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  1. #1
    Join Date
    Feb 2005

    Question I can't take it!!

    What is the name of your state? California, My case has been settled and I am supposed to recieve lifetime medical for a back injury.I am still in severve pain and now workmans comp is denying all treatment.My lawyer wont respond to my calls and letters (this is my third lawyer) and i need help. If workmans comp. is denying all treatment can my personal medical insurance legaly deny treatment as well?

  2. #2
    Join Date
    Mar 2002
    Have you received a denial letter from the WC carrier, denying any further liability for your injury, or are they simply not paying? If the former, then presumably your group or private medical insurance will pay the bills under the terms of that plan.

    If your lawyer won't return your calls and letters (which I find unconscionable), then it may be time to seek yet another WC attorney.

    A person, who is nice to you, but rude to a waiter, is not a nice person. (This is very important. Pay attention. It never fails.)
  3. #3
    Join Date
    Jul 2003

    phone calls

    I'd be calling everyone from ins. to appeals board. You should have all your paperwork with phone numbers.

    if not get a different lawyer!!!!!

    Last edited by celitag; 02-24-2005 at 06:11 PM.
  4. #4
    babyseth Guest

    Hope you got it in writing

    I hope you got it in writing about them covering all medical the rest of your life. Usually when you settle you give up your rights to ever come back on Workman's Comp again for anything pertaining to your case. When you settle you give them permission to not pay for anything again.. Like I said I hope you have it in writing and if not this is probably why the attorney won't answer your calls. He probably got his money so now he is down also with you.. I would never settle for anything. They tried settling with me and I didn't and now glad because I may be looking at more surgery. If I had settle I would of gave up all rights to them paying for it. They then tell you that is what the settlement money is for, to pay for any problems down the road.

  5. #5
    Join Date
    Nov 2004

    I can't take it!!

    There could be several reasons why the work comp carrier is not paying for treatment. 1. If settlement included your being treating only by an authorized treating physician (and you are not complying) or 2. The injury which you are trying to receive treatment for is not the injury the settlement was based. Nevertheless, if you have followed the settlement - take these steps.

    1. Obtain a copy of the final settlement papers(signed by a judge).

    2. Obtain a letter from the doctor stating that treatment administered is for the injury (or directly related to the injury ex. double back fusion which has now caused impotency sorry but that was the one example I remembered while working with a work comp attorney) sustained which is subject to the work comp claim.

    3. After you receive that information, either contact the attorney who represented you either by certified letter and U.S. regular mail or telephone and explain that the work comp carrier is denying treatment and give him copies of the supporting documents.

    Having this information will help speed the process along. Techinically, once your case is over - through trial by court or through settlement the attorney who represented you is no longer your attorney unless he/she is being kept on a retainer. But I believe if you get this information, the attorney will help you- if not seek counsel elsewhere.

    As to your personal insurance covering you - if work comp is not covering the injury (even if they should) your personal insurance will probably cover it. They are probably going to ask you to sign subragation papers - which simply means if it is proven that your injury should be covered under work comp - your personal insurance company will recover the monies they have spent.

    It does not matter that you settled your work comp case as long as you kept the meds open. If the settlement provides for lifetime treatment for the injury then that is what it means. Now, if you were later contacted by the work comp carrier and was offered a cash payment to settle and close your meds and you did that - then they will be under no obligation to do anything further. If you have not closed your meds and your injury falls under the guidelines setforth - you will be ok.

    Hope this helps.

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