For about a year now I've been fighting a workman's comp decision for my wife. I've had to do this on my own since no lawyer in WV will take a case that isn't a permanent disability, but the insurance company had no problem getting a lawyer. This was a simple sprain that resulted in 2 weeks off work and 3 doctors visits. Finally the judge ruled in our favor and they didn't appeal the decision. Here's the kicker. Now the insurance company says they will only pay medical bills not time off work. This is because my wife asked for a doctor's note saying she could return to work before 3 days if it was light duty. When she returned the store manager told her she wasn't allowed to work at all until she was 100% recovered. She went back and got a 2nd note from the doctor saying she couldn't work at all for the 2 weeks, but the insurance company is focusing on the original note. I really don't want to go though this process all over again, but what they are doing is wrong. Any WV lawyers here? What are my options? I just want her to be paid for the 2 weeks and the medical bills. probably less than $2000 total with most of that being the doctor's which they have to pay now anyway.    

I know our Traveler's policy (NC) didn't pay for the first week of missed time. Not sure what the company was legally required to cover. Small family business, cheaper to just pay than get an attorney to explain it

The law here is after 3 days.



 

They tell me if her work confirms that they sent her home and wouldn't allow light duty they will pay at least some of the missed days, but none of the days she took vacation to cover. What a scam workman's comp is. It's paying for nothing. I'm thinking if they deny saying it I'll request a deposition from the manager who told her. I wish I had a little more experience at this.

For $2k I wouldn't even bother...

This, an attorney will want more than that as a retainer.  I'm assuming that your wife's employer doesn't offer any kind of short- or long-term disability insurance coverage?

I fought it out of principle not because I needed the money. You are right no attorney will take the case or any other case that's not a permanent disability but the insurance company will use a lawyer on every case. It's not a fair system. I found myself fighting a lawyer who does this everyday for a job and knows the law. I had zero experience with the workman's comp system. Until this happened last year neither of us had ever filed any kind of claim for benefits. I won but think due to my inexperience I might not have filed something correctly and it's how they are trying to weasel out of paying the lost hours. About 76 in total.  

 

The insurance company is Liberty Mutual. They use a different name but it's one of their companies. If you have them for workman's comp, from what I've seen expect them to do everything possible to get out of paying. It was satisfying to read the judge's decision on the medical bills. They were called out for some of the unethical behavior.

Well it sounds like we are going to get money for her time off also. I called up the adjuster and told her how I felt, and how I would fight this for another year even if it was only $1. The conversation went so well she told me I was no longer allowed to call her, but it looks like our fight with Liberty Mutual is over.



I don't know how other states handle workman's comp but here in WV the deck is stacked against the worker. Since there is no jury trial, no lawyer will take your case unless it's a death or long term injury. There's just no money in it for them. Insurance companies however, will hire a lawyer no matter how low the dollar amount. They try to intimidate you into dropping the case with unreasonable requests like 5 years of tax returns and ALL your medical records whether it was related to the injury or not. Along with pages of interrogatories that are often worded so you admit guilt if you answer. The final straw for me was when they tried to schedule a deposition at their office. I didn't like the sound of that since we didn't have a lawyer so I called the state and asked what was required. They told me they needed to give us 2 weeks to schedule and couldn't make her miss work for it. They also said a phone deposition was allowed. They had 3 days until the deadline to submit final arguments and all of those days my wife worked so we never called them or agreed to a time. 3 days later I get a certified letter saying she had to be at a deposition 2 hours ago. I called the law office and said we never agreed to a time and they said my wife had (a lie). I requested a phone deposition they said no and hung up on me. Their final argument said they worked with us to schedule a time but we didn't show. Thankfully I had wrote a letter that day to the court describing what happened.



Anyway enough of my boring life, but I hope this might help someone else in a similar situation.

West Virginia Workers' Compensation Telephone Directory
West Virginia Division of Labor	(304) 558-7890
Workers' Comp Board of Review	304-558-5230
Self Insurance	304-558-1207

I'm glad you were able to get resolution.  Sorry I didn't see this thread earlier.  Have handled workers comp claims for my company for a couple of decades.