Insurance won't pay for surgery

[kgab1155]

I was hurt on the job. Workers Comp. refuses to pay for the surgery my doctor says is need. My health insurance provider, HMO Blue, refuses to pay saying Workers Comp. has to pay. It there anything short of hiring a lawyer I can do?

 

[ALawyer]

The first thing to do is get a second opinion from another qualified doctor -- the WC carrier may have concluded (rightly or wrongly -- I can't say) the operation was not necessary or not work related. If the second opinion is the operation is really needed, that will eliminate one issue.

Then get the employer's HR people involved. I assume they pay for both WC and Blue Cross coverage, and get them to resolve it. If that is not fruitful, a lawyer's letter may do the trick.