Although Einstein never said, “Insanity is doing the same thing over and over again and expecting different results,” that doesn’t make it any less true.
I learned that lesson recently in my first (and hopefully only) encounter with the workers comp system – as a claimant, rather than counsel.
It all began with a “routine” false alarm in our center city high rise office.
Since 9/11, we have all been motivated to walk down the fire escape stairwell, no matter how often the alarm sounds.
In fact, we have had several real evacuations, when noxious chemicals spread through our ventilation system.
At least I am only on the 6th floor. At our last building, I once hustled down from the 29th floor when I saw smoke spewing out of an air vent.
This time, however, I tripped and fell at the bottom of the fire tower. In my mind’s eye, I was jostled by someone behind me, or in the crowd milling around the ground floor exit.
Those behind me in line, however, told me I suddenly went down, for no apparent reason.
Although I remember feeling something trip me, I could not find any uneven surface in the fire tower exit during our next false alarm evacuation.
I distinctly recall falling in cartoon-like “slow motion” – with a clear expectation that a major hit would occur – and that nothing I could do would avoid an impact.
Instead, I recall a detached curiosity about how badly I would be hurt.
First my rear end hit the ground.
Next came my right elbow.
Finally, the back of my head slammed into a concrete wall.
(It all happened in a fraction of the time it took you to read this.)
To my surprise, I seemed fine – but not so well that I didn’t agree to an EMT ride to a hospital emergency room.
Fortuitously, it was the one time where all my doctors were on staff. By the time I arrived, the ER doctors had all of my medical records on their screens – as well as my health insurance information.
Fortunately, everything checked out fine. After a detailed neurological exam, I was discharged, with instructions not to use my brain.
Huh? Apart from life functions, I am an attorney, and compulsive reader.
Nonetheless, I stayed awake on the train ride home. I even skipped the newspaper that night.
The next morning – I never considered commuting to work – I rested in a dark room, listening to calm music. “Alexa, play quiet soothing music.”
Nine months later, I see no evidence of my fall and concussion – except for the large pile of dunning letters and collection notices.
But the letters sent to my home were not the worst of it.
Since I fell at work, the claims (above the amount paid by my health insurance) were supposed to be paid by our workman’s comp carrier.
We got calls at home, in the evening and on weekends, asking for the same information I had previously provided to our comp carrier’s adjuster in the days immediately after the accident.
Even worse were the repetitive questionnaires from the three collection agencies hired by the hospital and doctors’ offices to collect the bills that the carrier had not paid, months after the accident.
Spoiler alert – they all requested the same information I had previously provided to the carrier’s adjuster.
I didn’t understand the problem until months later, when we had a conference call with our health and liability insurance brokers, who identified what had happened.
By receiving immediate medical treatment from my own doctors – in an emergency room – paid by our group health insurance, I apparently bypassed the normal workers comp system and carrier.
(I still don’t know how I could have understood that “in the moment,” while waiting to be examined, concussed, in the hospital ER. No one from the carrier to whom our firm business manager had reported the accident contacted me.)
As a result of that conference call, I finally understood that the comp system works differently than normal health insurance.
In addition, our brokers found the real culprit – the same hospital that sicced collection agencies on me, had received but not responded to the comp carrier’s requests for information about the claim.