Caught in Limbo With Injury - Worker's Comp or Not?
Last Friday, I bumped into a doorway at work. It happened so quickly I'm not sure what exactly happened, but I think I banged my hip bone into a corner/edge of a doorway. I was at work, and heard the microwave ding that my hot water for tea was ready, and got out of my chair to head out the door. I'm naturally clumsy, so I of course bumped into the doorway as I was heading out. I immediately felt a sharp pain, which then subsided to a dull ache. However, a few minutes later I noticed that the area below my hip bone was numb to the touch.
I called my Primary Care Physician's office to ask if this was normal or if I should come in to see her. I spoke to a nurse who asked me, "Are you at home right now?" and, not thinking, I replied, "No, I'm at work, that's where it happened." The nurse said they don't do worker's comp cases, and I told her it wasn't really a work related injury. She said she'd confer with the doctor and call back. She asked if I could still walk okay (yes), still had full range of movement (yes), and if there was any bruising (no). She called back later to say the doctor said the symptoms should resolve in a few days, but if they didn't, I should call back.
Over the weekend I thought I was feeling a bit better. But then on Monday night I slept on my stomach (which I don't usually do) and this must have put pressure on my hip because it's been sore since yesterday (Tuesday). And I've noticed that there is still some numbness. So last night I decided I would call the doctor to make an appointment.
I called this morning at 8am, right when they opened, and spoke to a receptionist, or whoever answered the phone. She looked at my records and said, "I see this happened at work. We can't see you for it because that's worker's comp." I told her again that it wasn't a work injury and could have easily happened at a doorway at home. She told me, "But you've already said it happened at work and now it's in your record." She told me I'd have to see the company doctor. Well, we don't have one because we're a tiny office. She said then I'd have to file a worker's comp claim at work, and recommended a local practice that does handle worker's comp cases.
Just to make sure I had the facts right, I called my health insurance's customer service. They referred me to an expert in their claims department. I described how the injury happened, and she said that a doctor is within their rights to refuse to handle worker's comp cases if they choose. However, she also said there could be some leeway as to whether or not this was a workplace injury, since it didn't happen in the capacity of performing work-related duties. However, She asked me to talk to my HR person and ask if they wanted to file a claim. Then call her back and let her know.
Our HR person felt that this was not really a workers' comp issue. She said if I had slipped on spilled water, or injured myself moving heavy boxes that was one thing, but "clumsiness" wasn't the same thing. So I called the woman at the insurance company, and she said she would call my doctor and tell them that my insurance would cover it, and they would not have to consider it worker's comp. I called back a little later to find out what happened. She said the doctor's office gave her "a hard time" but that she had her supervisor call and speak to the billing manager, who agreed to let me make an appointment and that she would call me.
I admit I was getting impatient then, so I called the doctor's office and tried to make an appointment. After looking at my record, the receptionist had to confirm things with the billing manager. She came back and said that the billing manager had to first confirm with their "administrator" to get the OK, because even though the insurance said it was OK, they didn't want this to "come back and bite them." She said the billing manager would call me as soon as she hears.
So at 3:20pm, that's what I'm waiting for now. I spoke to our HR person again and asked if it would still be possible to file a worker's comp claim if the doctor still refuses to see me, and she said we could, but I may have to wait for that to be approved before I can see a doctor about it.
Any other thoughts on what I can do? Another co-worker suggested trying a local urgent care center and telling them it happened at home, but since I already have a record at my PCP saying I told them it happened at work, I don't think that's a good idea.
I live in New York State, if that makes a difference. Any suggestions on what to do if my doctor's office still refuses to see me?