And Just Like That It’s Over -A Workmen’s Comp Nightmare!

1.616 days ago my husband fell at work. He slipped on an oil-water spill someone had left unattended. An accident at work! On the 6th of December 2018, a special kind of nightmare began, one nobody prepares you for, because somehow we all think we are covered by an insurance, known to all in the US as Workmen’s Compensation.

My husband hurt his shoulder when he fell, but he managed to get up. We wouldn’t know it for a long time, but he had torn three muscles in his right arm when he tried to ease the fall.

Biggest mistake!

Don’t ever get up when you get hurt at work. Make sure they call the ambulance and have the paramedics transport you to the next hospital. Insist on being carried away!

My husband got up and so instead of going to a hospital, he was asked to go to an Urgent Care close by, where he filled out an accident report. He had to take a drug test, which he passed. He was seen by a nurse practitioner -no doctor- and was then sent back home, without an x-ray, without an MRI but with a prescription for Prednisone (Steroids). He couldn’t lift up his right arm, he was in crucial pain. All of this got ignored.

He was excused from work for three days. He got some pain meds. The first night when he asked me to help him into bed, tears run down his cheeks and his face showed the pain he was in when he moved. He didn’t sleep at all! Neither did I.

Lawyer?

He went back to work after three days. His right arm in a sling. He was then told that Workman’s Compensation Insurance had asked a lawyer to take over his case, which surprised us endlessly. Why?

When my husband came home and told me about it, we decided to get a lawyer as well. We didn’t know a Workmen’s Compensation lawyer. We went by reviews!

You got hurt at work! Why do you need a lawyer? It was even on camera.

Let the games begin!

The Workmen’s Comp insurance didn’t give the approval for an X-Ray but asked him to have physical therapy instead. (Quite idiotic without an x-ray confirming what kind of injury we were dealing with.)

After two months of crucial pain, there was a hearing in court, and the X-Ray got approved but it didn’t show too much. Another court hearing a month later where we asked for an allowance to get an MRI done -which was denied. We appealed, won, and finally, almost four months after his fall, my husband had an appointment for an MRI.

Four months of unnecessary misery.

By then the three torn muscles had started to deteriorate -muscles turn into fat when you can’t use them. We then went to court and asked for an allowance (that’s what it’s called when THEY do their job) for surgery.

Same routine! Hearing – We won! They appealed – We won again! Altogether it took three more months, then finally my husband was seen by an orthopedic surgeon, a specialist in shoulder replacement surgeries because now after all the time that has passed, his shoulder couldn’t be repaired anymore.

Hearings – Appeals – Fights for everything we thought were our rights.

Money, money, money!

At the moment my husband became a Workmen’s Compensation claim, he was under work restrictions. He couldn’t work overtime anymore. He was only allowed to be on light duty and work maximum 40 hours a week -which is unheard in his job.

Workmen’s Compensation has a limit on what they pay you for the wages you lose. ‘Wage Loss’ or LOST WAGES, is also not a given, you have to ask for it.

We had to go to court again! We lost, we appealed. We won -they appealed. We won again. Four months later they agreed to pay him ‘lost wages’ which is paid weekly. They take your income for the last three months before the accident, the average, that’s the number they are working with. But only 80% of it. You never the full 100% you made before.

From that moment on sent a weekly check if your earned wages are less than the 80% you had before. (Dahhhh!)

During the last 1,616 days, we lost $40,000.

Workman’s compensation also doesn’t cover health insurance. If you want to continue your coverage, you have to pay it from your reduced income. The logic behind all of this is lost on me.

Blessing in Disguise!

Five days before the scheduled shoulder surgery in November 2019, my husband didn’t pass a stress test during pre-op. He called me and told me “They want to keep me.” I laughed but not for long. They kept him and monitored him after they couldn’t put stents in his blocked arteries. Five days later he had open heart surgery, a quadruple bypass.

The fall at work had spared him a heart attack, which I assume would have been a massive one.

How did I take this all? Don’t ask!

He came home five days after heart surgery. He walked on a walker, and he sat in the recliner we had bought for shoulder surgery. His shoulder still hurting, a big scar on his chest. I am still in awe of how he took it all.

Now we had no income because Workmen’s Comp stopped paying. The heart surgery was not their problem.

How we made it. Good grief! By plain luck.

Our savings had already taken a beating during the year of lost income. I worked harder (not smarter), and we sold some things we didn’t want to sell. Co-workers took up a collection because it was so close to Christmas and two bloggers and a friend donated money to the “Go Fund Me” page I had set up when I was on my wit’s end.

We got hammered with a $5,000 deductible from our health insurance for 2019 and a $5,000 deductible for 2020 as well. If you have to have major surgery, don’t have it by the end of the year.

Our savings disappeared!

Shoulder Surgery

Most Americans will never find out how screwed up our health system is. You pay high monthly premiums, then you pay high deductibles. It brings you to your breaking point. It is so wrong, on so many levels. Why do we not fix this?

The cardiologist cleared my husband for shoulder surgery, another invasive surgery, three months after open heart surgery.

In February 2020, right before the first lockdown for COVID, he got shoulder replacement surgery.

He was sent home. He was in pain. He became a zombie for one week on oxycodone. The pain got better, and physical therapy began. More pain! Shoulder surgeries are no fun!

COVID Lockdown

When the lockdown happened we got the first Workmen’s comp check. By then it was April. We had been without any income from my husband’s side for almost six months. I am still mighty proud of myself that I pulled us through.

The first check was a nice one, and our lawyer got 30%. The check was solely used to pay bills.

During the COVID lockdown, I started sewing facemasks after hospitals called everybody in my line of work. We all sewed our little hearts out. After a few weeks, I made my husband my helper and he stepped up.

For hours and hours, he ironed fabric, cut fabric, put the layers together and I sewed from 8 am to 5 pm every day. He cut and ironed for eight hours. It gave us something to do.

We donated thousands of facemasks but sold hundreds of them on Etsy and eBay as well.

We needed to live!

Light Duty – Humiliation

Then the Workmen’s Comp insurance company asked him to go back to work on light duty. They refused to pay “Lost Wages” for him sitting at home and so four months after surgery he reported back to work. His company was considered “essential”, the rest of the world was still in lockdown.

My husband’s weight restrictions were 10 lbs. His job required him to lift 75 lbs, even as a supervisor.

They gave him a desk in the warehouse and from 8 am to 4 pm every day he had to hand-copy a safety book. He filled notebooks over notebooks writing with his left hand. I don’t know how he did it. It became clear they wanted him to quit. With that Workman’s compensation would end and they would be off the hook.

I could have not done what he was doing. I would have refused. I am certain I would have walked out.

My husband, who is damaged goods just like me, remembered the time in our lives when he had been desperate for a job.

“It’s a job, it pays the bills,” he said and while he hated every minute of it, he made it through two months of daily writing. Two months of humiliation?

BYE BYE Lost Wages?

Then, from one day to the next, he was sent to a different department. Overtime was required, and all of a sudden they ignored his 40-hr restrictions. He worked 50+ hours. Finally, he got some checks that made life good again. He worked there for 2 months, then he was sent back to the old department, this time he sat in an office and helped the ‘girls’.

He was back on 40 hours but no more lost wage checks came in. When I asked the lawyer’s office why, they told me that it ended because he had worked overtime. We would have to apply again and they didn’t think it would work.

For them, the case was closed. A voice inside me rebelled.

His restriction would go on for two more years. His next appointment with the shoulder surgeon was set for 2023. Not getting some kind of compensation didn’t make any sense to me. I researched it for days, made calls, and asked questions.

Sure enough, the law says he was eligible for 200 weeks of lost wages. So far he had only gotten 60 weeks.

Without our lawyers, I filled out the paperwork and send it to the Ohio Bureau of Worker’s Compensation and to the Worker’s Compensation insurance. Also, I faxed our lawyers a copy. “That’s how your job is done,” I wrote because I couldn’t help it.

The Insurance declined the claim and asked for a hearing but they were out of appeals. We won! They agreed to pay for 170 more weeks. The last payment will come in two weeks from today. 🙂

Workmen’s Compensation has sent us through a special kind of hell. As far as I am concerned (and I am) they should pay what they owe us, because everybody who is injured at work, loses a lot.

More Humiliation?

After we won the Lost Wage Claim and they had to pay, somehow his company came up with a ‘new job’ and a new form of light duty for my husband -even though there were other opportunities.

Now THEY asked him to open the warehouse and office every morning at 4:30 am.

In 2021 and almost the whole year 2022 my husband got up every day at 2:30 am to be at work on time. He went to bed at 7 pm and started jawning around 6 pm. Dinner all of a sudden had to be ready by 5 pm. It rattled my world!

When I was finally done with my day and ready to unwind, my partner was in bed.

It took a toll on our marriage. We hardly had any quality time left and no matter how hard I tried (and I tried) I woke up every night. Either I heard him, or the dogs did. Every night I was awake from 2:30 am to around 4 am when he left. Then I was able to fall asleep again, for about 1 1/2 hrs when it was time for me to get up as well.

One night I found myself sitting in my bed in the middle of the night, crying. I had just slammed a door, which is something I normally don’t do.

My husband had asked to be released from his opening-duty numerous times. No luck! Promises made- that weren’t kept. Our sleep-deprived life continued.

By the end of 2022, right after Thanksgiving, I said the words I thought I would never say. “It’s me or your job, this is killing me, this is killing us.” And when I heard myself say it, I knew it was what had been on my mind.

This insanity had to stop, one way or another. I didn’t have an answer on how to stop it, but just knew we couldn’t go on like this.

I always believed a lack of communication destroys most marriages and so we both sat down and talked for hours. My side! His side! Our side!

It was US against THEM!

The Angry Wife

I composed a letter on my computer and made it sound like it was him, but clearly, it was me. I am the ‘desk worker’, the thinker, and good with words -if I want to be. A good -and honest- friend of mine read it. “That’s a complaint of an angry employee, they are not taking this seriously,” she said. Her advice: Get rid of the angry wife!

In the evening my husband and I re-wrote the letter and the next morning the following was sent out via email to HR, the President and Vice President, and his boss:

I am writing to express concerns about my current position.
Every morning, Monday to Friday, I am opening the office and warehouse at 4:30 am in the morning. I get up two hours before, at 2:30 am.

I am a cardio patient and have brought up my concerns frequently. Since months I am sleep deprived.

I had open heart surgery (quadruple bypass) in November 2018. I am a cardio patient for life. I am on medications (morning and evening) and have adjusted my lifestyle accordingly. I take care of my health situation and do everything on my end to stay healthy.

Until I had to get up that early, I felt strong and healthy. This has changed. According to my cardiologist, being sleep deprived puts me at a high risk of having a cardio episode. It increases the chance to have a heart attack or heart-related complications between 30-40%. A risk I should not have to take!

Over a period of four months I have asked numerous managers, and people temporarily in charge, to put me on a different schedule. All of them assured me they would look into it, and made promises they didn’t keep.

I have been told I would not have to open up anymore after my Thanksgiving vacation, which ended yesterday, December 4^th, yet to my surprise, I was again on the call log for today, scheduled for 4:30 am.

For the last ten years, I have shown nothing but dedication and loyalty to the company. I even once got a bonus for being so dedicated and reliable, and my name was mentioned in an employee meeting because my attitude and my work ethic were found worth mentioning.

Finally, when I asked why I have to open up I was told because I am reliable. In other companies, you get promoted when you are a dedicated employee, yet I got demoted and punished.

Working under these circumstances is unacceptable. No employee should be belittled, insulted, discriminated against, or forced to risk their health.

I am requesting this issue to be addressed as soon as possible.

Sincerely,

No more anger! Only facts! Two days later he was transferred back to his old job. Our sleep cycle and our marriage were back to normal.

2023 and the future

Now 1,616 days after his fall, his shoulder surgeon who he just saw, allowed him to work as much as he wants. No more hourly restriction, and hardly any weight restriction (50 pounds now).

Back to normal?

No!

My husband put in his two-week notice last Monday after he asked for a significant raise -which was denied!

He will start working for a competitor on May 22nd, and they will start him out exactly at the amount his company just declined to pay. They tried to get him for years.

The Workmen’s Compensation nightmare is almost over.

There will be a settlement hearing in February 2024 (there is a wait time of six months after Lost Wages run out, which also doesn’t make any sense).

I will speak at the court hearing because let’s face it, who else than the spouse who watched the loved one in pain could speak better on his or her behalf. I will not be the angry wife, but will spit out facts and I will make sure the three missing muscles in his arm, won’t be overlooked!

Our future looks good!

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