• FreeAdvice has a new Terms of Service and Privacy Policy, effective May 25, 2018.
    By continuing to use this site, you are consenting to our Terms of Service and use of cookies.

w/c insurer refusing payment on medicals

Accident - Bankruptcy - Criminal Law / DUI - Business - Consumer - Employment - Family - Immigration - Real Estate - Tax - Traffic - Wills   Please click a topic or scroll down for more.

xfrustrated

Junior Member
What is the name of your state (only U.S. law)? Colorado

In 2000, my brother received a settlement and judgment stating that the medicals, arising from his injury, be paid for the rest of his life. The attorney he used has since retired and he can not afford another attorney as he is having to live on a very limited income. He received extensive injury to his leg and, after 18 failed surgeries, he decided to have his leg amputated just below the knee. He has permanent nerve damage and damage to his wrists and back from years of having to rely on crutches while going through the afore-mentioned surgeries. After having his leg amputated, he had to move in with my parents in Florida and has lived there ever since. The case manager he is having to deal with is located in Georgia. He has been treated by a pain management physician ever since the amputation and the w/c insurer is now refusing to pay for his medicals and prescriptions. The case manager is very rude and beligerent to both him and his doctor and has even chuckled when my brother questions him about why his medicals are not being paid. His doctor has not received any payments since last October but is still trying to treat him. They have both spoken to the case manager's supervisor who states that the decision is in the hands of the case manager. We desperately need some advice about who can we turn to and try to get this resolved. I am really worried about the stress and pain my brother is having to live under on a daily basis. Can someone point us in the right direction. Thank you so much.
 


OHRoadwarrior

Senior Member
It does not appear the agreement to pay for leg issues extends to issues with his back or wrists. If he has little or no income, he should file for social service insurance.
 

xfrustrated

Junior Member
It does not appear the agreement to pay for leg issues extends to issues with his back or wrists. If he has little or no income, he should file for social service insurance.
They have been paying for this as the authorized doctor has diagnosed these problems are directly related to his original injury and just all of a sudden stopped making payments to his doctor.
 

OHRoadwarrior

Senior Member
Have been and continuing to pay, can be 2 different things. It appears he is now feeding a drug addiction and that is causing the pain. It appears he will need to "dry out" to establish a history of causality.
 

Find the Right Lawyer for Your Legal Issue!

Fast, Free, and Confidential
data-ad-format="auto">
Top