Need ER can I go on workman's comp - Printable Version
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RE: Need ER can I go on workman's comp - hollywoodyed - 06-12-2009 01:14 AM
Bernie57 Wrote:But I had jelly!
You always have something to make me smile. thank you. oh and as a matter of fact I do have a little grape jelly left I had totally forgotten about it (lol) but 4yrs and 2wks oh dear. I hope I at least don't have to wait that long to get some TTD payments. Settlement at this rate who knows. I just want my 66 and 2/3% weekly wages. It has been over a month without income. I would definitely not make it on any Survivor Reality Series.
RE: Need ER can I go on workman's comp - sparkey - 06-12-2009 04:59 AM
I am confused as to why you have not recieved a TTD payment if you filed for WC and were not denied and out of work. What is the IC reason why they are not paying? Can you call your adjuster or do you now have a lawyer??
RE: Need ER can I go on workman's comp - hollywoodyed - 06-12-2009 08:26 AM
sparkey Wrote:I am confused as to why you have not recieved a TTD payment if you filed for WC and were not denied and out of work. What is the IC reason why they are not paying? Can you call your adjuster or do you now have a lawyer??
I have not received any written reason from the IC the only thing I have received from them was the medical release and history forms to fill out which I have and faxed back to them. I have called and faxed the IC adjuster no response, I have called and emailed my employer HR dept who states it is now in the hands of the IC. I have talked to 2 lawyers for free consultations if you read in my previous posts and basically both told me I really have no recourse until after 90 days??? I did send a letter to the audit bureau informing them that I had not received a letter from the IC within 14 days stating accepted, delayed, denied as I am suppose to no response from them either. I called the DWC office for help in the matter. I tried to apply for SDI as I wrote in an earlier post and the PA would not fill out the DR Certificate stating it was an accepted claim or they would not be treating me. So as much as I hate to meet with the IC rep today who is coming out to get my statement (a statement that has already been submitted in writing multiple times) and for me to sign medical release forms (forms that I have already faxed to the adjuster) I am hoping to get some answers from him. I have gone through the proper channels to the best of my knowledge and have gotten nowhere. So if you think you are confused I am totally disoriented to the whole situation.
RE: Need ER can I go on workman's comp - hollywoodyed - 06-12-2009 04:00 PM
Well the investigator hired by the WC insurance met with me, recorded my statement, I was honest and described the incident and my history just like I have in writing what seems like a million times already. He then said he was going to go talk to my employer and would be working on his report and should have it to the claims adjuster by Monday. He said a lot will hinge on the MRI results. He stated that I was lucky that it only took a little over 3 weeks to get the authorization for the MRI. Perhaps that is true, but it seems like an eternity when you are in pain and have no source of income going on 5 weeks now. I asked how long to expect to know about TTD and he said he could not give me any date but would relay to the claims adjuster my financial concerns. Well, I have relayed my financial concerns to the claims adjuster in form of voicemail and faxes already to no avail. So who knows. I felt like I was a criminal being interrogated for a crime that I did not do. What happened to innocent until proven guilty?
RE: Need ER can I go on workman's comp - 1171 - 06-12-2009 04:38 PM
where $$ are involved documentation is critical--there is always someone looking to second guess the situation later.
the price we all pay for using some else's dime.
RE: Need ER can I go on workman's comp - hollywoodyed - 06-12-2009 04:56 PM
1171 Wrote:where $$ are involved documentation is critical--there is always someone looking to second guess the situation later.
I suppose. It is definitely not right. Apparently though there is a huge problem with the WC system otherwise we would have nothing to write about in this forum. Just because he recorded the conversation doesn't mean that he cannot spin it differently. I don't have a copy of the recording. I know what he asked and what I said for over an hour but can I prove it NO. I do have all my emails, status reports, faxes etc since the injury so if need be I have something to back me up. I am just so ashamed to know that this is how we treat each other in our society when it comes to taking care of honest workers trying to make an honest living and provide for our families and unfortunately end up getting hurt while performing our work duties. Then we are treated like garbage and become another statistic for the bankruptcy courts and have our credit rating ruined because we can't pay bills. Oh I am just so irritated not to mention in pain, because I did not take my narcotic this morning so I would be clear headed when I gave my statement.
RE: Need ER can I go on workman's comp - 1171 - 06-12-2009 06:41 PM
you are reving yourself up with loaded images and words when you need to remain in contol and manage yourself and your condition productively.
you know there is no way to tell who's right and honest by looking at them. you also know that you are not the only party involved in the claim and the money.
keep the big picture in mind and look at the situation more objectively. Don't project motives and behaviors that are not there. You don't want it done to you -- maintain the high road.
I'd recommend you push the SDI claim with the doctor or change doctors to one who will complete the SDI authorization.
the PA is wrong. they don't have the right to conceal/withhold their medical opinion from a state agency that requests it. It's not up to them to decide which claim is valid.
you can report the facility and the PA to the local medical board.
I would certainly file a written complaint with the physician in charge.
RE: Need ER can I go on workman's comp - hollywoodyed - 06-12-2009 07:11 PM
Thank you and you are right. I must not let my emotions creep in. I must remain professional. I will give the claims adjuster just a few more days by then she should have the investigators report, hopefully the MRI results and will let me know otherwise I will pursue the SDI avenue again. Thank you for the so to speak slap in the face for my hysterics, that is what happens when my pain gets out of control. I apologize
RE: Need ER can I go on workman's comp - Bernie57 - 06-13-2009 02:24 AM
Just me again. I was looking over the old posts. For everyone that you are seeing, P/T, MD, DO, PA and WC providers what are using for the DX code. On my claim they had to be watched to be sure everyone was using the same DX code. I know the MRI results are still pending, But they should be using a close code. My doctors got my DX wrong, but everyone was on the same error page.
You did mention your back, your hip, and belly and hand. I would be sure each area of pain is addressed as one total claim. Even if they are not writing out the DX, they need the code for billing reasons, even if it is just to r/o the cause. You may not need all of this infor, but why take chances. At least it will keep you mind active, while enjoying that PB&J. Don't forget the food cupboards, I sure didn't.
Good Luck with MRI results, Stay Strong. Bernie; sandwich queen!
RE: Need ER can I go on workman's comp - hollywoodyed - 06-15-2009 08:52 PM
MRI partial results: L1-2 level degeneration of intervertebral disc with mild loss of disc height, focal central disc protrusion 6mm with thecal sac indentation. Mild central stenosis. L3-4 level mild degeneration of intervertebral disc no protrusion or stenosis. So not exactly sure what that means, but the PA is going to ask WC insurance for authorization to refer me to a Orthopedic physician. Have not heard anything about my TTD benefits, so I am still without income 5 weeks now.