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i just wanted to get this off of my chest. i got hurt a while back fell through a porch while working. i tore my knee up tore alot of cartilage. grade 3 chondralamalacia, cartilage almost gone under kneecap. workmans comp paid for 1st surgery i had to have another surgery,workmans comp did not think i needed it regardless what the doc said. so they did not pay. okay no big deal can worry about that later. i turned it in on my regular health insurance told them the situation, they said no problem approved everything. had surgery all the bills were paid. now the insurance company wants there money back saying it was a workmans comp accident and workmans comp should pay. so i am stuck in the middle plenty of insurance but niether wants to pay it just burns me up. my health insurance and workmans comp are same company federated. i am trying to get this cleared up because i was told i will probably need a third surgery next month something about resurfacing not really sure what that is about yet.
 

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I hate insurance companies with a passion. I took my wife to the er one time after a horse we were working with reared up and striked out catching her in the head. Didnt knock her out but gave her a goose egg and made her nautious. Insurance company didnt want to pay it saying it wasnt an emergency.

I had to go to the er one time with an asthma attack from brush hogging a field. I could barely breath and they tried to balk at that too. I chewed their butt about both and finally got them to pay.

Good luck to you. Give em both barrels!
 

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This isn't my field really, but I'd say it's time to lawyer up. I would look for one who does Worker's Comp and personal injury - yes, a trial lawyer (they do, in fact, serve a necessary purpose). Most WC/PI lawyers have a free initial consultation policy. I'll bet your yellow pages is full of advertisements. Start asking people you know for recommendations. If you U2U me your location, I might be able to give you some names.
 

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Originally posted by Booches
This isn't my field really, but I'd say it's time to lawyer up. I would look for one who does Worker's Comp and personal injury - yes, a trial lawyer (they do, in fact, serve a necessary purpose). Most WC/PI lawyers have a free initial consultation policy. I'll bet your yellow pages is full of advertisements. Start asking people you know for recommendations. If you U2U me your location, I might be able to give you some names.
good advise
 

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First thing I would try is tell your insurance outfit to contact workmen's comp and get yourself out of the middle of it. They are your insurance outfit and they should get the blood out of whatever turnip they think is responsible.
 

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I am a one of those useless attorneys in Columbia everyone hates so much until they need one :) I will be happy to give you some referrals also if needed. I know how frustrating your situation is. I never understood how the legislature expected someone who was injured and unable to work to be able to pay bills on their own in these situations....
 

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i had a somewhat similair situation last november. A faulty coupling on a neumatic hose flew off a airwrench and hit me in the mouth. It ended up breaking off most of my front tooth and they sent me to the dentist. They had the dentist throw the cheapest cap on and sent me on my way. It looked horrible and wasnt color matched since it was so cheap. Ive had perfect teeth my whole life and people used to always ask if ive had braces and were shocked when i told them no. Ive never had a single cavity either so i was very upset when they tried to replace my perfect tooth with junk. I had super sharp pains from the tooth and was on vicodin for a week or two and it just kept getting worse.

I went in and told my supervisor to have someone from HR come down because i needed to talk to them. They sent a couple people down and i told them that i was very upset about the whole deal and that the fake they had on wasnt going to pass. They tried the ole well thats what the dentist said was the thing to do blahblahblah. Then i told them i talked to our family friend who is also my lawyer and that changed their attitudes really quick. Right away they made me a dentist appointment the next day. I went and saw the same dentist and told him the story and he told me how the deal is with workmans comp and that he was glad i came back and he was going to take care of me. They had to do a root canal and they sent me to a labrotory to get a vinier custom made so that its perfect. After 10 or so visits to the dentist for fittings/rootcanal/lab/ and a couple veniers and alot of pain i got it all taken care of. The dentist told me that workmans comp tries to do everything as cheap as possible even though in most situations its nowhere near the right way.



SOO after that novel the moral of the story is ....if you get a lawyer things will do a 180 and its all downhill from there. If you tell them you have a lawyer that bill for the surgery will probably miraculously become paid and everything else.

I never filed suit but i have a trial thing for a settlement set for a couple weeks from now that the state of missouri filed on my behalf. Im not looking for any money, but hopefully after all the crap i had to go through i might get enough money for a sammich or two.:cheers:
 
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