Who foots the bill for an at-work medical situation?
October 13, 2006 9:02 PM Subscribe
I was attending an off-site, work-related meeting when I felt faint and passed out. An ambulance was called and yada, yada- I'm fine. Since this is work related, who foots the bill?
I have group health insurance through my employer, but would like to avoid paying 20% of a substantial bill for emergency services. Does the fact that I was "on-the-clock" matter?
I have group health insurance through my employer, but would like to avoid paying 20% of a substantial bill for emergency services. Does the fact that I was "on-the-clock" matter?
At my job (texas, portrait studio) any injury sustained while on the clock is paid for by my employer. Everyone is so eager to sue that companies figure it's cheaper to pay for one emergency room visit every so often. of course, ianal.
posted by nadawi at 9:10 PM on October 13, 2006
posted by nadawi at 9:10 PM on October 13, 2006
I have no idea what the legal issues are, but look at the reasonableness of the situation: was the fainting caused directly by whatever you were doing for work? If not, I'd say it's probably your responsibility.
posted by dirtynumbangelboy at 9:24 PM on October 13, 2006
posted by dirtynumbangelboy at 9:24 PM on October 13, 2006
It's your problem. If you were violently ill and an ambulance was called for you, it would still be your problem. They were acting in your best interest, and would have been negligent if they hadn't called.
Also, I think it should be assumed that no one here is a lawyer unless they state it specifically.
posted by o0o0o at 9:55 PM on October 13, 2006
Also, I think it should be assumed that no one here is a lawyer unless they state it specifically.
posted by o0o0o at 9:55 PM on October 13, 2006
Talk to your HR office, or call your workmans comp insurance. They will investigate the issue and determine who is at fault.
I recently was at a company retreat, and broke my toe playing volleyball. The HR director was there, and immediately wrote the incedent up and forwarded it to our workmans comp people, who stated it was a covered incedent, and the issue was solved within the week. I never payed any co-pays, and never saw a bill.
But this isn't an 'injury', this is a medical issue of yours I would assume. You didn't give details of the findings at the hospital. Given that you were unconcious, an ambulance was the right course of action.
As for who foots the bill, was anything the company did a cause of the issue, or was it just chance you were at work, at a company meeting when it happened?
posted by SirStan at 10:05 PM on October 13, 2006
I recently was at a company retreat, and broke my toe playing volleyball. The HR director was there, and immediately wrote the incedent up and forwarded it to our workmans comp people, who stated it was a covered incedent, and the issue was solved within the week. I never payed any co-pays, and never saw a bill.
But this isn't an 'injury', this is a medical issue of yours I would assume. You didn't give details of the findings at the hospital. Given that you were unconcious, an ambulance was the right course of action.
As for who foots the bill, was anything the company did a cause of the issue, or was it just chance you were at work, at a company meeting when it happened?
posted by SirStan at 10:05 PM on October 13, 2006
Yeah, talk to HR. Did they ask you about workman's comp at the hospital? The one time I had to see a doctor about a work-related thing, they had special papers for me to fill out, and I wished I had talked to my employers first. It might be a workman's comp issue or it might not, but they probably want to be in the loop on it. Of course, IANAL.
posted by I Am Not a Lobster at 10:14 PM on October 13, 2006
posted by I Am Not a Lobster at 10:14 PM on October 13, 2006
Third on talking to HR and/or worker's comp.
posted by Opposite George at 11:16 PM on October 13, 2006
posted by Opposite George at 11:16 PM on October 13, 2006
Whatever else you do, don't count on worker's comp to really take care of things. If the lawyers get involved, you're likely to be screwed. I had to stop working at a job that caused me horrible tendonitus in my thumb tendon. The compenation ended up being a tiny drop in the bucket.
posted by Goofyy at 1:14 AM on October 14, 2006
posted by Goofyy at 1:14 AM on October 14, 2006
The fact that you were on the clock may well matter. While workers comp laws vary in all 50 states, there are some fundamental commonalities: injuries or illnesses must have arisen out of and in the course of employment. "Arising out of" generally would mean - was the injury or illness job-related? Was your employer deriving some benefit from your activities? And "course of" generally refers to the time and place of the injury. Since you were at a work-related event, that condition is likely met. Work-related activities don't have to be on the work premises. They can even be extracurricular activities if the employer encouraged or mandated participation, as in SirStan's example.
Both injuries and illnesses are generally covered by workers comp if they meet these tests. Illnesses have a lot of gray areas and can be tricky because they may be the result of a pre-existing condition or a condition that results from the ordinary activities of life, and not necessarily related to work. If your fainting was the result of stress or overwork and not some pre-existing condition or something like a flu, it might be compensable under workers comp.
If so, workers comp would pay for your medical care, and any subsequent medical care, if necessary. However, you would need to file a claim, and each state has a varying required time frame for doing so.
Most states have information online for workers about their rights and responsibilities related to workers comp - here is a link to All 50 States' and D.C.'s Home Pages and Workers Compensation Agencies. And you should talk to your HR department. Sometimes, companies have someone specifically designated to manage workers comp claims.
I hope you are feeling better!
posted by madamjujujive at 10:42 PM on October 14, 2006
Both injuries and illnesses are generally covered by workers comp if they meet these tests. Illnesses have a lot of gray areas and can be tricky because they may be the result of a pre-existing condition or a condition that results from the ordinary activities of life, and not necessarily related to work. If your fainting was the result of stress or overwork and not some pre-existing condition or something like a flu, it might be compensable under workers comp.
If so, workers comp would pay for your medical care, and any subsequent medical care, if necessary. However, you would need to file a claim, and each state has a varying required time frame for doing so.
Most states have information online for workers about their rights and responsibilities related to workers comp - here is a link to All 50 States' and D.C.'s Home Pages and Workers Compensation Agencies. And you should talk to your HR department. Sometimes, companies have someone specifically designated to manage workers comp claims.
I hope you are feeling better!
posted by madamjujujive at 10:42 PM on October 14, 2006
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posted by thirteenkiller at 9:06 PM on October 13, 2006