Is Tendinitus in the shoulder covered under workers comp?

Asked 9 months ago - Orange, CA

If I work construction and my personal doctor feels it might be due to work, will my Tendinitus have to get treated at my employers clinic ? Can my doctor refuse to treat me and tell me to go to my works clinic? I can't move my arm without having lots of pain.

Attorney answers (8)

  1. Matthew William Hoffmann

    Contributor Level 14

    10

    Lawyers agree

    Answered . You'll need to be seen by a work comp doctor and you'll need to file the appropriate paperwork to make a claim. Consult with a worker's compensation attorney in your area. Try Avvo's "Find a Lawyer" service.

    This answer is for general purposes only and does not establish an attorney-client relationship. Consult with an... more
  2. David J McAuliff

    Pro

    Contributor Level 13

    9

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    Answered . Yes, tendinitis is covered under CA workers' comp. As to which doctor you can treat with, at a minimum the doctor has to be in your employer's Medical Provider Network (MPN), assuming that they have one. And really, it's not the employer that has the MPN, it is the employer's insurance company that has the MPN. There are some excpetions to this rule, and this is why you should talk with a CA workers' comp attorney. Areas to talk about are whether you had a family doctor before you started working for your employer and you notified your employer of this; whether you received notice about the employer's MPN; and because you are in the construction trade you may be covered by a "carve-out" program where there are very different procedural rules for how injuries are treated and dealt with administratively. Click the link above for Find a Lawyer.

  3. Shmuel A Steinberg

    Contributor Level 9

    7

    Lawyers agree

    Answered . If you can relate the injury to the work then it is covered under Workers Compensation. As long as the injury was caused by the work you were performing then you should be covered. The question is, was there a single incident or a continuous activity that caused this injury? Also, what is your injury worth? You should consult a seasoned WC attorney as they deal with such matters on a daily basis. You do not want to fight your employer or their insurance carrier on your own. Don't forget to notify your employer of the injury as soon as possible.

  4. Christopher John Gansen

    Pro

    Contributor Level 18

    7

    Lawyers agree

    Answered . Most likely yes. Get a WC lawyer.

  5. John M Connell

    Pro

    Contributor Level 18

    7

    Lawyers agree

    1

    Answered . Yes, in most states typically when the personal Dr determines that it is a work related injury they refer you back to the employer to go to the employers designated physician.

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  6. Christian K. Lassen II

    Pro

    Contributor Level 20

    7

    Lawyers agree

    Answered . Yes, Tendinitis is covered

  7. Richard Andrew Harting

    Pro

    Contributor Level 18

    5

    Lawyers agree

    Answered . Yes its covered. consult with a local work comp atty. You will need to report the injury to your employer.

  8. Daniel W Epperly

    Contributor Level 13

    4

    Lawyers agree

    Answered . Whether or not your tendonitis will be covered by WC is a question that will need medical evidence to answer. Considering the facts you have posted, I think it is likely that if you file a WC claim your injury will be considered work related.

    If your doctor will continue to treat you using your private health insurance, you always have that option. The down side of that option is there is a one year Statute of Limitations to file a WC claim (with too many exceptions to discuss here) and any time off from work will not be covered as Temporary Disability (unless you file a WC claim).

    Is your doctor willing to treat you as a WC patient? Most private MD’s no longer will treat a work related injury because dealing with the insurance company is a hassle. If your doctor will treat you as a WC patient, did you ever give your employer a form pre-designating this doctor as your primary doctor? If you did pre-designate your doctor and he is willing to treat you as a WC patient, then you can continue to treat with him for this injury even after you file a WC claim.

    If you did not pre-designate your doctor and the employer has a Medical Provider Network, you will have to treat in network. Your employer can control who you see for the first appointment. If your employer insists on you seeing a particular doctor for the first appointment, unless you really like that doctor, after the first appointment you should probably switch to a different doctor on the MPN.

    My suggestion is that you consult a reputable WC attorney. An attorney can file the paperwork on your behalf, get you into treatment, and if you need time off to recover get this time off covered as Temporary Disability rather than using vacation time or worse dock time. The other alternative is to ask your employer for a DWC-1 claim form and turn it in yourself, but you run the risk of the employer or the insurance company not treating you fairly.

    I hope you have a speedy recovery. Good luck to you!

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