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(Some Guy) Sad Social worker who risked his life trying to save three developmentally disabled adults from the Joplin tornado is denied workers' comp and must pay at least $2.5 million in medical fees. "Heroism doesn't pay the bills"   (syracuse.com) divider line 150
More: Sad, Janis Joplin, developmentally disabled, social workers, Rick Fox, Joplin tornado, Mount Vernon, administrative law judge, tornadoes  
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10882 clicks; posted to Main » on 24 Oct 2011 at 10:13 AM   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»   |    Get this fabulous T-Shirt and impress the methane out of your friends! shirt it!



150 Comments   (+0 »)
   

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2011-10-24 01:50:51 AM
Accident Fund Insurance Company of America is going to be in deep, deep shiat if they continue to deny this claim. I am not as familiar with Missouri Workers comp law, but I handled workers comp claims for 20+ years in Iowa and this kind of crap would earn the company sanctions and stiff penalties under Iowa law.

I would almost be willing to bet cash money damn near every workers comp attorney in Missouri is calling on this guy, just champing at the bit to take the case. The insurance company is going to get reamed if they don't wise up.
 
2011-10-24 01:54:30 AM
his claim was denied "based on the fact that there was no greater risk than the general public at the time you were involved in the Joplin tornado,"

WTF does that even mean?? Anyone familiar with lawyer-speak want to parse that bullshiat for me?
 
2011-10-24 02:02:31 AM
It means something like this:

"We are a big, important insurance company and this guy is a middle aged, low income Ozark yokel we figure is too dumb to fight a denial."

BTW, you didn't hear it from me, but there is a link in the story to the insurance company's web page, not that anyone here would ever dream of letting them know what a bunch of douche bags we think they are.
 
2011-10-24 03:00:36 AM
Aulus: It means something like this:

"We are a big, important insurance company and this guy is a middle aged, low income Ozark yokel we figure is too dumb to fight a denial."

BTW, you didn't hear it from me, but there is a link in the story to the insurance company's web page, not that anyone here would ever dream of letting them know what a bunch of douche bags we think they are.


You mean leaving an email to the effect of, "since you clearly believe in acts of God, consider that it will take one for you to stay in business if you persist in denying this claim."?
 
2011-10-24 08:21:46 AM
Its been my impression for a few years that it is standard procedure for insurance to deny a lot of claims, based solely on knowledge that if they do, X % of those denied won't fight. Which in turn makes money as a strategy, even if you do have to pay out in the end.

Perhaps an insurance adjuster could confirm that for us.


Saw this happen to a family member back in the late 80s, claim was valid, insurance denied anyway. In those days without internets to consult, it was a pain in the butt to fight.
 
ZAZ [TotalFark]
2011-10-24 09:33:58 AM
He assumed workers' compensation would cover his bills, but his claim was denied "based on the fact that there was no greater risk than the general public at the time you were involved in the Joplin tornado," according to a letter to Lindquist from Accident Fund Insurance Company of America, his company's workers' comp provider.

Workers' comp is usually strict liability. Is it an on the job accident? If so, you're covered. It was intentionally designed not to look at fault or risk. Under the old system the employee would sue the employer for negligence for making him work in a tornado and the employer would say it's your fault for working in a tornado and the case would dissolve into a big, swirling, dusty mass of lawyers.
 
2011-10-24 10:16:12 AM
USA! USA! USA!
 
2011-10-24 10:18:30 AM
And thats what you get for trying to help


Dont help. Its every man for himself. You know, the American way.
 
2011-10-24 10:18:42 AM
And somewhere a Republican debate crowd cheers.

/that bastard should have bought insurance!
 
2011-10-24 10:18:59 AM
I don't know anyone who went into social work for the pay and benefits. Then again, I only know one social worker. I won't disparage the work that she does, but it's not a career for getting wealthy.
 
2011-10-24 10:20:28 AM
Was he on the clock or not?

Its the difference between being covered for the injuries or not under workers comp.
 
2011-10-24 10:20:42 AM
$2.5 million in medical fees??

Damn, USA. You's a steep mofo.
 
2011-10-24 10:21:28 AM
What happened to the other worker?

What happened to Ryan?
 
2011-10-24 10:23:32 AM
Seriously though, let's not pretend like this sort of crap isn't obviously going to happen when you have a company making the decision to fund or not fund based on their profits. These stories are not going to go away until you do it as non-profit, read: socialized health care.
 
2011-10-24 10:24:23 AM
No good deed...
 
2011-10-24 10:25:48 AM
fusillade762: his claim was denied "based on the fact that there was no greater risk than the general public at the time you were involved in the Joplin tornado,"

WTF does that even mean?? Anyone familiar with lawyer-speak want to parse that bullshiat for me?


You should have known the danger and cleared out.

A lot of W/C carreirs use this to deny claims involving robberies.
 
2011-10-24 10:25:53 AM
$2.5 million?!

Where the fark do American medical people come up with this shiat?

You can buy a hospital wing for that amount.


/guessing
//still, 2.5 mill for one man, ffs!
 
2011-10-24 10:25:59 AM
Sounds like a good candidate for the Region 2 Death Panel.

/bootstraps
//socialism
 
2011-10-24 10:26:42 AM
thinks_on_feet: What happened to the other worker?

What happened to Ryan?


James Francis Ryan?
 
2011-10-24 10:27:01 AM
GungFu: //still, 2.5 mill for one man, ffs!

How much is one man worth do you think?
 
2011-10-24 10:27:06 AM
Waiting for two days later when the insurance company "reexamines" the case and finds they can cover it after all because they like it when big swarms of angry media go away.
 
2011-10-24 10:27:11 AM
fusillade762: his claim was denied "based on the fact that there was no greater risk than the general public at the time you were involved in the Joplin tornado,"

WTF does that even mean?? Anyone familiar with lawyer-speak want to parse that bullshiat for me?


It means "there was nobody's life worth saving above your own and since you took no precautions to protect yourself we aren't paying the claim." Kind of like if you work on a construction crew and the employer says you are required to wear a helmet; then if you walk into the zone without a helmet and get hurt they can deny your claim because you were being negligent and not following proper safety precautions.

Anywho...it is all bullshiat and the insurance company should pay his claim. It was an emergency and he improvised to the best of his ability since there were no buildings or basements to get the clients into. Maybe it is a bad call, maybe not, but the fact remains he was still at his job performing his job duties which involve protecting their clients from harm.
 
2011-10-24 10:27:19 AM
cgraves67: I don't know anyone who went into social work for the pay and benefits. Then again, I only know one social worker. I won't disparage the work that she does, but it's not a career for getting wealthy.

You're right! Fark them social workers for not being greedy assholes who need to be wealthy. Let them rot and die! They should have seen it coming and invested in gold or something brilliant.
 
2011-10-24 10:27:35 AM
hey, if you don't want to be poor, just get some cash together.

duh.
 
2011-10-24 10:28:04 AM
TimeWaste: $2.5 million in medical fees??

Damn, USA. You's a steep mofo.


Given the interventions over a 5 week period and the non insurance contract rate, I could see that.

If health insurance was involved, they would probably knock that down to about 40% of the total.
 
2011-10-24 10:28:51 AM
Probably the insurance company is hoping some good milionaire will help the hero, and they will save 2.5 million. They are playing a game in order to save money.
 
2011-10-24 10:29:00 AM
NewcastleBrownAle: cgraves67: I don't know anyone who went into social work for the pay and benefits. Then again, I only know one social worker. I won't disparage the work that she does, but it's not a career for getting wealthy.

You're right! Fark them social workers for not being greedy assholes who need to be wealthy. Let them rot and die! They should have seen it coming and invested in gold or something brilliant.


i'm sick of this assumption that greed is the sole motivator for progress. not everything is market driven, much the modern conservative would like to think otherwise. for example, Jesus Christ was not in it to get rich. They like that guy, but he's just not greedy enough for their financial beliefs.
 
2011-10-24 10:30:04 AM
absolutely outrageous
 
2011-10-24 10:30:13 AM
fusillade762: his claim was denied "based on the fact that there was no greater risk than the general public at the time you were involved in the Joplin tornado,"

WTF does that even mean?? Anyone familiar with lawyer-speak want to parse that bullshiat for me?


I think the idea is that they're saying his injuries aren't related to work. He was in the path of a tornado and got hit, the fact that he was at work at the time is incidental.

However, this only applies if there was no better shelter that he could have gotten to if he didn't try to help the people he was taking care of.
 
2011-10-24 10:30:21 AM
Another Government Employee: TimeWaste: $2.5 million in medical fees??

Damn, USA. You's a steep mofo.

Given the interventions over a 5 week period and the non insurance contract rate, I could see that.

If health insurance was involved, they would probably knock that down to about 40% of the total.


So in other words, if your medical bill is being paid by a corporation then the fee for a certain procedure is n, and if you'r epaying it for yourself then it's 3n?

/genuinely confused
 
2011-10-24 10:30:31 AM
lennavan: GungFu: //still, 2.5 mill for one man, ffs!

How much is one man worth do you think?



Well, if the going rate for a woman is something like $50 (read this in a Fark story probably), I'm guessing it'll be something like $100. Men are instantly worth double.
 
2011-10-24 10:32:43 AM
TimeWaste: $2.5 million in medical fees??

Damn, USA. You's a steep mofo.


I blew 60K with two days in intensive care. So very possible.
 
2011-10-24 10:32:51 AM
This happens thousands of times / day. This particular instance just happened to garner some press given the circumstances.

/American Healthcare = Go somewhere and die
 
2011-10-24 10:35:36 AM
*GOP crowd cheers*
 
2011-10-24 10:35:52 AM
But, hey, at least you guys aren't subjected to the commie-socialised medicine nightmare that us poor Canucks have to deal with, right?
 
2011-10-24 10:35:53 AM
No mention of the "Obamacare" "death panels" yet? You're slipping, Fark trolls.
 
2011-10-24 10:36:06 AM
COMP THREAD

If he was acting in the course of his employment, the WC firm will lose bigtime.

/maybe someone should reintroduce Accident Fund Insurance Company of America to the Meredith Principles
 
2011-10-24 10:36:12 AM
Loren: fusillade762: his claim was denied "based on the fact that there was no greater risk than the general public at the time you were involved in the Joplin tornado,"

WTF does that even mean?? Anyone familiar with lawyer-speak want to parse that bullshiat for me?

I think the idea is that they're saying his injuries aren't related to work. He was in the path of a tornado and got hit, the fact that he was at work at the time is incidental.

However, this only applies if there was no better shelter that he could have gotten to if he didn't try to help the people he was taking care of.


Funny, I read it quite differently:

"2.5 million is a lot of money to us. So here's some bullshiat we made up that sounds relevant that you'll probably swallow since you have no idea and what are you gonna do?"

I mean, my understanding of worker's comp is there is a single litmus test for whether or not they get it and that the only thing that mattered was were you injured in the line of work or not. Seems pretty clear the answer is yes here. But the company admitting that costs them $2.5 million+. So they made some shiat up and hoped to get away.
 
2011-10-24 10:36:23 AM
why would he need 11 perscription drugs
 
2011-10-24 10:37:23 AM

bacccc


This happens thousands of times / day. This particular instance just happened to garner some press given the circumstances.

/American Healthcare = Go somewhere and die


I know a number of conservatives, all of whom adamantly believe that health care is a privilege, not a right.

/they have insurance
 
2011-10-24 10:37:27 AM
Can we get the occupy movement to take on the medical industry too?

Our financial, govt and medical industries all need an overhaul
 
2011-10-24 10:37:28 AM
It's stories like these that make me cringe whenever I hear someone say, "I'm so glad I have insurance. They always pay."

Insurance is not your friend. Whatever policy you have, read the exclusions. Then read them again. Anything that can be interpreted, will be, just to fit one or more exclusions.

And don't get me started on the ads the companies put out. Insurance companies exist to make money for stockholders. The way to do it is to collect money in the form of premiums, bank it for interest, and not pay claims for as long as possible. They do not exist to make your life all sweetness and light, regardless of the cute ads promising to solve every crisis in sight.
 
2011-10-24 10:37:31 AM
His bootstraps flew off in the F5 Tornado.
 
2011-10-24 10:38:32 AM
haywatchthis: why would he need 11 perscription drugs

Perhaps because his bones and organs broke
 
2011-10-24 10:39:11 AM
TimeWaste: $2.5 million in medical fees??

Damn, USA. You's a steep mofo.


Best medical system in the world, for 1% of the population.
 
2011-10-24 10:39:41 AM
Some brief bad press that will be quickly forgotten is not > $2,500,000. Hate to be realistic but insurance companies aren't there to actually help you but to make money on refusing benefits on people that pay out but never need it. As long as they have a legal cause to deny it will stick.
 
2011-10-24 10:40:18 AM
scavenger: His bootstraps flew off in the F5 Tornado.

Wind is a pre-existing condition.
 
2011-10-24 10:40:37 AM
$2.5 million in medical fees ? So they applied a second plaster ?
 
2011-10-24 10:42:29 AM
Matthew Keene: TimeWaste: $2.5 million in medical fees??

Damn, USA. You's a steep mofo.

I blew 60K with two days in intensive care. So very possible.


maxbuyer.officemax.com

and what were you fapping to?
 
2011-10-24 10:42:50 AM
bacccc: American Healthcare = Go somewhere and die

Close: Get rich or die elsewhere.

I'm glad I'm rich, by those terms. Even so: I have to fight the insurance company on every significant claim that comes across their desk, as any administrative error on their part is a denial, any math error on their part is a denial, and any new child, no matter how carefully listed is always billed to the wrong insurance account... which is a denial. I can see how someone without spare time and rage to project could get screwed at every time.

This poor man with the shattered body and huge heart is getting f*cked by man and nature, however. The free market solution for him: next time try bigger bootstraps and be more selfish.
 
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