Irregular workmans comp checks

[memories1]

My husband has been off on workmans comp since Sep of 2010. For half the month of October and all of November we did not receive a workmans comp pay check. We did the first couple of weeks and then they stopped. Kept calling the adjustor with no return phone call and finally they called us back and said they were issuing us a check for $1400 dollars which we received the first week in December, and apologized for the delay and they they didn't know how my husbands name fell out of their automated system to have a check issued. Our bank account mind you was seriously overdrawn. So then the end of December comes, I beleive Dec 27 and the adjustor tells us that they are a 3rd party company that works with my husbands employers insurance company and that the Insurance company hasn't placed anymore funds in my husbands workmans comp account for them to cut another paycheck. They are waiting for funds. Apparently they determine how much longer my husband would be on workmans comp and distribute funds according to their best guess is what we were told. Let me stop right there...On Nov 4, the doctor was recomending surgery for my husband and we were told that we needed to go see the company's doctor after the new year so obviously he still was going to be off from work and still on workmans comp so you would have thought they would have funded his claim so the 3rd party adjustor could have continued to cut paychecks thru the new year. Prior in this post I mentioned that the adjustor didn't know how we fell out of their system to get a paycheck sent....in February, our adjustor used another excuse that he/she had not been at work to generate a check for us....I thought we were supposed to be in the automated system to have these checks cut automatically...hmmmm. Now last week we called the adjustors automated system that said the check was "issued" on Friday and we received it on Monday...this is how it should be. Now this week, the automated system says the check was cut last friday and here it is the following wednesday, mail came, still no check. How does this work? Are they doing this on purpose? As I read thru other posts on this wonderful website I see how people are just fighting to get medical care and I have to say this sicken's me. My husband has received surgery for a micordiskectomy two weeks ago and for that I am thankful. On the flipside, with the inconsistancy of receiving these checks, our bank account gets overdrawn, we haven't been able to pay our mortgage since Sept because by the time the check comes half of it goes towards overdraft fees....How can they do this. The company doctor agreed with our doctor without a shadow of a doubt. They have their proof. Maybe this was just a stress releif for me to reach out and ask...how can they stall like this?
Thanks....

[1171]

many states have penalty provisions for late benefits.
if yours does, you should file.
every time a check is late file for a penalty with a copy to the carrier.

keep a copy of the envelope/postmark and the check information to document.
even though the check printing/accounting is computerized most require manual approval. many require that the medical records be checked for authorization before approving.
every office, carrier, adjuster is different. there is no one answer.
obviously with so much outsourcing accountability is sacrificed.

maybe you could arrange direct deposit or personal pickup.
sometimes the the employer can have a positive influence if they called to complain.
make sure doctor notifies carrier for all time off.

[sonny1]

I also had the same experience in the beginning in NYS with my adjuster. She had every excuse under the sun. Then when I hired an attorney to handle the unnecessary stress (from adjuster) she was flipping mad. Well I found out that the attorney I had hired was not any good as I was still having to call my attorney everyday to have them track down my checks. FIRED him, got a new attorney and guess what? checks are coming early now, go figure! Some adjusters are just plain nasty, so follow the advice of above post and if that doesn't speed up the process, maybe an attorney can, not sure. What I can tell you from my personal experience is that it got way to hard to have to deal with pain, surgeries, PT, doctors appointments, healing, work ,home AND the adjuster on top of it all. It really took a toll on me for 2 1/2 years!! I got to the point where I felt that I was taking time away from my medical needs to get paid and pay the bills.

Good luck to you!

[SandyK]

(03-09-2011 06:04 PM)memories1 Wrote:  My husband has been off on workmans comp since Sep of 2010. For half the month of October and all of November we did not receive a workmans comp pay check. We did the first couple of weeks and then they stopped. Kept calling the adjustor with no return phone call and finally they called us back and said they were issuing us a check for $1400 dollars which we received the first week in December, and apologized for the delay and they they didn't know how my husbands name fell out of their automated system to have a check issued. Our bank account mind you was seriously overdrawn. So then the end of December comes, I beleive Dec 27 and the adjustor tells us that they are a 3rd party company that works with my husbands employers insurance company and that the Insurance company hasn't placed anymore funds in my husbands workmans comp account for them to cut another paycheck. They are waiting for funds. Apparently they determine how much longer my husband would be on workmans comp and distribute funds according to their best guess is what we were told. Let me stop right there...On Nov 4, the doctor was recomending surgery for my husband and we were told that we needed to go see the company's doctor after the new year so obviously he still was going to be off from work and still on workmans comp so you would have thought they would have funded his claim so the 3rd party adjustor could have continued to cut paychecks thru the new year. Prior in this post I mentioned that the adjustor didn't know how we fell out of their system to get a paycheck sent....in February, our adjustor used another excuse that he/she had not been at work to generate a check for us....I thought we were supposed to be in the automated system to have these checks cut automatically...hmmmm. Now last week we called the adjustors automated system that said the check was "issued" on Friday and we received it on Monday...this is how it should be. Now this week, the automated system says the check was cut last friday and here it is the following wednesday, mail came, still no check. How does this work? Are they doing this on purpose? As I read thru other posts on this wonderful website I see how people are just fighting to get medical care and I have to say this sicken's me. My husband has received surgery for a micordiskectomy two weeks ago and for that I am thankful. On the flipside, with the inconsistancy of receiving these checks, our bank account gets overdrawn, we haven't been able to pay our mortgage since Sept because by the time the check comes half of it goes towards overdraft fees....How can they do this. The company doctor agreed with our doctor without a shadow of a doubt. They have their proof. Maybe this was just a stress releif for me to reach out and ask...how can they stall like this?
Thanks....

When this started for me two years ago, I had problems getting medical care and when I was home recovering and exhausted all of my leave, I was told that WC would start sending me checks. Well, the checks did not come. The only way to get the ball rolling was to hire an attorney.

After repeated attempts from my attorney to get the checks started and medical care a hearing was demanded to determine my benefits. We never had the hearing just a deposition. Sure enough...it was agreed that I should be receiving benefits. The IC still stalled. The attorney had to aggressively pursue them. It took them another month to get the checks started. Like Sonny1, I had too much going on to take on this fight. I've left it to my attorney.

The biggest problem I have now is that the checks are supposed to come weekly but I never know when they will arrive. During the Christmas holiday I did not receive my checks on time (I guess because they were on leave for the holidays). The first week of January, I received two checks. I'm grateful for the benefits but just as my attorney's paralegal told me "never get used to the check coming on a certain day". Things change and you never know when or why. I'm just truly thankful for the information that is posted here and the benefits that I'm finally receiving. But I must admit, I feel like I'm on a tight rope, I never know what the IC will do or require next.

Good Luck

[sonny1]

It is very unfortunate that the IC can get away with doing this. I always thought to myself, what if this was happening to my adjuster? What if the shoe was on the other foot? I know they have a job to do, HOWEVER, not everybody is a scammer. I know that there are penalty laws as 1171 stated above, but that means waiting for a hearing and what do people do in the mean time, just lose everything they have? Doesn't seem right, I doubt anybody here enjoys being in pain, having multiple life altering surgeries just to collect peanut shells for $$. I am 40 years old, my WC case started 5 years ago...and if you look at my Social Security statements (the ones they mail with estimated retirement benefits) it shows I have worked since I was 15, without missing a beat..does that not say something about a person and their character? I am also tired of being under the IC thumb.

I hope your situation gets better without it causing you more financial devastation and mental stress.

Good luck to you and Sandy (from above)