Health insurance vs workers comp question

long story short, my knee has been hurting a little on deep bends for a month or so. I had to go in to work on Saturday and stepped up in a vehicle and my knee buckled. Swollen, pain, limited range, blah, blah, blah. Went to ortho Monday and MRI will happen Friday. I feel like I am on the line between my insurance ($$$) and it being work related. My boss pretty much laughed it off when I mentioned it. I dunno. I just don't want to get bent over the barrel if I don't have too. Thoughts?

 

Sounds like you hurt your knee at work.

 

Not sure why you are contemplating workers comp fraud on a public Internet forum.

 

As a business owner, I got a couple claims, even minor ones and my workers comp rates skyrocketed. Workers comp tells me it doesn't matter if the claim is big or small, they see it as xx number of claims and you must not be worrying enough about safety.

 

If you hadn’t had any issues with it prior, I might be able to support your w/c claim. But given the pre-existing aspect, it’s hard to say it isn’t an idiopathic issue that simply manifested while on the job versus occurring because of your job. Don’t f@ck your employer just b/c you don’t wanna pay for having a bum knee.

 

I'm not contemplating fraud in any sense of the word. I don't think we have a strong HR department and I've never been in a situation like this. Just asking questions to a broad knowledge base because I don't know where I stand.

 

Your story is already crumbling

 

Okay?

 

I took that as a joke. Since your knee is hurting but you said “where I stand”

As for the claim. Tricky situation. If you really hurt it on the job it is workers comp but from your employers point of view. Stepping into a vehicle shouldn’t be considered a dangerous task. If you can’t do that without getting hurt maybe you aren’t in the right job.

 

personal health ins. premiums won't rise much at all even with a sizable claim. At least it hasn't with bc/bs. With a work claim, you have a job to think about.. and it was kinda pre-existing from how you describe.

 

Yep. Exactly. My agent has told me the same thing. They look at occurrences not severity of injury. Work comp has become much more of a pain, especially if you are with State Fund. Thankfully I got away from them a year or so back.

To the OP, see what the prognosis is and discuss with your doctor if this was a long time building up. As a business owner, I hate to see the company take the hit if it was not their fault. But, if it was traceable to your work/ profession, then their insurance might have to take care of it. Seems like a difficult call since you said it had been bothering you for a month or so. Did you file any kind of incident report? Sounds like you at least told the boss if you said he laughed it off. Good luck on your recovery.

 

It's a three foot step into the back of a transit van so it's not a typical vehicle entry, but yeah.

 

Obviously I'm biased, so take this with a grain of salt. But I commend you for asking and learning. If I didn't have a business, I wouldn't have a clue that turning it into workers comp.......screws the employer, but turning it into my own health insurance does not. As a business owner, I don't know if there are legal ramifications, but if we had a conversation and you were considering workers comp, because you saved a deductible or some other reason, I would offer to reimburse you, since this sounds like it could go either way.

I really think one of my employees that actually unintentionally screwed me, wouldn't have turned it into workers comp, if he understood how it changed my entire program. It has cost me thousands in extra premiums.

 

Are you looking to recover lost wages for an injury that was work related and will cause you to miss work or are you just trying to get your knee fixed. You have health insurance for a reason. given your uncertainty I'm guessing this is not workers comp

 

You should have reported your knee hurting the moment it happened. Your claim is probably going to end up being denied because it’s been so long since the initial pain. They could have setup a preventative treatment plan as to not aggrevate your knee anymore, instead you worked on it and made it worse.

Health insurance is the right way to handle it.

 

Sorry but BS!!!! They will not deny anything, if there is anyway they can pay it and hang it on the employer. At least that's how it is out here in the land of fruits and nuts.

Different subject but similar on unemployment insurance. I had a combative employee around 2008. I got rid of him and he filed and lost based on my explanation and proof, with witness statements, etc. At some point, they sent out another claim for him after his unemployment ran out with another employer. Because we didn't dispute again, they tagged me.

I'm sure I somehow dropped the ball the second time, or my bookeeper and I presumed it was a mistake because we won the case. Anyway he started collecting off my unemployement. Even though I won the first time and proved everything he later was able to collect off me.

For those that do not know....business owners pay a % of their entire payroll for unemployment. That percentage goes up the more bad employees you have that collect off of it, or the more good employees you have that get laid off and collect on it. But usually the really good employees don't manage to get fired or laid off.....even in tough economic times.

 

Considering I’ve had this exact situation happen, it’s far from bullshit. Suck it Rob!

 

All I can say is how many employees do you have and how long have you been in business in California? Aren't you working for some big rocket company now that shoots electric cars into space.

Just look at another thread I had where my van caught on fire and every freaking California agency was "in my business", they don't make it easy out here.

 

It was years ago when I worked for Best Buy Corp. Similar situation to stumpy. I learned my lesson. This isn’t when I had my shop.

And yes, we shot 1 electric car into space as a proof of concept and we’ve also done 3 launches since then including last night which was the 3rd largest payload we’ve ever done with a single F9 Rocket. But I’m just some low skill peon, main job duties include taking the trash out and sometimes I’m allowed to sweep.

 

Hey, I may not be in the Long Beach ghetto much longer, when are you stopping by?