Worker's Comp for a broken Prosthetic? Responses
Daniel Sheret
Description
Collection
Title:
Worker's Comp for a broken Prosthetic? Responses
Creator:
Daniel Sheret
Date:
1/14/2009
Text:
My question about Workers Comp was quite interesting to many and I think you
for the responses. I will be pursuing a claim with them and any other
expenses will be covered by the company insurance it appears. I have
several different legs for cycling skiing and kayaking so was not too
worried about not being able to ambulate. Here are the responses thanks to
all that expressed an interest in this question.
Dan Sheret
Abilitytrek.org
I hope you get paid for your new foot but my guess is that Worker's comp
won't pay as they would only pay for bodily harm. For instance, if you were
delivering something for work using your own car and it was totaled, your
own insurance would have to ante-up. Worker's comp would only pay if you
were injured yourself. Still I hope I am wrong about this and you get
paid/reimbursed.
Many years ago (probably 20--but it gets hazy after a while) I was
working in Maryland and took care of a Transtibial amputee who worked as a
landscaper. A Bobcat ran over his prosthesis and broke it. My recollection
is that Maryland workman's Comp covered the replacement of his prosthesis at
that time. Time and my faulty memory has erased any other pertinent
details.
Hello Dan. We have had success getting this covered by comp carriers in the
past. If not your employers liability ins. Should cover it. Get hold of
Maggie in Grants Pass and she should get it covered for you.
Hope all is well. I assume you know the answer to this but I have to ask....
Why wouldn't the company's insurance pay for a new foot? It seems as if the
company would be happy to file an insurance claim on this one. Lucky them.
Certainly this would be a better/cheaper deal than if the foot HAD been your
real one... lucky you.
Personally having dealt with this issue - yes it should be covered under
your Workers Comp insurance. We have had 2 issues dealing with this. Even
though you were not hurt your limb was and needs to be replaced.
Glad to hear you were unharmed :)
YES YOU HAVE A WORK COMP CLAIM. ASK YOUR EMPLOYER IF HE IS GOING TO
REPLACE THE FOOT, AND ITS CLINICAL LABOR TO ORDER,ALIGN, AND FINAL INSTALL
FOR A NEW ONE. DO THIS IMMEDIATELY OR YOU MAY LOSE YOUR RIGHTS!!
Even though you are an amputee your prosthesis should be treated as part of
your body and it is necessary for you to be able to do your job. What you
will need is a prescription from your physician with a letter explaining the
medical necessity of the prosthesis and the need to get the foot repaired or
replaced. I know it sounds weird but you do have to explain the medical
necessity of the prosthesis, there have been a number of cases over the
years when some clerk thought that the prosthesis was not a medical
necessity and denied the claim. Be sure to also explain the damage to the
prosthesis in the accident report but they should cover any repairs as a
workmen's compensation claim.
I would check with a lawyer. Workers comp I believe is for injuries, not
damages. For example, if you get your pants torn at work, I don't think one
can file a complaint. However, their liability policy on the building
likely would cover it, so I would check there. However, it may be just as
simple to see if the foot is covered under the manufacturer's warranty and
obtain a replacement that way.
It does in Ohio, I am sure it would also be covered in MA. I have billed for
many claims like this over the years and they were never questioned. Just
think how much money your W/C insurer is saving over a similar injury to
your sound side.
Good luck,
Sounds like yours is a case of damage to personal property, and should be
handled through your employer's liability and comprehensive insurance plan.
Most facilities have policies that should cover this sort of mishap.
It should be covered just like any other personal item, say a pair of
glasses etc. just ask HR if that has ever been happened. Since it is not a
real body part it should not involve workers comp. That would be reserved
for a physical injury. Ask what they do if you brought in a personal tool
or device and it was damaged. They also would be better off just to pay the
cost of the foot and labor because it would be cheaper than turning it into
insurance. Depending on the foot even medicare allowable on the most
expensive one would be $6K. Unless you have a proprio from ossur then it is
like 15k. Your prosthetist might even cut them some slack just to pop a new
one on, no real issues cause alignment is not changed, then again they
should allow you to go during work hours and be paid for it.
Yes indeed, I would file for a new foot and any other associated repairs.
It was a work related injury to your prosthetic leg. They should be happy
that it wasn't your good one. We had a situation like this at my office in
WA state and L & I paid for the repair. I think it was a Pathfinder foot as
well.
Yes, you can claim a workers comp for the damage. There have been a couple
cases like that in Kansas including one I was involved in. The patient
crushed his Greifer with a sledge hammer. It was processed as a new w/c
case. I am not sure about other states .
Without being an expert in this, my first thought would be these...
Worker's Comp is for physical injuries of a worker. A prosthesis is
personal property and would be covered under liability insurance of the
employer or perhaps under your homeowner's or renter's insurance for damage
as you mention.
I can't see why they wouldn't since it happened at work. If your foot
was in working order when you came to work and the accident was work
related, it should be covered. The best thing to do is get on the phone
with WCB in Mass. and get an answer to this question. I have had my
go-around with WCB in Canada over the last few years. Asking an honest
question to someone who will give you an honest answer is perhaps the best
way to get somewhere.
If your foot is crushed, how are you getting around? I perceive you may
need help fairly soon in order to keep working. WCB may be a bit slow in
getting their act together unless you are unable to work (and thus on their
bill) because of the problems with your prosthetic foot.
Since I reside in Canada, am not an amputee and only deal with partial
foot amputations, I am out of my league to answer such a question. Best
wishes in getting this sorted out.
I heard of a story you may relate to- a missionary that was a BK went to
a tribe of cannibals. They wanted to eat him eventually and came to get him
ready. He took a knife and peeled some of his wooden leg off and gave it to
them and said that they wouldn't like him - he was not good to eat because
he was so old and crusty. He was allowed to live on the island for the rest
of his life with no bother from the cannibals wanting to eat him!
Yes, you should be able to receive a new foot, as long as the incident was
documented thoroughly. This seems justified, and of course it is medically
necessary if the damaged foot is not functional. Function and Safety is of
the utmost importance.
The office providing the new foot should obtain prior authorization in
advance.
No virus found in this outgoing message.
Checked by AVG.
Version: 7.5.552 / Virus Database: 270.10.6/1891 - Release Date: 1/13/2009
8:17 AM
for the responses. I will be pursuing a claim with them and any other
expenses will be covered by the company insurance it appears. I have
several different legs for cycling skiing and kayaking so was not too
worried about not being able to ambulate. Here are the responses thanks to
all that expressed an interest in this question.
Dan Sheret
Abilitytrek.org
I hope you get paid for your new foot but my guess is that Worker's comp
won't pay as they would only pay for bodily harm. For instance, if you were
delivering something for work using your own car and it was totaled, your
own insurance would have to ante-up. Worker's comp would only pay if you
were injured yourself. Still I hope I am wrong about this and you get
paid/reimbursed.
Many years ago (probably 20--but it gets hazy after a while) I was
working in Maryland and took care of a Transtibial amputee who worked as a
landscaper. A Bobcat ran over his prosthesis and broke it. My recollection
is that Maryland workman's Comp covered the replacement of his prosthesis at
that time. Time and my faulty memory has erased any other pertinent
details.
Hello Dan. We have had success getting this covered by comp carriers in the
past. If not your employers liability ins. Should cover it. Get hold of
Maggie in Grants Pass and she should get it covered for you.
Hope all is well. I assume you know the answer to this but I have to ask....
Why wouldn't the company's insurance pay for a new foot? It seems as if the
company would be happy to file an insurance claim on this one. Lucky them.
Certainly this would be a better/cheaper deal than if the foot HAD been your
real one... lucky you.
Personally having dealt with this issue - yes it should be covered under
your Workers Comp insurance. We have had 2 issues dealing with this. Even
though you were not hurt your limb was and needs to be replaced.
Glad to hear you were unharmed :)
YES YOU HAVE A WORK COMP CLAIM. ASK YOUR EMPLOYER IF HE IS GOING TO
REPLACE THE FOOT, AND ITS CLINICAL LABOR TO ORDER,ALIGN, AND FINAL INSTALL
FOR A NEW ONE. DO THIS IMMEDIATELY OR YOU MAY LOSE YOUR RIGHTS!!
Even though you are an amputee your prosthesis should be treated as part of
your body and it is necessary for you to be able to do your job. What you
will need is a prescription from your physician with a letter explaining the
medical necessity of the prosthesis and the need to get the foot repaired or
replaced. I know it sounds weird but you do have to explain the medical
necessity of the prosthesis, there have been a number of cases over the
years when some clerk thought that the prosthesis was not a medical
necessity and denied the claim. Be sure to also explain the damage to the
prosthesis in the accident report but they should cover any repairs as a
workmen's compensation claim.
I would check with a lawyer. Workers comp I believe is for injuries, not
damages. For example, if you get your pants torn at work, I don't think one
can file a complaint. However, their liability policy on the building
likely would cover it, so I would check there. However, it may be just as
simple to see if the foot is covered under the manufacturer's warranty and
obtain a replacement that way.
It does in Ohio, I am sure it would also be covered in MA. I have billed for
many claims like this over the years and they were never questioned. Just
think how much money your W/C insurer is saving over a similar injury to
your sound side.
Good luck,
Sounds like yours is a case of damage to personal property, and should be
handled through your employer's liability and comprehensive insurance plan.
Most facilities have policies that should cover this sort of mishap.
It should be covered just like any other personal item, say a pair of
glasses etc. just ask HR if that has ever been happened. Since it is not a
real body part it should not involve workers comp. That would be reserved
for a physical injury. Ask what they do if you brought in a personal tool
or device and it was damaged. They also would be better off just to pay the
cost of the foot and labor because it would be cheaper than turning it into
insurance. Depending on the foot even medicare allowable on the most
expensive one would be $6K. Unless you have a proprio from ossur then it is
like 15k. Your prosthetist might even cut them some slack just to pop a new
one on, no real issues cause alignment is not changed, then again they
should allow you to go during work hours and be paid for it.
Yes indeed, I would file for a new foot and any other associated repairs.
It was a work related injury to your prosthetic leg. They should be happy
that it wasn't your good one. We had a situation like this at my office in
WA state and L & I paid for the repair. I think it was a Pathfinder foot as
well.
Yes, you can claim a workers comp for the damage. There have been a couple
cases like that in Kansas including one I was involved in. The patient
crushed his Greifer with a sledge hammer. It was processed as a new w/c
case. I am not sure about other states .
Without being an expert in this, my first thought would be these...
Worker's Comp is for physical injuries of a worker. A prosthesis is
personal property and would be covered under liability insurance of the
employer or perhaps under your homeowner's or renter's insurance for damage
as you mention.
I can't see why they wouldn't since it happened at work. If your foot
was in working order when you came to work and the accident was work
related, it should be covered. The best thing to do is get on the phone
with WCB in Mass. and get an answer to this question. I have had my
go-around with WCB in Canada over the last few years. Asking an honest
question to someone who will give you an honest answer is perhaps the best
way to get somewhere.
If your foot is crushed, how are you getting around? I perceive you may
need help fairly soon in order to keep working. WCB may be a bit slow in
getting their act together unless you are unable to work (and thus on their
bill) because of the problems with your prosthetic foot.
Since I reside in Canada, am not an amputee and only deal with partial
foot amputations, I am out of my league to answer such a question. Best
wishes in getting this sorted out.
I heard of a story you may relate to- a missionary that was a BK went to
a tribe of cannibals. They wanted to eat him eventually and came to get him
ready. He took a knife and peeled some of his wooden leg off and gave it to
them and said that they wouldn't like him - he was not good to eat because
he was so old and crusty. He was allowed to live on the island for the rest
of his life with no bother from the cannibals wanting to eat him!
Yes, you should be able to receive a new foot, as long as the incident was
documented thoroughly. This seems justified, and of course it is medically
necessary if the damaged foot is not functional. Function and Safety is of
the utmost importance.
The office providing the new foot should obtain prior authorization in
advance.
No virus found in this outgoing message.
Checked by AVG.
Version: 7.5.552 / Virus Database: 270.10.6/1891 - Release Date: 1/13/2009
8:17 AM
Citation
Daniel Sheret, “Worker's Comp for a broken Prosthetic? Responses,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 22, 2024, https://library.drfop.org/items/show/230021.
