Ran out of physical therapy but I need more HELP

[Nrod8285]

[align=right] so I live in the great State of california that has a limit Of physical therapy appointments regardless of the injury. I've burned through my 24 but I have an attorney and he was able to get me 5 More. Those 5 are coming to an end but I'm still not healed ad my physical therapist and doctor agree I need a lot more! Now I have probably the best doctor And therapist in California so I know they are not blowing smoke up my ass. I don't care if I have to pay outta pocket. Money isn't the issue, my health and getting my knee back since I'm only 25 is much more important. My Workers comp adjuster said no, that I could not use my private insurance. I asked my attorney and hes still looking into it. My physical therapist said i could but it takes a denial letter of treatment from workers comp and some Medical evidence saying I need therapy still. Does anyone have any insight regarding this topic? Anyone else know how I can get more physical therapy??

[bronco54501]

Here in wi, you need the denial letter as well.. As far as using your private ins, the wc ins cant controll you using it.. When I was first injured, not working I qualified for state funded ins.. I had to sign a waiver stating they would be reimbursted any money used for my wc injury, (lawyer aproved). In the end if you have a good lawyer, wc ins will have to pay back the private ins company.. I have been denied all bennifits from wc, and now have state funded ins again.. They have been paying all medical needs that wc denied, even chiropractor visits.....

You are correct, your health comes first.. If you need more pt and are able to pay out of pocket, then do it.. As I'm sure you already know keep all reciepts and give coppies to your attorney, so he can get you your money back....

[1171]

sounds like your therapist has got it right. most health carriers will pay on work denied treatment but you should talk to them.

in california it's a hard cap, so the health carrier won't
be getting reimbursed.

[Nrod8285]

Thanks for the replies. My therapist was right. Finally got a hold of my insurance and they said they cannot deny me medical attention if my MD is saying I need it. I do still need to be denied from My workers comp, but I don't need a second opinion and can use my same doctor. No conflict of interest issues. Even better my physical therapist is covered by my network provider. I get 24 sessions a year through anthem blue cross California. Now my new obstacle is I can't go to my new therapy appointments while I'm at work since it's not workers comp providing the coverage. But the doctor put me back to work so how im gonna find the time to go to physical therapy 2x a week and work 5 days too is beyond me. Gotta deduct sick time and use up my vacation time if necessary. If its not one thing it's another!

[1171]

you are entitled to 1 day of comp for every 8 hrs of treatment time off - plus mileage.