Help Me to Help: Workplace Injury
April 11, 2022 11:00 PM   Subscribe

An immediate relative who lives in North Carolina was seriously injured while working. Last night he asked if I could be available by phone or email to help advocate for him as he tries to get his needs met. While you are not his lawyer, doctor, or employer, I'm hoping fellow Mefites might have advice or experience to help. The details and my questions are below.

Bob is 66 and employed as a sales rep for a well-known technology company that is not unionized. A month ago, a robbery occurred as he finished a routine visit to the store of a vendor that was on his caseload. Bob was almost to the door when he heard the store alarm activate and people shout, "stop him!" He turned and saw a man running towards him. At that point, Bob's memory clicked off and didn't switch back on until paramedics arrived; even after that, his memories of the next 24 hours are quite fuzzy. Per witness reports (he doesn't have copies), the robber barreled into Bob, knocking him backwards. As he went down Bob hit the side of his head against the edge of a thick metal windowsill and was knocked unconscious for at least 5 minutes. He has a vague memory of paramedics tending to him. He was taken to the ER by ambulance, and over the course of just a few hours a CAT Scan was performed, concussion was confirmed, orders for follow up by a physician were provided, and Bob was discharged. The store manager had gone to the ER to check on Bob and gave him a ride back to the store; from there, Bob drove home, where he lives alone.

I wasn’t aware of the incident/injuries until Bob called me a week later. As soon as he started talking, I noticed a difference in his speech. He is generally very mellow but that night he was stuttering a little, which is not normal for him, and his thinking was not orderly. Maybe I should have asked more questions, but I didn't want to sidetrack him, and it sounded like he really needed to talk, so I tried to just listen. The discharge paperwork directed Bob to be seen by an Osteopath for possible neck or spinal injuries but did NOT include a referral to a neurologist or for an MRI. I don't know why the hospital didn't at least keep him overnight or why more assessments weren't completed/ordered. In the days following the incident, Bob was seen by an Osteopath who confirmed neck and spinal damage and stated that surgery may be needed, but first the Osteopath wanted Bob to be evaluated by a Neurologist. Bob says he's had a constant headache since the incident and he’s unable to lie down without experiencing severe vertigo and feeling like his head will explode, so he sleeps propped up and is unable to sleep more than a couple hours at a time. Bob is left-handed but since the incident he has pain in his left arm and his left hand shakes noticeably. The stuttering has gotten much worse since the incident. Bob went to the Neurologist that he was referred to by the Osteopath and he thought the Neurologist was very helpful. The appointment resulted in referrals for an MRI and Speech Therapy. The incident and all medical reports were immediately shared with Worker's Comp (WC)

At the advice of his son, Bob hired a law firm that specializes in personal injury, but the assigned attorney has not been timely in returning Bob's calls. Once an attorney got involved, WC stopped communicating directly with Bob; referrals need to be routed to and from the attorney (again, who is not timely). A third-party case manager was assigned by WC and within the past few days the case manager informed Bob that the "Neurologist" he was referred to is actually a Chiropractor and cannot make referrals for an MRI or Speech Therapy. Bob felt certain that the Neurologist was a Neurologist but is now feeling extra frustrated and is doubting himself. The next appointment with the Neurologist/Chiropractor isn't scheduled until next week, and the Case Manager stated that they will also be present. Due to his frustration with the lack of a timely response from the attorney and not being able to communicate directly with WC, Bob tried to fire the law firm, but the "owner" (the attorney whose name is on the sign for the firm) followed up with a phone call and promised that he will personally handle the case and talked Bob into not firing them.

Other possibly relevant info:
Bob noticed that he is continuing to be paid his regular wages without the use of sick or annual leave. The case manager told Bob that the company has not placed him on leave even though Bob has not been able to work. It’s not clear how long they’ll continue to pay him and he doesn't have anything in writing from the company informing him of his status.

Bob had a great relationship with his employer before the incident and he’s hoping to return to work at some point, but his position required in-person communication with clients, so he’s worried the stuttering will mean he can't continue with the same job. Additionally, he might not feel safe returning to the small stores that are on his caseload. I don’t have any data to support this, but Bob told me these stores, most of which are located in strip-malls, are frequently targeted for robbery. He might feel better in time, but right now, the thought of going there scares him.

Questions from the case manager suggest that WC or the company may think Bob is at fault in some way. They asked if he was wearing his work uniform on the night of the incident (he was) and if he intentionally blocked the robber (he doesn't remember but probably didn't have enough time to block or dodge). There were multiple witnesses who confirmed that Bob was just in the wrong place at the wrong time and there should be video recording of the incident. I’m hoping the questions are just part of a standard checklist for WC to confirm employees aren’t reckless or committing fraud but the questions are making Bob feel defensive and causing him to doubt himself (Is it possible I instinctively blocked the door? Should I have done more to avoid being hit?).

While I tagged this question with Aphasia, the ER's discharge and the Osteopath's evaluation did not reference this diagnosis. It seems very possible given the symptoms, but we're hoping the speech and language challenges will resolve as his brain heals.

1. What can be done to get Bob the medical care he needs ASAP, including an evaluation by a legitimate neurologist? I think he should go back to the ER with a copy of the discharge paperwork and the Osteopath’s findings and demand a neuro eval and MRI but I don’t want to give Bob advice that might backfire or place him in deep medical debt for procedures not authorized by WC. He also has medical insurance through his employer and should be Medicare eligible (but AFAIK he hasn’t applied).
2. Is having an attorney helpful at this time? At first I thought it was good advice, and that an attorney could help ensure complete and timely medical care, but so far, that hasn’t been the case. Maybe the problem is that it’s a Personal Injury firm and their goal is settlement rather than care.
3. I want to believe the company is allowing Bob to be paid without using sick/annual leave because they know he was seriously hurt through no fault of his own, but I’m worried there may be something nefarious in their actions. Could this be a strategy to fire him for claiming hours that he hasn’t worked or something else? (note: the hours are being entered and approved by Bob’s supervisor)
4. Similarly, could the company’s action to pay Bob rather than have him use PTO create a problem for WC? I’m worried WC will refuse to recognize the seriousness of Bob’s injuries because he appears to be working, even though he’s not.
5. Is there anything else Bob (or I) should be exploring? ADA, FMLA, SSDI, . . . ?

Thank you for any advice you might have.
posted by kbar1 to Health & Fitness (4 answers total)
Best answer: I'm a neurologist in NC. While I do not manage concussion, many of my colleagues do. Feel free to memail me and I'll give you names.

Fwiw, "osteopath" refers to the medical degree (DO, as opposed to the more common MD) but not the kind of work. DO grads can be PCPs or surgeons or, in fact, neurologists. They are real doctors. Don't get me started on so-called "chiropractic neurologists" (I think I know exactly who you are talking about, they are notorious for exceeeding their scope of practice and delaying necessary care. I've reported them for a similar scenario before, only to be told by the medical board of NC that they have no jurisdiction over this charlatan. Infuriating.)
posted by basalganglia at 2:45 AM on April 12, 2022 [10 favorites]

Best answer: Two other thoughts:

1) Does Bob have access to an EAP or benefits navigation support person via his work or health insurance? (A lot of places offer something like this now.) They may be able to help him figure out legal and medical care options by doing the work of "neurologists covered by your plan".

2) Given the cognitive issues, one thing that you (and others) could to do help is (if Bob is willing) agree to be on a phone call or video call with specialists. (If someone can go with him, even better, but a lot of places will allow video calls when multiple people aren't allowed in the space due to Covid limitations. Especially if you explain this involves a head injury, there may well be some option. This does obviously require Bob's direct consent.)
posted by jenettsilver at 11:18 AM on April 12, 2022 [2 favorites]

Best answer: Hi, I'm a workplace safety person and previously worked very closely managing WC cases, from the employer's side.

Those questions are 100% normal incident investigation questions. They're trying to pin down what happened, not necessarily assign blame.

Refusing to talk to the employee after they have chosen to litigate is also standard procedure. I understand that it's very frustrating, but it's what is done.

I personally would not recommend Bob going to the ER or doing anything without talking to the WC case manager first. . As you mentioned, this may put him on the line for those bills, and even if they do pay them, it might take a while and it gums up the system. He should talk to the case manager with his concerns.

As far as his pay, even though he is litigated, he should still be able to call and ask somebody from HR those questions.

I am biased, but I don't believe that workers comp attorneys are really that helpful. Most states have maximum amounts that you can be paid out for certain type of injuries, and attorneys just eat up fees.

I'm very sorry this happened to Bob, and I hope he feels better soon. Feel free to email me any further questions, if you think having a safety person's perspective is helpful.
posted by Sparky Buttons at 3:57 PM on April 12, 2022 [1 favorite]

Response by poster: THIS is why I love Metafilter. While I also love the community engagement aspect, like card exchanges and Metatalktails, I know I can count on mefites for thoughtful and helpful advice on some really big and deeply personal issues. Thank you all!

Basalganglia and dancing leaves, please check your memail.
posted by kbar1 at 4:51 PM on April 12, 2022 [1 favorite]

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