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If I had a hernia prior to a back injury I had at work and the back injury is seeming to make the hernia worse...

Bakersfield, CA |

Could the employer be responsible for making my hernia treatment more urgent due to my back injury? I also think the hernia is limiting what I can do at physical therapy so i'm not much better after over a month.

Attorney Answers 4

Posted

Sadly, what YOU think will get you Zero.

As Mr. Corson noted, FOCUS ON GETTING THE PRIMARY TREATING PHYSICIAN TO REPORT that you MUST have the hernia corrected so as to finish healing from the industrial injury.

There is Comp Case law that finds where a non-industrial condition is stopping the healing of an industrial injury, the comp carrier has to provide treatment 'reasonably necessary to relieve the effects of an industrial injury'.

IT IS UNLIKELY THAT MOST TREATING DOCTORS 'in bed' with the Insurance Adjuster will write that you need a Hernia Repair Surgery immediately to recover from the industrial spine injury properly, but that's what you'll need to get the hernia repaired now.

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Posted

Anything is possible. The doctor would have to make a coherent argument that he has to fix your hernia to treat your back. I am at a complete loss to understand why you would ignore a pre-existing hernia and hope for the WC Carrier to fix it, but I see this stuff every week.

We offer general concepts, but you should give ALL your facts to a licensed Attorney in your state before you RELY upon any legal advice.

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Asker

Posted

I was waiting for HMO insurance authorizations for a colonoscopy and endoscopy before i could see the bariatric surgeon to repair my hernia. With HMO this is a lengthy process. I was NOT hoping for the WC carrier to fix it. In the meantime I was told by my dr. I could still work, but then I injured my back.

Asker

Posted

But I need to know if my hernia is hindering my recovery from my back strain if they are liable to pay for treatment and recovery for the hernia repair, and my pay, so that I can get the treatment I need for my back to get back to full-duty as soon as possible.

Posted

WC usually covers medical care that is reasonable nad necessary to cure the work accident so if you doctor can explain how fixing the hernia must be done before addressing the back injury, it might be covered. But I would expect WC to accept just any explanation and I can see them getting a second opinion. Might be wise to hire an attorney to give you specific advice.

Good Luck

I am licensed to practice law only in Illinois. Any advice that I render is for general information purposes and does not create an attorney-client relationship. Also it is very important to keep in mind that all legal claims have statues of limitation to file that cannot be missed. A local attorney should be consulted to learn the time limits applicable to a particular claim.

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Larry Alan Apfelbaum

Larry Alan Apfelbaum

Posted

oops. sorry! I would NOT expect WC to accept...

Posted

I think it is a reasonable conclusion that your back injury aggravated your hernia. Please consult your doctor and a Workers’ Compensation lawyer in your area.

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