Workmans Comp & Repetitive Action/ Carpal Tunnel Coverage
Sticking it to the Middle Class, another story... If you live in Arizona and get hurt on the job due to repetitive action, chances are slim you will get coverage from Workmans Compensation. You may know of people who have had carpal tunnel, received benefits, and treatment through the Workman’s Compensation insurance. Hand, elbow, and tendentious problems due to repetitive actions on the job are NO LONGER COVERED. This is just another example how insurance companies save millions of dollars each year while many hard working Americans suffer. After being turned down by Lumbermen's Underwriting Alliance last fall, I searched for an orthopedic surgeon to support my cumulative and repetitive action injury case. I thought my case was solid. My extremely high desk at my place of employment was the source of my discomfort and created an awkward position for my elbows and arms. This work station was perfect for a 6 foot 4 inch tall worker but I stand 5 foot 2 inches. I slowly lost the use of both my hands and arms until I was unable to work at my office job of two years thus missing about two months of work. I was diagnosed with a pinched nerve in the cubital tunnel of the elbow and told if there is no improvement, I would need ulnar nerve transfer surgery. I prepared OSHA documents, an ergonomics chart from The Hand Rehabilitation Center of Indiana, and documentation for everything that happened to me over a three month period. Here is the response of my orthopedic surgeon, “It is the feeling of the Academy of Orthopedic Surgeons that carpal tunnel syndrome is not a work related activity.” He gave this example: A person operating a jackhammer for many years cannot prove he developed carpal tunnel due to his job. I was told by another Arizona hand specialist, this is also true for other repetitive/cumulative injuries to your arms and elbows. Tendinitis and cubital tunnel syndrome are examples of injuries that cannot be proven work related. That's right, if you lift heavy boxes all day, everyday, for years (or some other physical work) and develop problems, you are probably going to be on your own. I am too and here are my ulnar nerve (funny bone nerve) transfer surgery - post op pictures. The nerves are now inside the front of my forearms...
Here are some questions you will be asked after filing a claim: Do you garden, do needlepoint or crafts, sew, play a musical instrument, have grandchildren, cook, work at another job, play sports, do construction work, etc? Any of these things can be blamed for your arm and hand problems. I said no to everything except the second job which was bookkeeping five hours a month at a ergo dynamic station designed for a five foot two inch person. Workers' Compensation is supposed to cover injuries that worsen pre-existing conditions. You will have to prove it. Most doctors do not want to deal with Workmen' Compensation or disability claims. After I was turned down by Workers' Compensation/Lumbermen's Underwriting Alliance, one doctor didn't want to fill out a simple Aflac temporary disability form. My Aflac representative said he sees this all the time and will try to work around it. A lawyer will not take your case if you don’t have a doctor to back you. This is another dilemma for the American worker. AZ Workman's Comp has maximum cash pay out of 67% of your salary. The ceiling is low for these benefits. If you can push it through, they pay your medical bills, too. There is no compensation for pain and suffering. Hardly worth a lawyer's time. Fight if you can, but be prepared to be without work, without pay, and expect mounting medical bills. We are all at the mercy of the insurance companies. Workers' Compensation insurance in many cases, is not about protecting the worker or the employer, but protecting its own interests. The IME doctors profit immensely by participating in this system. See the video below regarding this practice.
The RICO Law - video regarding defrauded workers and denied claims by IME doctors
2011 UPDATE Late 2010, I went back to work after receiving cortisone injections in both elbows. The doctor said he can only do this one time due to risks of scar tissue developing in the canal. Aflac pulled through with a payment last fall for lost wages due to this "illness". Their payment was reasonable as I was still working full time. Five months later, even though I was working at a smaller workstation with a headset, the damage was done, the cortisone wore off and the elbow pain returned. I was unable to perform the duties of my job and I left my position. That's right, unemployed and without unemployment benefits. After running several tests ruling out autoimmune diseases such rheumatoid arthritis, my neurologist discovered that both arms had severe ulnar nerve damage resulting in muscle wasting of BOTH hands. My second ulnar nerve transposition procedure was completed recently. The procedures took about one and one half hour for each surgery. The second ulnar nerve transposition surgery failed. A third surgery is required for the elbow along with a necessary carpal tunnel surgery for the same hand. I am currently disabled and in pain. The retail price for the first two surgeries - $30,000 Lost time will be approximately 10 months, if treatments are successful. (which they were not) Estimated Amount The Insurance Company Saved by rejecting my claim - $50,000. How did this failed Worker's Compensation case hurt my small business employer? He paid his premiums and his employee wasn't taken care of. He invested time and training of an employee and ended up losing that employee. It took 8 weeks to collect my meager check from Aflac the second time around. Be prepared for an Aflac coverage hassle if you are unemployed. I was told $1,800 is the maximum benefit under their "transitional disability benefit" plan. Meaning, since I am not working full time, the pay out is $20 per day with a three month maximum coverage instead of six months. This is far, far less then when working full time. I assumed since I was paying the same premium, I had the same coverage. To assume is to blunder. I was also told if the Aflac Physician Statement doesn't have at least two boxes checked for ADL's, the claim may be rejected. ADL means Activities of Daily Living: Continence, Transferring, Dressing, Toileting, Eating. This means if you are unemployed, you have to be half dead or have a very serious condition like mine to collect pennies on your Aflac premium dollar. Notice all the things Aflac DOESN'T cover; the flu, bug bits, etc...
Aflac Disability Form
Jay Leno said mental illness is on the rise in America’s universities. Half of the students are depressed because they don’t think they will find jobs after they graduate. The other half are delusional as they believe they will land jobs after completing their degrees. As individuals, we need to have a back up plan for when things go wrong. Having a second business, a home based business, is a good solution. See other articles here at this website for suggestions. Here is a CBS video about turn key companies
Aflac & Lumbermen's Underwriting Alliance, You're Fired! Tell us your story
This article is my story. I am not a lawyer. If you have legal concerns please contact an attorney for advice.
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