 |
 |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|
|
|
|
Winslow v. Montana Rail Link9/6/2005
On March 13, 1992, Winslow's treating physician, Dr. Earl Book (Dr. Book), diagnosed Winslow with a left femoral hernia. On March 24, 1992, Winslow filed an injury report with MRL claiming that he "strained something," but did not disclose that a hernia had been diagnosed two weeks earlier. Winslow claimed that he did not think he had to inform MRL about the hernia diagnosis because it did not interfere with his ability to work. Even though Dr. Book recommended hernia-repair surgery, Winslow opted to not seek further treatment at that time because the pain dissipated. However, between 1992 and 1995 Winslow experienced increasing pain in his groin area.
On September 7, 1995, Winslow attempted to "throw" a railroad switch, and as a result felt a hot, burning pain in his groin, inhibiting his ability to walk. Winslow filed an MRL injury report describing the pain, and signed a written authorization allowing MRL to obtain medical information from "any physician . . . who has examined or treated [Winslow] in regard to the injury." The following day, Dr. Book examined Winslow and concluded that the groin pain was related to the hernia he had originally diagnosed in 1992. Upon the advice of Dr. Book, Winslow decided to have hernia-repair surgery.
On September 8, 1995, Winslow informed his supervisor, Tim VanOrden (VanOrden), that he had a hernia and was making arrangements to have it repaired. MRL's claims manager, Mark Bjorlie, commenced an investigation and obtained Winslow's medical records which disclosed that his hernia was first diagnosed in 1992. Although Winslow would claim that he never represented to anyone that the hernia was caused by the throwing of the switch on September 7, 1995, MRL asserted in later proceedings that Winslow led VanOrden to believe that his hernia initially appeared on September 7, 1995, and that the hernia-repair surgery was first recommended by Dr. Book the following day.
After Winslow's hernia-repair surgery, he submitted his medical bills to MRL for payment. In October Winslow was briefly re-hospitalized to be tested for possible blood clots, which further increased medical costs. Thereafter, Winslow attempted to pay the medical expenses through Blue Cross/Blue Shield (Blue Cross), which administers MRL's self-insured medical plan.
Winslow returned to work in October 1995 and began to receive notices from Blue Cross that indicated it was not paying Winslow's medical bills. Winslow gave the notices to VanOrden. MRL subsequently sent Winslow a written order requiring him to attend a fact-finding hearing to address his "failure to provide factual information regarding injury."
The MRL fact-finding hearing commenced on January 10, 1996, the purpose and effect of which were contested at trial. Winslow attended, but was not represented by counsel. At the hearing, VanOrden stated that Winslow led him to believe that the hernia first appeared on September 7, 1995, and that surgery was first recommended at that time. MRL noted that Winslow initially denied having knowledge of the hernia in 1992, but finally admitted that he was aware of it when confronted with his medical records, and argued that Winslow's failure to report that he had a hernia three years earlier rendered his claim fraudulent. Winslow countered by arguing that MRL presented no evidence at the hearing that he had represented that his hernia was as a direct result of the switch incident, that he had not been dishonest with VanOrden, and that his injury report was accurate.
On January 19, 1996, MRL notified Winslow that he was being terminated from employment because Winslow had been repeatedly dishonest, and had failed to report all of the f
Page 1 2 3 4 5 6 7 8 9 Montana Personal Injury Attorneys
Personal Injury Lawyers
|
| |
to fill out a simple form to connect to Personal Injury Lawyers in your area.
|
|