As some of you know, DH cut up his hand pretty bad with a Skil saw at work. Now his boss is saying that he doesn't have Workman's Comp, and that he'll "try to help out" as best he can. Yeah right. Anyway, how do I find out if he really DOESN'T have WC or is just trying to avoid having to claim and raise his rates (Thom and his co-worker both swear that they were either told or given the impression that bossman was fully insured when hired), and if he doesn't does anyone know if that's illegal in NC? He has only 2 or 3 employees.

Part two of the question is this - if DH's bossman really doesn't have WC, can the homeowner's insurance (the homeowner whose property he hurt himself on) cover the accident and what would be the nicest way to find out. Mind you we could care less about a "pain and suffering" settlement. Money don't do s**t for that. We just aren't going to be able to cover these bills ourself, especially with one wage earner out of work, and if the HO insurance would cover the bills, then that's what it's there for.

Those of you who have HO ins.,please chime in on this and let me know how to tactfully proceed (it truly would be a last resort deal, if all else failed.) DH has a good relationship with the homeowner at present and would hate to change that, but bankruptcy is becoming an option the more that I hear about "plastic surgery" and "skin grafts", and I'm ready to do all that I can to get this under control without becoming either a litigious asshole or a penniless doormat.

Any other suggestions would be appreciated. Would he qualify for any disability (he lost a fingertip, a finger joint, mybe some minimal loss of motion in another, and his palm may not ever be the same again, work wise. This is his non-dominant hand)? How about poor people financial help? Any straws held out will be gratefully grasped at, so let loose, even if it's a long shot.

Thanks oodles, guys, and BE CAREFUL! It's scary out there.

-- Soni (thomkilroy@hotmail.com), August 13, 2001

Answers

It would have to be covered under the company he works for, not the homeowners insurance. Your husband has a boss who is not the homeowner. Only if I hire someone to come to my farm and work for me personally will it be covered. The company is required by law to carry insurance, and workmans comp. You better claim on workmans comp ASAP, there is a short time limit. The hospital knows how to file under workmans comp, maybe they can help if the boss won't. I am sure they can give you phone numbers. But hurry.

-- Cindy in KY (solidrockranch@msn.com), August 13, 2001.

Soni, is your husband an employee of the boss, or a subcontractor of the boss? This is important, if the boss pays all the taxes, income as well as social security and unemployment taxes, your husband is an employee, and SHOULD be covered by workmans' comp, IF the boss pays into it. Your husband could have signed a waiver of coverage long ago because most of the time he would have to pay into the WC account as well as the boss.

However, if your husband pays all his own taxes, income as well as social security taxes, he is responsible for paying and keeping his own WC coverage. In this case, it's your total responsibilty for having accident insurance coverage on the job, known as disabilty insurance coverage, very expensive for a subcontractor to carry.

My Dad has been a subcontractor for over 35 years, last year he fell through a window while installing it. Major plastic surgery to repair his arm, off work totally for 9 months, slowly regaining the feeling in his left arm (thankfully, he is right-handed), and is now back to work. Survived on his savings account, which self-employed folk have to have to survive these things!

We have been self-employed for 20 years, also have a rather large, but necessary, savings account just for this type of occurance that we cannot work. We consider this to be self-insured rather than pay the large premiums required for WC and disability coverage for individuals ( we carry full health insurance coverage however).

On a more positive note, with proper plastic surgery, your husband should regain use of the hand, the nerves regrow at the rate of an inch a month, with good rehab exercises done as directed by his physical therapists.

Personally, I could never sue someone to cover damages incurred by myself by my own misfortune, it is just not done in our family, we were raised to be fully responsible for our own lives and happenings, and to be prepared for life's bad luck that comes our way.

-- Annie Miller in SE OH (annie@1st.net), August 13, 2001.

He might qualify for partial disability on taxes as well as disability income. Social Security might know. OSHA as well. Look into Goodwill, St. Vincent de Paul, and other organizations for retraining (sounds like a possibility from your post). Call the workman's comp office direct to see if his employer has insurance. Perhaps the Department of Labor would know as well? Make sure you write down EVERYTHING he knows concerning the accident--you and he have been and are going to be talking to a lot of people--you can't remember everything with the stress your going through right now.

The homeowner's insurance will definitely fight you on this one. The trouble with going after the homeowner is that from your post, the homeowner does not seem to be at fault in any way, i.e., your husband did not trip and fall over a badly maintained walkway, for example. Add to the fact that your husband was an employee of someone else at the time--it would be quite different if the homeowner had hired him for a side job by himself, but he hired the business. I am very leery myself of hiring people for side jobs for that very reason. To go after the homeowner then, is unfair, and you realize that (you say as much in your post). Would you want to pay for something that wasn't your fault because you were the only one who had any money/insurance?

I am not sure how the laws work on disability/health insurance for employees. He probably has too few employees to make it mandatory for him to offer health insurance, but I can't see in his line of work (which I don't know exactly from your post) that he would be allowed to operate as a legal business without the workman's comp.

Does his boss advertise as "licensed, bonded, and insured" in the phone book, or on business cards, or perhaps right on invoices? That would be a clue right there. Did he tell the homeowner that he carried such insurance? Does he tell other clients that? If the answers are yes, you have a much better case going after the boss and any of his and/or the business' assets.

Is your husband an employee or an independent contractor for tax purposes? This could also be a factor. Indie contractors are generally expected to carry their own insurance and provide the tools of their trade. Who's saw is it? Any possibility of a defective part? In that case, the manufacturer may also be involved.

I hate to say the W word, but you might qualify for welfare or some other state/federal aid. This is obviously an emergency, and that to me is what welfare and other state aid is for, and one reason why we pay taxes. If your husband was a veteran, he might also get help from the VA hospitals.

Also remember that you will probably have other costs that you want to recover--childcare costs for example, or hotel bills while visiting at the hospital--so keep track of them.

I wish you both luck in resolving this. If I think of anything else I will post it.

-- GT (nospam@nospam.com), August 13, 2001.

Contact the worker comp folks in your state to find out if you have to have workman's comp on employees. What was the working arrangement between your DH and his boss? was your DH an employee or subcontractor? check any paperwork filed. Also where was he working? What job site, You can always go back on that site and take legal action.

-- Gary (gws@redbird.net), August 13, 2001.

first,, make sure about his license,, under whos name its under,, then contact the license board, tel them what happened, Does he have a business card or something that sayd hes licensed and insured. Then the homeowner,, if the accident happened on their property,, YES,, their onsuramnce wiol cover him,, might have to sue for it,, then their insurance will sue the contractor for fraud, and ect. If it didnt happen on their property,, sidewalk,, street,, ect,, then you have to go sue the contractor. Also,,, was DH working as a sub contractor? Was he getting taxes takin out? or cpaid cash or 1099 ?? As long as the contractor has something printed that sayd, "locensed and insured", you can get him to pay for it. Right now,,Id get a lawyer,, and contact the BBB

-- stan (sopal@net-port.com), August 13, 2001.

Soni,

Check with your State's Workers/Workmans Compensation Board. It's really the only way to know for sure what the laws are, and if the boss has paid into Worker's Compensation- but do it quickly. Even if he is covered, and especially if he isn't, apply for Social Security Disability Benefits and Supplemental Insurance (SSI-I'm drawing a blank on what the other "S" stands for), you can apply for both over the phone or in person at your local Social Security office. Depending on what State you're in there may be additional benefits that you can look into.

How is your husband feeling? I hope this works out for you. Please feel free to e-mail me if you have any questions.

Stacy in NY

-- Stacy Rohan (KincoraFarm@aol.com), August 13, 2001.

Check to see if your state is a state funded, managed care state. Even if the employer didn't have coverage at the time of the injury, usually the state will start the policy for the employer on the date of injury to cover the employee. In our state, employer's who are self insured have to follow the same rules & reg's as state funded employers, the only difference being they pay the medical bills, ect. not a worker's comp policy. Mary

-- mary (yyydeelilah@hotmail.com), August 13, 2001.

Last nite I posted on your other post. This one gives me more food for thought.

I can only tell you what I know about operating here in NY. We have carried WC and liability for the entire time we have run our business (13 years). I do all the paperwork si this is up my alley.

If your husband was acting as a sub he may be on thin ice. There is a legal criteria however, for the definition of a subcontractor vs employee. Even if he meets the definition of a sub, unless he is totally on his own he may still have a claim on the boss' insurance. I have had to cover paymants we have made to subs because I could not prove to the auditors satisfaction they were independent and they did not provide me with a certificate of insurance (a mistake I did not make many timess!) So, in other words, these people gained some coverage under my WC. Businesses are audited yearly by WC. People also lie through their teeth about insurance.

Now, from the sound of what you have written your husband is an employee. You are on firmer ground if that is the case. Check with the State Work Comp Board to find out if his employer has insurance!!!! This will probably be a frustrating experience if they are anything like the board here in NY. Hang in there!!! Have the hospital file a claim if they will. This is DEFINITELY work related. You are trying to fulfill your obligations. If I have an employee get hurt it is MY obligation to make sure the claim is filed in a timely fashion, if not I am liable and they do prosecute for this.

Talk to your insurance agent, hopefully he or she is an independent agent. He can be a great source of legal info. If he is someone you have known for any length of time, even if he has nothing to do with the boss' insurance he probably will be happy to give you info and possibly point you in a direction to go (maybe even phone numbers and names of helpful people.) You would have a claim here in NY on the Homeowner's insurance. That is one reason I am such a stickler about us having proper insurance. HO have had policies cancelled because they did not take the time to make sure the contractor they hired did indeed have insurance, someone got hurt and subsequently the claim went on the HO insurance. There does not have to be "fault" with something the HO has on his property. For example, I walk over to the neighbor's house, trip and break my leg, the bills may go on his insurance. In a situation like yours the HO is at fault for not making sure the Contractor has insurances. If you have a good repoire with the HO you could ask him if he requested a Certificate of Insurance from the contractor. If you could get a copy you would then either be able to know he had WC or else is involved in fraud by providing a false Certificate.

Find out from the insurance agent or the State WC Board what the requirements are for carrying WC. If the boss is operating illegally, you have claim as well as the WC Board. They may prosecute the boss.

Further, as to proof of insurance, I have to have posted in my office a Certificate of WC and Disabilty coverage for the employees to see. I get one yearly, sign it and post it. Maybe this is where your husband saw something.

We now have a website where you can go to find out if a person has WC. This is a new service.

Another resource may be the social workers at the hospital. They are often a wealth of info for the available services and the proper way to procure them. Don't be shy. Hang in there. I have a feeling you may be spending more hours on the phone than you would choose to. Keep open lines of communication.

You have a lot on your shoulders now. If your husband is anything like mine, this is something you are going to have to check out. When I am in a situation like this, I keep reminding my self that information is power. Uncertainty is more stress. Even bad news is better than none because it means I have to take a different approach and that may work out better.

-- TA B (burnash@gisco.net), August 13, 2001.

Some other thoughts, does your state require licensing of contractors? Ours doesn't. If yours does that may give you further legal recourse.

As for disability, that is something as an employer I pay for. If your husband's employer has that I believe he would have to also have WC. A portion of this comes out of the employee's pay - legally. Check one of your husband's pay stubs and see if this is listed. That type of insurancew is generally for non work related problems, I don't know if it will kick in for lost work time if there is no WC. Talk to an insurance agent and someone at the hospital.

As for WC premiums being taken out of the employees pay, WRONG!!! That would get me in more trouble than I care to deal with. They may get paid less that they would if the premiums weren't there but, it does NOT come out of their pay!!!

Has your husband ever drawn unemploymnet? If yes, this would indicate the boss has an element of being a legitimate business.

As a complete stupid question, what does DH mean?

Keep a stiff upper lip! Keep us posted!

-- TAB (burnash@gisco.net), August 13, 2001.

The employee vs. independent contractor issue is crucial in this case. The time constraints on filing claims are as well. I have a gut feeling this boss either lists your husband as an independent contractor or lacks the appropriate insurance coverage. My best advice to you at this point would be to contact your attorney. If you don't have an attorney and don't know of one who does this kind of work (attornies, like most others, specialize), you can contact your local Bar Association for a referral. Do it today! I hope this helps.

-- Gary in Indiana (gk6854@aol.com), August 13, 2001.

As for feeling bad about going after the HO Insurance, not on your life. I have spent years paying thousands of dollars into WC. MANY, MANY times HO get estimates and go with the contractor who BLATENTLY tells the HO it is an "under the table job". Less money becuse there are no insurances paid. Well, it is an obligation on the HO part to make sure the proper insurances are carried by anyone hired. Not a big deal, a phone call and the HO should have the certificate.

Further, if you are only trying to get coverage for the bills, isn't this one of the reasons we carry insurance. Why should your family have to suffer if there is a legal and legitimate recourse?

-- TAB (burnash@gisco.net), August 13, 2001.

Who botched up and cut his hand? The boss? The homeowner? Why does someone else have to pay for a careless grown mans actions? I avoid anyone working for me because if they trip on there own shoelaces they then think someone owes them something. So what is really right about this? Ray

-- Ray (Ray@rimmercom.com), August 13, 2001.

Defintely apply for social security disability as soon as possible. It takes time to qualify so the sooner you get the ball rolling, the better. There is permanent and temporary disability. For temporary, you have to be unable to work for at least one year. As some one else said, this can be done over the phone. You do not get paid for the first 5 months of a disability so it is a long process and very very often they turn you down the first time so be prepared for a fight! Also, as someone mentioned, the social worker at the hospital is a wealth of info about what may be available to you. After all, the hospital wants their money! Good luck and God bless, you will be in my prayers.

-- ugly (here@home.com), August 13, 2001.

In Ohio, if WC is not taken out of your check, your part of paying into it, you are not covered, you got to pay in to get maoney back, just like unemployment and social security!!!

-- Annie Miller in SE OH (annie@1st.net), August 13, 2001.

Hopefully this will help. Ran a search on "Ask Jeeves". North Carolina workers compensation information for injured workers with links to state and federal resources. Voice your opinion about workers compensation in our forums. From: http://www.workerscompensationinsurance.com/workers_compensation/north _caro... ---------------------------------------------------------------------- ----------

-- TA B (burnash@gisco.net), August 13, 2001.

Alot, of good points except for the person that said it was your husbands fault. Get real, accidents happen and unless he was trying to cut his own hand off, that is what workers comp is for.Do a search on GOOGLE.COM and punch in workers comp and your state. You will find lots of links. Also if your husband has lost a finger he is intitled to a lump some payment along with medical bills and monthly reimbursement till he is able to return to work. SSI is an option but it is very difficult to receive and they will turn you down atleast 2 times before you ever receive anything.The plus side is if you finally do get approved you get paid from the time you submitted a claim. It could be well over a year though.AS much as I dont like frivolus law suits, I would contact an attorney that specializes in workers comp immediatley. Most do not charge for an initial consultation and if you have a case will work on a contingency basis. Hang in there. If it sounds like I have been there it is because I have. My SO has been off of work for 14 months now to to a work related injury. IF you want more info feel free to email me and I can try to help. DONT GIVE UP THE FIGHT

-- tracy (murfette@stargate.net), August 13, 2001.

I checked the website listed above and NC requires WC if three or more employees. I don't know where that leaves you w/o more info.

Now, accidents happen, that's why we have the word in our vocabulary. I'm not saying I agree or disagree but, the system is set up as follows: a responsible operator of a business has WC. A responsible HO has insurance. Most of us don't think twice about filing a claim if the wind takes half of our roof. It isn't our fault a storm happend. It isn't an insurance companies fault, but they are in the business to cover such incidents. That's partly why we carry it. Now, there are MANY people who are not responsible and even lie, so therefore, as a HO, when I hire someone it is my responsibility to ask for Cert. of Ins. otherwise, if an ACCIDENT happens, my HO insurance may be held liable. I persoanlly, after paying premiums for a long time on both types of insurances do not want to see anyone left destitute b/c of an accident. That is one of many reasons why I pay premiums. I run into a lot of unfairness but, unfortuneately, that is part of the system. I deal with it.

That said, I can tell Soni that there are many links on that web site that may be helpful. I hope you have a fast modem. There is a lot of info there. Keep your chin up!

-- TA B (burnash@gisco.net), August 13, 2001.

I disagree with you, TAB. Whenever someone says "it's under the table", they are referring to discounts for cash payments or barter because of no taxes, not insurance or lack thereof. WC insurance is paid by the year or some other period of time, isn't it, not by each job performed?

I also feel that this is a classic case of why we should all take out disability insurance, and in some cases, with certain types of work, you pay extra for specific disability insurance. For example, you do skilled labor (say you're a surgeon), and fall on your head, causing brain damage. Normal disability will pay until you can be retrained to any job at any level. Special disability will continue paying because you can no longer work at your skilled job.

Certainly Soni can try to go after the homeowner in the proud and happy tradition of suing anyone who even looks like they have money. But it is wrong. And if you yourself carry no insurance (like health insurance or homeowner's insurance) on purpose it is doubly wrong. Just being there or owning something does not make you responsible for every bad thing that happens in life to someone else.

The fact of the matter is that her husband was working at the time for someone else, so WC should cover it, regardless. That is what it was designed for. If the boss doesn't have WC, sue him. People hire businesses instead of Joe Cool on the street because of the insurance issues. Was the business referred to the HO through some third party (our insurance, for example, has a helpline referral service for repair businesses)? Agencies screen for this type of thing, and they could also be held accountable, because the HO was relying on them (special trust and confidence).

The portion of WC on HO insurance is meant to cover casual employees like babysitters, the kid who mows your lawn, someone you employ to clean out your backyard and take it to the dump for you. A licensed business is always assumed to have proper insurance. Some advertise it as a way to reassure the customer, some do not.

I suppose now that tripping and breaking a leg and suing has been mentioned, people are going to think twice about hiring anyone, or even having visitors!

Another resource for you Soni,

www.nolo.com Nolo Press self-help law. Lots of informative articles.

www.lawguru.com may also be of help.

Also, the IRS www.irs.gov has a list of questions (I think about 20) to help you determine whether your husband was an indie contractor or actually an employee. There are very few jobs that are considered to be outright indie jobs--real estate agent is one of them--so chances are your husband is an employee regardless of what his boss put him down as.

Keep us posted.

-- GT (nospam@nospam.com), August 13, 2001.

In my neck of the woods the IRS and WC are in a close working relationship and if you aren't paying taxes and yet have WC you are a real fool. I have been doing this for a number of years. The WC Auditor looks at all federal and state forms filed concerning payroll and I have had auditors look at all my invoices as well. NEVER had a problem because I don't operate under the trable. The taxes and insurances are paid.

Anyways the laws are such in NC that Soni's boss may be w/in the law not to have WC.

I guess bottom line, it doesn't matter about what any of us think about ins. Some people keep bringing the word sue up. That may not even be an issue. May not be necessay. That was NOT what I was saying. Let's slow down a bit and get of our high horses. That's where I said info was the most important thing right now. A lawyer may not even have to enter into the picture. The HO ins may just pick up the claim!! That's what I'm saying, the proper procedure and working within the framework that's there.

As to saying what any of us would do in this situation, guess without experience many of us can only speculate without having been in a similar situation or out there dealing with this stuff.

-- TAB (burnash@gisco.net), August 13, 2001.

Soni, Am I right in understanding that you don't have health insurance at all? That sure is a bind. At worst, you might want to look into medicaid programs. You may qualify. As much as I wouldn't WANT to apply for help from the government, I see that as preferrable to bankruptcy. Maybe the local surgeons could be negotiated with....

What have you learned from your research? I hope you are as well as can be.

-- Anne (HealthyTouch101@wildmail.com), August 13, 2001.

TAB, you make some very good points. And Soni may not have to sue--his boss may actually come up with the money, even if he doesn't have WC.

My only point is that the HO insurance is not going to pay without a fight. Windstorms and other types of damage are covered by insurance in most policies, and you're talking about a one-time payment to fix it. WC or disability can be a lifelong payment, so any insurance company is going to find any legal way of getting out of paying a claim that it can.

We're also looking at other reimbursible costs here, nursing care, therapy, over the counter medications, dressings and so forth. That stuff mounts up quickly.

What if no one carried HO insurance? By law you can only go after so much, and I don't think you can take someone's primary residence in any case.

I think the burden of having insurance (in this instance) or paying (which is the real issue--some are self-insured) rests with his boss. The homeowner was not at fault (at least until we know differently from Soni) in this instance and should not be penalized for this. Even if "no fault" (like no fault car insurance) applied here, and I don't think it is the same thing for HO, what percentage would it be for the HO (1% for hiring the business?), and how does that change the fact that the employer should have had WC?

I just believe you should go after (through paperwork or the courts) the right party which should be the employer in this case (unless we get some other information from Soni), not anyone with more money than you. No wonder insurance rates keep going up, and no wonder many go without.

-- GT (nospam@nospam.com), August 13, 2001.

Excellent point, Anne, about not having health insurance, I refuse to feel sorry for anyone who does not carry health insurance on themselves and their family! We have paid our own very expensive, and getting more expensive every year we get older, health insurance for over 20 years now, in good times and bad, if you can afford a car/truck and carry proper insurance on it, you can afford health insurance.

No cry babies heard here in this camp about not being able to afford proper health insurance, ever!

-- Annie Miller in SE OH (annie@1st.net), August 13, 2001.

Annie,

It's great that you've been able to buy insurance, but the reasoning that if someone can own a car and pay car insurance they can pay for health insurance is faulty. Lots of people simply don't have the money left over after car payment and car insurance to buy health insurance. We have never had a car payment because we buy old vehicles and pay cash for them (usually $2000-$3600). Lots of homesteaders live off of very little money, and health insurance costs a lot. If the money is not there it just isn't. There's a long thread on this topic somewhere in the "older messages." I truly don't mean to be rude to you but lots of people simply can not pay for health insurance. We don't have a TV, VCR, our water is free (well water), we live rent free on my father-in-law's land in a house we built 100% by ourselves from salvaged lumber--even some of the insulation, wiring, light fixtures are salvaged. Despite all that, the money was never there for insurance. We pay our medical bills cash or pay them out. Didn't mean to steal this thread but people live different lives and we can't conjecture about others by drawing on our own experiences.

-- Elizabeth in E TX (kimprice@peoplescom.net), August 13, 2001.

Elizabeth, I don't think you're stealing the thread, you're making a valid point. That was a good thread you referred to (still there, at least for now), some of us got there a little late (okay, 'way late) and posted to it.

Personally I think that if you make health insurance a priority you will find some way to get it. Goverment, private, whatever. Some people choose not to have it, as they choose homesteading over city life. A catastrophic plan would have made a world of difference in this case, but hopefully others will learn from this.

However, what I and others were concerned about, was the idea that you go after the person who does have money or property, whether or not they were at fault, just because you don't have any and the person you should be going after doesn't have any. The homeowner probably isn't wealthy--he may just be someone who worked hard and saved his money. Why should he be punished for that? Why should his rates go up because of a claim that he shouldn't have to make?

How would you feel if your father-in-law lost everything he owned due to a case like this?

That's where I'm coming from.

-- GT (nospam@nospam.com), August 13, 2001.

WC laws vary from state to state but it is my understanding that they are pretty simimilar. In Florida where I was a contractor for 15 years the employer was responsible for the employee being injured, PERIOD. You carried WC insurance not just because the law required it but because your employee would own you if he got hurt. Not helping your husband is not an option for the employer. If your husbands boss doesn't have WC and he doesn't bend over backwards to do everything he can for you, then get a lawyer because he's not doing you right. I cant believe I said that but it's good advice.

Question: What the difference between a lawyer and catfish.

Answer: One is a scum sucking, bottom feeding, garbage eater and the other ones a fish.

-- Carter (chucky@usit.net), August 13, 2001.

Keep in mind that I did not advocate suing, period, especially the HO. I have been (let me repeat) in contrcting for over 13 years. I have seen cases like this and the HO ins. HAD to pick up the med. bills. As far as I can read Soni is not looking for easy street off this, just a way to pay the bills. I won't repeat what I've already written.Insuance laws may vary in NC. As I stated, and others have too, she needs to get info.

The WC laws are different in NC than in NY. The website in NC states 3 employees or more as to a requsite for carrying WC. It does mention something about managed care as one post mentioned as well. This is something worth checking out. As I already stated, there may be recourse against the boss.

As far as I am concerned, if you don't have info to share or something positive to say, maybe go to another thread. I'm with you Elizabeth, there are a kazillion different circumstances and to be so cold as to say, too bad, so sad, it's your own fault is, in my opinion just not needed. A lot of insurances have very poor coverage for something like this accident.

I thought this website was kind of like chatting with friendly neighbors but, I'm beginning to wonder.

We look forward to an update from Soni.

-- TAB (burnash@gisco.net), August 13, 2001.

I can't talk as an expert, because your legal system is different, and I don't know how or how much. From what you and others have said (three employees) it sounds like your Dear Husband (DH for whoever was asking) and the others should have been covered by their employer with Worker's Compensation insurance. Even if that isn't the case, or even if he just didn't bother to pay the premiums, he told them they were covered. Even better if he said it in writing somewhere. So - if he doesn't have the WC Insurance, then one way ot another he is still personally liable for their injuries - either because he acted illegally in not insuring them, or because he is legally self- insured, or because he defrauded them in lying to them about them being covered. He may be going to see your husband right, and do everything that WC would do for him - there's no sense in getting him off-side before you know. However, it is certainly essential to find out ALL your rights immediately - the social worker at the hospital is an excellent starting point. Also get all applications in soonest - so many of them work from the date of application rather than the date of injury, because it's a legal loophole to let them wriggle out of paying what they're supposed to. If necessary you may have to sue the employer - or at least threaten to. Let's face it - better he go bankrupt rather than you do, particularly if it's because he defrauded his employees about their WC Insurance.

-- Don Armstrong (from Australia) (darmst@yahoo.com.au), August 13, 2001.

GT, I want to clarify that I was responding to Annie's statement, "if you can afford a car/truck and carry proper insurance on it, you can afford health insurance." I understand and agree completely with what you're saying about it's not being right to "go after" whoever has money or insurance, regardless of who is actually responsible. I feel Soni's dh's boss is the responsible one, as the one who promised the WC insurance was there. I just felt that Annie's statement came across as too harsh, (please don't take offense Annie) and wanted to show Soni my support by giving my opinion. I'm hoping I've made some sense.

-- Elizabeth in E TX (kimprice@peoplescom.net), August 13, 2001.

No offense taken, Elizabeth, I meant that statement to mean that if DH had the money at all to drive to work, and by the sheer impact of having "work" and money coming in at all, he can afford health insurance, at the very least, catastrophic medical coverage. I do take offense at folks who shirk personal responsiblity for ALL their actions, and expect the "system", meaning us tax paying contributors to society, to cover their errors in judgement when bad stuff happens to them.

Keep in mind, that when times got tough in our marriage and the economy really hit our business hard, I worked two jobs a day to be able to afford that health insurance and pay the bills. But then, I was raised that you do not take money from any one for something you did not work for or earn, meaning no form of welfare was acceptable, ever. Nor did you sue someone for something not their direct fault or cause.

Folks have to be fully responsible for what happens in their lives, and this includes planning for the unexpected and accidents too. And, as an employee, it is your own responsibility to make sure you are getting what your employer says you are, after all, if you assume you are covered by WC, you have to see the money coming out of your check every week to have WC, you do not wait till you really need the WC and then check to see if you have it. Do you also just assume your employer is properly paying your income tax and social security, and don't check by asking for copies of the appropriate tax forms until after the IRS calls you in for an audit for non-payment?

-- Annie Miller in SE OH (annie@1st.net), August 14, 2001.

I didn't think you meant me, so wasn't offended, but just in case anyone got a wrong idea, I was only mentioning all of the costs I could think of that Soni could legitimately seek reimbursement for. Maybe even for vacation time that Soni has taken from her job (if she works outside the home) to look after her husband.

Most people carry very limited HO insurance, and even less on their car insurance--how many carry only the bare minimum on liability? So normally, when the insurance won't cover, you almost always have to sue to get the rest.

This is not going on easy street, this is how much medicine costs. A few years ago a college classmate of mine lost her son in a motorcycle crash. He was on life support for four days while they agonized over pulling the plug (he was brain dead). Those four days cost over $25,000 back then. I hate to think what it would cost now. Plastic surgery and skin grafts are not cheap either. These amounts would be 'way past the limits on most HO policies.

At the www.lawguru.com website they had a section on workman's comp, and you could go to their state section. Not too many answers from lawyers posted in NC, but Soni could post her question there and maybe get an answer from a real lawyer. None of us are lawyers, sorry to say. She may even qualify for Legal Aid. Leave no stone unturned.

-- GT (nospam@nospam.com), August 14, 2001.

Well, here's what I know to this point: The bills are likely to be about 5G. Doubtful that Hub's boss will go the full amount. He doesn't have to have WC (I checked the state web page) and doesn't. You have to have three full time emplyees to make it neccessary. Well, boss man has three full time guys he calls sub contractors, who by all legal definintions aside from who pays the taxes, are EMPLOYEES. However, one of them refuses to be seen in any photos, will not admit to working for bossman and would quit and drop of the face of the earth in a heartbeat if pressed to do so. WHen I checked the state site, I found a listing of notable WC cases. There was one listed about a guy with the same first name in the same county as this guy, and we're going to check the last name to be sure. Therefore, if this is the case, DH's boss may already be harboring a WC fraud and noo telling what effect this will have on the proceedings.

I really didn't want to go after the homeowners, and after reading thses posts, I doubt that it will happen. I, too, believe that they were not responsible, but with bossman's stance of things, I thought that it might be the only option to bankruptcy. Every other avenue will be thoroughly flogged to death before I even consider that option. Thanks for all your help.

-- Soni (thomkilroy@hotmail.com), August 14, 2001.

Good grief, this is beginning to sound like a soap opera. Will the other co-worker be willing to testify should things come to that (surely this was a wake-up call for him)?

You might have to go to court just to subpoena his records.

Persevere, and we're thinking of you!

-- GT (nospam@nospam.com), August 14, 2001.

This is why it is VITAL to understand your employment situation by understanding your taxes as well. If you pay your own taxes, then you are responsible for your health care. If you choose to take a risk without insurance, this is what can happen. It stinks, and I wish this family wasn't in this bind.

For independent contractors/ self-employed persons, you can get catastrophic or complete (you decide) health insurance through the National Assoc of Self-Employed (NASE.org). All at a reasonable rate. No, I don't work there, but recently switched when my other company cost too much.

Now $5000 is a lot of money, but not necessarily reason enough to go bankrupt. Perhaps the bottom line is arranging for payments that the ex-employer can assist with. I say 'ex' since I doubt your husband will trust him enough to work there again.

-- Anne (HealthyTouch101@wildmail.com), August 14, 2001.

Soni,

*IF* you get stuck with paying for it all, don't panic! We planned a $600 midwife-attended homebirth with our first baby--ended up having to transfer to the hospital and had about a $12,000 bill when it was all over. No insurance. We worked out a deal where we paid it out at $50/month. We could have filled out some forms and applied for charity (it's a Catholic hospital) You don't have to go bankrupt! Another thought is that if you have any cash at all sometimes a hospital or doctor will give a large discount for cash paying customers. We had to take one son to a heart specialist last year and she gave us a 50% discount!

I realize that this isn't what you were asking about but I know you nust have a lot of worries of what'll happen if your other inquiries prove fruitless, and I just want to offer encouragement.

-- Elizabeth in E TX (kimprice@peoplescom.net), August 15, 2001.

I really have a great deal of empathy for your situation. You can pay off the $5000 though probably making payments to the various medical providers. Since I am a tax-preparer I would like to clear up a few mis-conceptions on this thread. I am from Ohio. The EMPLOYEE pays from their check: social security, medicaid, Federal, State and Local taxes. These are the only deductions taken from an employees check. The EMPLOYER pays their half of the social Security and medicaid, as well as unemployment (state and federal) and compensation. The amounts paid by the employer for unemployment and compensation are based on the amount paid to the employee and a rating based on the safety of the business. If you make $10 per hour and you are receiving the total $400 you are being considered a sub- contractor in which case no taxes are being with-held and no comp or un-employment are being paid into. This may help some of you who aren't sure. But compensation and unemployment should never be with- held from your paycheck, if they are the employer is not performing legally!!!!! This is in regards to Ohio Law, but I believe that most states follow these same guidelines. If you aren't sure call the IRS.

-- Melissa (CMNORRIS@1ST.NET), August 15, 2001.

Thank you, Melissa.

Soni, did you get any info from the social worker at the hospital? This is the kind of situation they are trained to deal with. I don't mean charity, either.

How is your hubby (and you) holding up under all of this?

-- TAB (burnash@gisco.net), August 15, 2001.

Hubby is as okay as new amputees get, all things considered. Social worker at hospital can't do us much good - we live in a different county than the injury and treatment took place, even though we are so close to the border that our mail has that county's address on it (we still pay taxes to the county we marginally live in. What sucks is that the hosp is in Wake county (state capital, rich in taxes and funding) and we live in Harnett county (one of the poorest and underfunded in the state). On top of that, our state has seriously cut back social services due to an "unforseeable" budget shortfall (yearh, whatever) and so the chance of getting any social services help from this county is about on par with my chances of entering hubby in the employee of the month club.

No, the other co-worker would not only not testify, from all indications, he would actually flee a subpoena, for whatever reason it is that he's hiding. If he's not the guy I saw on the website, then it's probably child support or some such.

I had a good cushion of savings (or thought I did) a few months ago, but for reasons I can't go into, some one (or someones) else ended up with all of my money (unbeknownst to me) and left me with several of my bills not only latem but actually unpaid for a few months (also unbeknownst to me). I am trying to pay off a %00+ gas bill before the tank (that isn't registering) runs out (they won't refill until its paid), pay off 3 MONTHS of unpaid rent, plus current rent and bills due, and now I've got this financial nightmare staring me in the face, and I am now the sole provider as well (in case you haven't noticed, its the middle of the month and they're all due NOW!!!)

Sorry - got off on a rant there. That's why I'm so high strung lately, that and the fact that my business has almost ground to a halt this August (it does every summer as the entire economy goes to the beach) and that's why I wasn't going to go right back to my regular job straight out of Americorp, but rather take a vacation and rest. HAHAHAHAHAHAH. Uh oh, the guys in the white coats are coming. Gotta go!

-- Soni (thomkilroy@hotmail.com), August 16, 2001.

Soni, I know some of the responses were very strong, but I was wondering how your husband was doing? My husband works construction too and I know how easy accidents can happen. I'm sure there are many people on the forum who are interestred in how the two of you are faring. If you have time update us on the situation.

-- everyone (afriend@home.net), September 04, 2001.

well all i cansay is i am sorry. right now my fiance and i are going through the same thing. my fiance matt a couple months agowas lifting some heavy machinery he works for a plumbing company and he had pulled his back while doing it matt came home and took a couple days to rest andthen he bought a back brace to help he wentbackto work buthehad a hardtime digging becuase he couldn't bend thatwell and his bosshad told him that if he couldn't work he would be fired we disregared what hehad said and matt pushed himslef to work harder becuase i am nine months pregnant and we have a 2 yearduaghter alaready. well now just a couple days agi matt hadto lift some bags of heavy gravol used for making cement off the truck and he pulled his backagain this time more serious hecan;t work now he went to the doctors and the doctor said thathe had pulled somthing in his lower lumbar not sure what the exactword was though. hesaid matt owuld have to go on woprkmans comp. until further notice and hewanted ot see him again in 3 days to discuss this further. well hetalked to his boss and his boss said thathe doesn't carry workmans compensation and there nothing he can do. he asked matt are yousure you didn't pull your back from lifting your wife which is insulting but matt said i know how i huret my back. well i looked it up and the netand it says that companies should have workmans compensation butif they dont its at there own risk they choose to have thyerisk of being sued so when matt goesto the doctors again in threee days we find out how long hewill need phsyical therapy for and then wewill take legal action we are going to givehhis boss two options hecan pay matt his normal salary until hegoes backto work because not once but twice matt hurt his backandhis boss didn't give ashit or wewilltake him to court andsue him for medical expensnes etc etc so now you know that you cna take legal actio n alotof companies htough are required to haveworkmans comp but those that don't basically enter this atthere own risk bye for now noelle

-- noellejohnston (noellejohnston@hotmail.com), January 08, 2002.

Hi,

Many states have a minimum employee requirement, like Georgia. If there are five or less employees, the employer is not required to carry workman's compensation insurance. I worked for attorneys who got away with NO insurance as they always employed five or less people. However, you can contact the State Board of Workman's Compensation which will be located in your state capital and give the name of the business and the license number and they will be able to tell you if the business was covered. It sounds to me like he wasn't. Most small businesses do not carry workman's comp, but do carry some sort of health and accident insurance; however, where my Dad used to work, there was no health insurance; only workman's comp as they had 20 plus workers. I know you said you do not want to sue, but if you have to, before threatening to sue, find out what assets are obtainable. My late uncle had a contracting business, but to protect his assets, everything was in his wife's name and she was not part of the business. Needless to say, he eventually did get sued by a construction worker who fell off a roof. Well, my uncle filed bankruptcy and never lost a single asset as he had none in the business name nor in his name. The courts couldn't touch what was in the wife's name. So if you threaten to sue, make sure there is something there. I don't think he would be able transfer the assets in a very short period of time as the court would see through that.

You do have the option of contacting the hospital and asking them about their pauper's fund. every hospital has a fund for indigent people who can't afford medical care. But I will guarantee you none will come forward on their own and tell you about the fund. You have to ask the administration. You can get the information from Social Services at the hospital. OF course that won't help you with the Doctor's bills, but you can ask the doctors if they will accept payments (small amounts that you can actually pay). Bankruptcy should be your last resort, but don't wait to do that until you are faced with losing everything you own. and get a good attorney that specializes in bankruptcy as the laws change constantly. You'd hate to lose your home over something like this.

So sorry to hear of your husband's accident. And yes, under Social Security Disability if he can prove that he has lost the ability to perform his job he may qualify for SS disability. Granted it will not be much to live on and you will probably be turned down the first time you apply for it. But be persistent, and re apply and have the medical records from your doctors to back you up. Your husband will have to be seen by a SS doctor, but may agree with your doctors assessment. anyway, that is a long road to go too - but persistance usually pays off with SS, and when your husband is declared disabled, you are paid for the amount of disability. so you may not get much if SS decides your hubby can do other work. Good luck,

-- Cindy (colawson@mindspring.com), January 09, 2002.