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Lifetime medical benefits award
06-04-2010, 01:43 PM
Post: #1
Lifetime medical benefits award
One week ago, the w/c insurance carrier told me that my medical benefits were denied. Today, I get a letter from w/c saying I have been awarded lifetime medical benefits for my injury. I'm thinking this must be correct because w/c sent this letter to their insurance carrier as well. I am scheduled for rotator cuff surgery in 4 days. I just want to make sure to handle this the right way and it won't leave me responsible for the bills so far, as well as the surgery, recovery, or what else may come up in the future. Anyone seen this before?

Limojay
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06-04-2010, 02:10 PM (This post was last modified: 06-04-2010 02:11 PM by 1171.)
Post: #2
RE: Lifetime medical benefits award
you don't have your location in your profile.
comp laws are state specific and not providing your state limits any response to your requests for information.

i'll guess that your state specifically controls the type & extent of treatment with some sort of protocols and while you may be legally entitled to future medical care it is not a blank check for any and all you want or think you need.

again I have to guess as you did not provide any information about your state
http://www.workerscompensation.com/forum...?tid=10146
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06-04-2010, 07:11 PM
Post: #3
RE: Lifetime medical benefits award
1171 Wrote:you don't have your location in your profile.
comp laws are state specific and not providing your state limits any response to your requests for information.

i'll guess that your state specifically controls the type & extent of treatment with some sort of protocols and while you may be legally entitled to future medical care it is not a blank check for any and all you want or think you need.

again I have to guess as you did not provide any information about your state
http://www.workerscompensation.com/forum...?tid=10146

Sorry, I'm in Virginia
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06-04-2010, 07:21 PM
Post: #4
RE: Lifetime medical benefits award
Although I am not in your state. I do have life time medical. That covers my injury alone. Nothing else. It will cover future surgeries and meds related to a back injury. For anything else, I use my insurance.

If there is a question about whether or not something is covered, I call the adjuster. I also call the adjuster if the drug store makes a mistake and charges the wrong meds to them. Keeping an open line of communications with the ajduster makes things run smooth

8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. Jesus died for our sins. Soilders died for our freedom.
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06-04-2010, 07:48 PM (This post was last modified: 06-04-2010 08:03 PM by 1171.)
Post: #5
RE: Lifetime medical benefits award
virginia doesn't have a fee schedule or utilization or peer review for medical so it's likely that the dispute is about whether the treatment is releated to the work injury or some other condition.

who/what is w/c?
"...w/c sent this letter to their insurance carrier as well."

is it the state commission?
is it your employers risk management officier?
is it a third party administrator?
is it the comp court?
is it your wife's cousin?Smile

there are a lot of players in the system and it helps to be clear about who or what
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06-05-2010, 07:54 AM
Post: #6
RE: Lifetime medical benefits award
1171 Wrote:virginia doesn't have a fee schedule or utilization or peer review for medical so it's likely that the dispute is about whether the treatment is releated to the work injury or some other condition.

who/what is w/c?
"...w/c sent this letter to their insurance carrier as well."

is it the state commission?
is it your employers risk management officier?
is it a third party administrator?
is it the comp court?
is it your wife's cousin?Smile

there are a lot of players in the system and it helps to be clear about who or what

Sorry, Everyone I talk with knows & I just assumed everyone else that has any dealings with this forum knows that w/c stands for workers compensation.
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06-05-2010, 12:13 PM
Post: #7
RE: Lifetime medical benefits award
I would just give the Hospital or the Dr.'s Office that is going to do Your Surgery a Call, and Ask Them if the Letter You have Received will be the Way the Surgery is going to be Payed for. It seems to Me Your Case May have been Reviewed, and You were Given the Lifetime Work Place Injury Medical Award, and it should Cover Your Surgery. Give it a Try, and Please let Us know how Things Go!Wink

I Wish Everyone in the World would Take just One Minute to Take a Deep Breath and Look at the Wonders around Them. Too Much Time caught Up in the Moment can Cause Us to Miss soo Much that is Good, and given Us Daily! We are just too Busy to See!
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