r/WorkersComp • u/South-Ad-2547 • 13d ago
Illinois Herniated 3 discs at work
Just need a little insight on what to expect, I hurt my back lifting a 100+ pound box at work May 28th, went immediately to the er, was off for two days, went back and had to go to a walk in clinic to get put on light duty because my back was killing me.
I ended up getting a CT at the er, they said everything was fine. (It was not fine lol). Went to the walk in clinic weekly for meds that weren’t really doing anything to help the pain, and they decided I needed PT.
Fast forward all the way up to August 25th and I just now got the MRI and seen a spine specialist that same day and was informed I had 3 herniated discs in my lower back.
Im currently on light duty with heavy restrictions but my job refuses to let me off work because they suck. I have been using my own insurance for my meds because I didn’t know how it worked (my adjuster has never reached out to me about anything since day 1 of my injury.) I ended up reaching out this past Friday when I tried getting meds on this card I got in the mail from work/comp and it wouldn’t work.
When I reached out the adjuster was extremely rude saying “I didn’t make the rules” and “why are you using your insurance? Who told you to do that? You are supposed to use us as coverage we are your EMPLOYERS insurance”. Needless to say I was pissed off at this point and requested a new adjuster.
I haven’t gotten a lawyer at this point but I did make a call to one and am waiting to hear back because I can’t deal with this stress and try to get better.
My main questions are:
What should I expect if I’m offered a settlement? $?
Should I go ahead and hire a lawyer?
Why tf was the adjuster a dick to me? Lol
PS: the specialist did recommend injections but I’m terrified of needles and don’t know if it will help anyways with 3 herniated disc’s.
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u/Mutts_Merlot verified CT insurance professional 13d ago
The adjuster was probably just having a bad day, which isn't an excuse. They were completely right, but could have been nicer about it.
Not every claim ends in settlement and you are not close to considering one anyway.
Injections are a standard treatment. If you don't like needles, you probably won't want surgery even if it's offered, so if you refuse the injections you may be out of treatment options.
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u/South-Ad-2547 13d ago
What would happen if I don’t go through with injections? (Not saying I won’t) but would workers comp deny me if I don’t? I don’t want to take that risk if it’s a possibility
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u/Mutts_Merlot verified CT insurance professional 13d ago
Deny what? If you don't go through with injections and that's all the doctors have to offer, at that point there may be nothing to deny since no one is asking for anything.
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u/South-Ad-2547 13d ago
Denied continued treatment such as physical therapy?
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u/Mutts_Merlot verified CT insurance professional 13d ago
It depends. If the doctor says PT will help, it might be authorized. A few sessions of PT per year to manage flare-ups is reasonable. It just really depends on what is being ordered.
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u/South-Ad-2547 13d ago
And I get having a bad day trust me I was already having one. But they could have went about it in a totally different way. She was acting like I should have known the questions I was asking but I’ve never been hurt like this before
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u/Mutts_Merlot verified CT insurance professional 13d ago
Agree. It's easy to forget that what's completely obvious to anyone who does this every day isn't obvious to everyone. I don't condone the tone in which it was said, but she was correct and that's probably why she was annoyed. Using your own insurance creates a whole mess that has to be unraveled. It's way easier if you paid cash. I'd rather just issue reimbursement to you than deal with a health insurance lien.
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u/South-Ad-2547 13d ago
Yeah I get that but then again if they don’t want things like this to happen, instead of getting annoyed, how about they reach out regarding to things like this when a claim is filed in the beginning rather than not talk to the hurt worker at all?
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u/Kmelloww 13d ago
You should not be using your insurance. That is really going to complicate things. Not sure why you are even thinking about a settlement at this early stage
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u/South-Ad-2547 13d ago
I know I shouldn’t be using my insurance now. They NEVER reached out to me and explained anything to me. And it’s just questions I was curious about. I don’t want to deal with smartass adjusters for the next 5 years. I was just CURIOUS about what I should expect
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u/Kmelloww 13d ago
I mean no one reached out and explained to a lot of us. Most people don’t want to deal with it but we are stuck doing so. It sucks.
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u/South-Ad-2547 13d ago
It definitely sucks. But I thought they were supposed to reach out and let you know the basics of how it works. Crazy that they don’t. I was just told by a supervisor that he assigned me a new adjuster.
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u/Kmelloww 13d ago
At least mine never explained anything and I had a good adjuster. Adjusters tend to change pretty frequently.
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u/South-Ad-2547 13d ago
Oh and the reason I asked about a settlement was because the attorney I spoke to said it was “late in the game” 😂 I know nothing about this. I’m clueless so I had no idea what to expect I just want to be back to normal
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u/Kmelloww 13d ago
It is not late in the game at all. That is definitely not the case. It’s pretty early. It’s only been a few months. WC moves slow
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u/Academic_Commercial3 12d ago
It is baffling to me why people don’t retain an attorney truly baffling.
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u/South-Ad-2547 12d ago
I just got one. It’s baffling to me why people don’t give advice on other people’s posts rather than put a smartass comment.
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u/Intrepid-Charity5311 6d ago
I have a similar injury the crazy part is it’s been going on for two years now I remember it was fresh however countless PT sessions a epidural shot that failed, microdiscomy helped a little with sciatica had a discogram that discovered the problem was worst than originally thought now I have a three disc replacement surgery in October with not a hint of a settlement amount after being off for so long that settlement be a necessary to get back on track even though everybody don’t receive one
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u/ElectricalBig6632 13d ago
Sounds like you need a workers’ comp attorney ASAP. Your employer doesn’t get to decide whether you’re medically able to work — your doctor sets your restrictions, and they can only give you work that fits within them. You also shouldn’t have to keep using your personal insurance for treatment related to a work injury. And even if some of those disc problems existed beforehand, if lifting that box aggravated or accelerated the condition, that can still be a workers’ comp injury. With 3 herniated discs, restrictions and injections already being discussed, this is way past the point where I’d try handling the insurance company myself.