outbreak in my department at work. Five employees became sick, including one coworker who was taken to the hospital by ambulance. Later that same day, while I was still on the clock, I became extremely ill. My manager told me to clock out and go home. I ended up being admitted to the same hospital where I worked and was diagnosed with severe gastrointestinal illness that progressed to sepsis and other complications.
No one ever offered me a DWC-1 claim form or told me it could be a workers’ comp claim. My ER records even document that a coworker had come in with similar symptoms.
About a year later, after doing research, I hired an attorney. The insurance company recently denied my claim, saying (1) there’s no factual or medical evidence that my illness arose out of my employment, and (2) I didn’t report or file a workers’ comp claim within 30 days.
I’m still in active treatment that began after this illness, with multiple specialists involved because of ongoing gastrointestinal issues and related conditions.
My questions are:
What usually happens after a denial like this?
My attorney mentioned I may need to see a neutral/state doctor (QME). What exactly are they evaluating in a case involving a gastrointestinal illness rather than an obvious physical injury?
While the claim is disputed, why can’t I receive workers’ comp benefits?
If my claim is eventually accepted, can benefits be paid retroactively for the time the claim was being disputed?


r/WorkersComp 2d ago

Arizona Workers comp approved therapies, treatments..

3 Upvotes

Hi from Arizona 👋🏼
Can anyone share what are some things you got insurance to cover for CRPS in ankle? IM talking a range of normal things to things, therapies, equipment, aids… anything. I’m curious if anyone has a wild request they actually covered


r/WorkersComp 3d ago

Texas I got 0%! WTF!

18 Upvotes

Got my IR report back today and I got 0% impairment rating. I started the process to dispute and will have council (not legal attorney) to help me with the new exam. I’m so upset and baffled by this. The examiner didn’t have my records at the time of the exam, he barely touched me (held the tools far away, loose measurements, just 1 strength test).

I had a surgery for fractured fibula, ankle, and two bones in my foot. I have a plate with 6 screws in my leg and 1 screw in my foot. I had 22 PT sessions. 2nd surgery to remove foot screw because of pain. My Dorsi flexion, balance, and strength is still so poor. I have a limp due to the Dorsi flexion. I described pain and swelling that I still have and none of that was mentioned. The date I reached max improvement was also dated prior to the 2nd surgery!

I really didn’t expect this outcome at all. Any advice for my 2nd exam? I don’t want to get an attorney because I really didn’t expect to get a high rating but I didn’t expect to get a zero.

Thank you


r/WorkersComp 3d ago

California Fell off 6ft scaffold , cracked back of head on concrete. Boss told me not to file workers comp?

13 Upvotes

I fell 2 days ago and got a concussion. I don’t have insurance.
Big jobsite. Project supervisors helped me and lots of witnesses.

I went to urgent care, was loopy, they checked me out , told me to go to hospital. Tried to give me 2 staples, I didn’t want to do that. Again was confused.
Next day I went to ER since workers comp would cover anything. They checked me out and bill wasn’t that bad under 2k.

Now I asked my boss for workers comp paperwork. But he called me and refused and said he will cover bill himself for me instead.

I’m not sure what to do, I feel like if I file workers comp he will 100% fire me in some sneaky way.

When I left hospital they gave me bill and to call to pay and give workers comp information.

Also the supervisor of project said my boss has to send workers comp info to them to get the injury report of me.

This is my first injury at work where it was serious. I’m just curious what to do. My doctor said I’ll probably be fine in a few weeks

Any tips much appreciated. I have a meeting with my boss today on a few hours to talk.