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Some of you have probably seen my two-week-running saga on WYFP.

Well, yesterday, in short, I was propositioned to break the law.

Bring your handcuffs and follow me over the fold.

Here's the story.

I was volunteering for a dog rescue and was cleaning in the back of the kennel, which is pretty dark, and slipped and took a nasty fall landing hard on both my knees.  

My right knee was particularly anguished as this knee--my infamous 3-surgery, $80K knee--inflamed to twice its size so that even my leg brace wouldn't fit.  Sigh. I couldn't sleep for days and I can tell I reinjured it. Believe me, I know.

I am unemployed and uninsured and uninsurable (cancer survivor).

So, I contacted the rescue and asked them if they had liability insurance. Yep, they do. So how do I file a claim or what do I do given I am uninsured and don't have the money to see a doctor? We'll get back with you.

So they did after 5 almost 6 days.

In a nutshell, they're broke (like all dog and cat rescues and note that I am a cat/dog rescuer, also) and don't have any extra bucks to pay the $1K deductible for me. Crap. But then comes the suggestion: Why don't you just say you fell outside so it would be on the landlord's back. Since no one saw you fall, who would know?

Well first, we both would know, right?

Second, you're asking me to commit fraud to have you avoid spending $1K. What, are you nuts?

And third, no thanks. Not going there. I am honest.

So, the question is, what the heck do I do now?  I can't pay a doctor and neither can they. I know, if this is what I think it is, I will go to the doc who will send me for an MRI. Cha-ching. Anyone know how I can get this handled correctly and REALLY soon?????

I don't look good in stripes.

Originally posted to http://thisskysings.wordpress.com/ on Thu Mar 11, 2010 at 10:33 PM PST.

Poll

Has an employer ever asked you to commit fraud?

44%25 votes
51%29 votes
0%0 votes
3%2 votes

| 56 votes | Vote | Results

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Comment Preferences

  •  Tip Jar (16+ / 0-)

    866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

    by cany on Thu Mar 11, 2010 at 10:33:39 PM PST

  •  Hmmm... (5+ / 0-)

    Everyone should chip in for the deductible. What a mess.

    ::
    The Pluto Chronicles. You want reality? You can't handle reality!

    by Pluto on Thu Mar 11, 2010 at 10:45:22 PM PST

  •  A friend of mine (9+ / 0-)

    recently fell very sick with multiple problems. The first time, she got public assistance (some sort of Medicaid, I believe).

    The second time, she went to the hospital and ran up a $25,000 bill. Way too much for a college student to pay. Fortunately, Geisinger Health System did the right thing and just canceled the bill.

    Sadly, we are not all fortunate enough to have what is probably the most moral health system in the country.

    As much as it sucks, I would suggest seeing what assistance is available. That's just my two cents.

    OTOH: If you had a paypal account, I could probably kick in a few bucks from my own student loan money.

    Get well.

    If you're gonna play the game, boy, you better learn to play it right.

    by Casual Wednesday on Thu Mar 11, 2010 at 10:46:29 PM PST

    •  No, no! Thank you so much for offering, but (7+ / 0-)

      there HAS to be a way to handle this appropriately and taking money for others on this isn't the way.

      My thoughts have run towards going to the hospital, however, generally they just hand you a card and tell you to go to the hospital.

      The alternative to that, I suppose, would be to give then the group's information, run up the bill, and thus the $1K is now billed.

      I'm just so awfully uninformed (read stupid) on this kind of thing, I'm trying to figure out the right and legal way to get this handled.

      You are really kind to offer to help, but this needs to be handled by the folks that are responsible for it.

      866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

      by cany on Thu Mar 11, 2010 at 10:49:58 PM PST

      [ Parent ]

    •  I tried this once before, but they don't do ANY (2+ / 0-)
      Recommended by:
      MKSinSA, Ebby

      orthopedics unless they have changed in the last three years.  I will check.

      Thanks for the link and the reminder!

      866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

      by cany on Thu Mar 11, 2010 at 11:00:17 PM PST

      [ Parent ]

  •  Good call on skipping the fraud... (5+ / 0-)
    Recommended by:
    marykk, MKSinSA, Casual Wednesday, cany, Ebby

    I'd say get your leg looked at and figure out the financial mess after you (and everyone else involved) can see the mess. Your leg is the most important thing.

    •  I agree, but the problem is no one will see me (3+ / 0-)
      Recommended by:
      yella dawg, MKSinSA, Ebby

      without payment up front, and of course, the only check I could right would burn your hand right off:)

      866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

      by cany on Thu Mar 11, 2010 at 10:58:55 PM PST

      [ Parent ]

      •  Have you been turned away? (2+ / 0-)
        Recommended by:
        second gen, Ebby

        From a doctor, I mean? If so, go to the hospital. It's not like you're going because your eyelashes are tickling or something, you need to get your 80k knee checked.

        •  I will try the free clinic. I will call tomorrow (3+ / 0-)
          Recommended by:
          blueteam, yella dawg, Ebby

          (per the suggestion) to get an appointment.  The problem with the hospital is that they don't DO MRIs on injured knees.  X-rays, maybe.  At least that was my experience when I was first injured in 1997.

          They sent me home with a couple physician business cards given I didn't have a broken something or other (it was all cartilage/ACL damage as it turned out).

          Hospitals don't do much for this sort of thing.  Even for a break, they x-ray and sling it and hand you a business card.

          866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

          by cany on Thu Mar 11, 2010 at 11:18:30 PM PST

          [ Parent ]

          •  1997?!?! Dude that was before the Internet! (1+ / 0-)
            Recommended by:
            Ebby

            I'm. Sure things have changed.

            Don't tell me what you believe. Tell me what you do and I will tell you what you believe. h/t MeteorBlades

            by mdmslle on Fri Mar 12, 2010 at 02:09:50 AM PST

            [ Parent ]

          •  I bet they do MRIs now (1+ / 0-)
            Recommended by:
            Ebby

            at least, the hospital did an MRI on my knee this past summer, not precisely for an injury, but for an abscess and a staph infection.

            Do you have a Catholic hospital around? Many of them will treat you for free, or on a sliding scale, and I found that the outside billers (like labs) would give you the same discount the hospital does.

            Do you have homeowner's or renter's insurance? If so, I'd call your insurance agent and ask if they could lean on the shelter and their insurance.

            Otherwise, I think you need a lawyer--just because they can't afford the deductible doesn't absolve them of liability.

            •  I agree with this. (2+ / 0-)
              Recommended by:
              JeffW, Ebby

              Otherwise, I think you need a lawyer--just because they can't afford the deductible doesn't absolve them of liability.

              See if your area has a pro bono legal service, usually they are called "Legal Aid" or something similar.  If there is an organization like that local to you they could at least give you a preliminary opinion on what to do.  Social Security often has local referral lists and may be able to give you a phone number.  Call 1-800-772-1213 for Social Security.  

              Renewable energy brings national security.

              by Calamity Jean on Fri Mar 12, 2010 at 12:58:44 PM PST

              [ Parent ]

  •  I would check locally for a free clinic. (3+ / 0-)
    Recommended by:
    Casual Wednesday, cany, Ebby

    Usually if you can meet the requirements, there's someone available. Not much on treatment per se but they can do some tests and scrips.

    I have friend with diabetes who's going to a clinic. This one I believe.

    "The human eye is a wonderful device. With a little effort, it can fail to see even the most glaring injustice." Richard K. Morgan

    by sceptical observer on Thu Mar 11, 2010 at 10:59:03 PM PST

  •  Okay, Cany (10+ / 0-)

    I'll tell you how this is handled in the real world. You call a lawyer, he sues the kennel and the landlord. Both of their insurance companies get involved.

    You get your knee paid for plus a cash settlement. You can share some of the money with the kennel.

    That's how it's done.

    ::
    The Pluto Chronicles. You want reality? You can't handle reality!

    by Pluto on Thu Mar 11, 2010 at 11:02:04 PM PST

    •  I just want to play nice and get my knee looked (4+ / 0-)
      Recommended by:
      bobinson, Pluto, sceptical observer, Ebby

      at/fixed.  I don't have money for an attorney.

      866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

      by cany on Thu Mar 11, 2010 at 11:15:46 PM PST

      [ Parent ]

      •  P.I. lawyers usually work on contingency (2+ / 0-)
        Recommended by:
        Pluto, Calamity Jean

        If he thinks you will collect, they have you sign something then they pay your medical expenses that day. No waiting.

        "As God is my witness, I thought turkeys could fly."- Arthur Carlson

        by bobinson on Fri Mar 12, 2010 at 12:36:46 AM PST

        [ Parent ]

        •  contingency, yes (3+ / 0-)
          Recommended by:
          Pluto, Zoskie, Ebby

          payment up front - no.  Unethical.  

          And a lawyer will take 30-40% of whatever the insurance company pays.  Then you can use the rest of the settlement to pay the medical bills.  It probably won't be enough.  

          But Pluto is right, this is how it is done.  

          If you skip the lawyer part and just file a claim with the insurance company, they will undercut the settlement, and it will work out to roughly what you would receive after the lawyer takes the contingency fee.  Unless you have very little evidence, then the insurance company may dig in and fight the claim.

          In any event, the hospital will ask about potential insurance coverage from any source and unless you lie, the hospital will file a claim against the Rescue's insurance company anyway.

          The medical providers are pretty good about waiting for payment if they think an insurance company will eventually pay up.  Otherwise, your bill will quickly find it's way to a collection agency.

          You don't really have a choice.  File the claim.

          "Rules must be binding. Violations must be punished. Words must mean something." President Obama in Prague on April 5

          by jlynne on Fri Mar 12, 2010 at 05:12:51 AM PST

          [ Parent ]

          •  Okay, this is really helpful. (0+ / 0-)

            I will call their office and make an appointment and see what they say.  I don't have the name of the coverage, but I do, obviously, have the name, phone, e-mail and address for the rescue.

            Thank you for this.  

            866-338-1015 toll-free to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

            by cany on Sat Mar 13, 2010 at 07:05:10 PM PST

            [ Parent ]

      •  A few things. (3+ / 0-)
        Recommended by:
        Pluto, Zoskie, Ebby
        1.  If you tell your original orthopedist -- or any ortho, really -- that the injury was the result of an accident and that there is, in fact, liability insurance available, they will be much more willing to see you without cash up front.  Get the insurance policy information from the rescue so you can provide it to the doc.
        1.  DO NOT WORRY ABOUT whether the lawyer's contingency fee would take away too much for the bills.  It will all get negotiated out in the end so that you don't pay out of pocket.
        1.  I would also contact the landlord and notify him of the claim as well.  There are often overlapping areas of responsibility in claims like this, where both the liability insurance and the property insurance are on the hook, and they have to fight between themselves over who is "primary."

        GET THIS TAKEN CARE OF NOW.  NOW.  NOW.  The longer you wait, the easier it is for the insurer to say that you hurt it somewhere else, some other way.  Surely, they will say, since it's been weeks since your claimed injury, you would have gone to the doc and made a claim right away if you had really been hurt.  You must have hurt it falling at home/riding a bike/wrestling with animals/praying in church, and you're only claiming that it was at our premises in order to soak us for cash.

        TRUST ME ON THIS.  THEY WILL SAY THOSE THINGS.

        "He that would make his own liberty secure must guard even his enemy from oppression." -Thomas Paine

        by sierrak9s on Fri Mar 12, 2010 at 07:17:37 AM PST

        [ Parent ]

    •  Ever the realist. n/t (1+ / 0-)
      Recommended by:
      Pluto

      "The human eye is a wonderful device. With a little effort, it can fail to see even the most glaring injustice." Richard K. Morgan

      by sceptical observer on Thu Mar 11, 2010 at 11:47:40 PM PST

      [ Parent ]

  •  I was ordered to infringe on a patent (3+ / 0-)
    Recommended by:
    sandblaster, carpunder, Ebby

    We manufactured fume scrubbers for the semiconductor industry. These devices filtered out acids from the exhaust of chemical vapor machines. This engineer owned the patent on a low maintenance design and our company was contracted to sell and build the machines. As production supervisor, I knew how many got sold and how many got royalties paid. Didn't take long for my boss to sell some units behind the patent owner's back to avoid royalty fees.

    Personally, I liked the engineer. My dad was an engineer. As soon as I found out about the scheme, I told the engineer. Two days later, my boss had me sign a Non Disclosure Agreement. Fine, I did. Two months later, I was fired for ratting out my boss. My boss tried to sue me but that evaporated quickly. My boss told me I would never work in the industry ever again. I had a new, better job in 4 hours after being fired even after trying to defame me.

    It was pretty stressful during the ordeal. I just knew that I did the right thing and it would all work out.

    "As God is my witness, I thought turkeys could fly."- Arthur Carlson

    by bobinson on Fri Mar 12, 2010 at 12:33:02 AM PST

  •  I remember working for an insurance brokerage (0+ / 0-)

    as a college student, and one of my clearest memories of that period was of one of the sales reps suggesting, over the phone to a client, that he could move some of his not-up-to-code industrial equipment out of the factory and into an employee's garage while the insurance company inspected the premises.

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