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Denied Med refills again
10-10-2007, 02:46 PM
Post: #1
Denied Med refills again
When denied medication refills at least every six months for the last 15 years, what legal options, if any do I have.
Or is it because when I don't that this medication it can cause seizures and death?
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10-10-2007, 03:48 PM (This post was last modified: 10-10-2007 03:49 PM by WCisBS.)
Post: #2
RE: Denied Med refills again
Depends on the reasons and your states work comp laws. Each has different rules. Some have penalties for delay of benefits when it's unreasonable.
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10-10-2007, 05:37 PM
Post: #3
RE: Denied Med refills again
With this happening every 6 Mos. for 15 Years, Why haven't any steps been taken in 15 Years Time to Stop this?? Do You have an Attorney on Your Side, and if so, why hasn't any Petitions been filed against the i/c? This happened to Me Once, and My Attorney referred Me to Workers Comp RX, and they have filled and Mailed All of My w/c related Meds. since! You may want to check into finding a w/c related Pharmacy like this is Your Area. If You would like info. on Mine, I'm in Pa., I would be Happy to get the info. for You!Wink

Failed Back Surgery, Chronic Pain, Totally Disabled.

Knowledge is Power, Especially in the World of w/c. Learn as Much as You can about Your States w/c Laws, and don't Fight Battles alone, They Use Attorney's, and so Should You!!
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10-10-2007, 05:39 PM
Post: #4
RE: Denied Med refills again
Im in CA. For the reasons they won't state. The workers just toss it off on someone else. Eventually getting ok'ed, but the damage is already done with interruption of your meds and added stress which the meds are presrcibed for. I believe my doctor called it DECOMPENSATING my initial injury.
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10-10-2007, 06:53 PM
Post: #5
RE: Denied Med refills again
you or your atty should file a petition for penalty for each and every time there has been an unreasonable delay. If they won't give you a reason, they probably will to a judge.

"5814. (a) When payment of compensation has been unreasonably
delayed or refused, either prior to or subsequent to the issuance of
an award, the amount of the payment unreasonably delayed or refused
shall be increased up to 25 percent or up to ten thousand dollars
($10,000), whichever is less.

5814.6. (a) Any employer or insurer that knowingly violates Section
5814 with a frequency that indicates a general business practice is
liable for administrative penalties of not to exceed four hundred
thousand dollars ($400,000)."
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10-10-2007, 07:23 PM
Post: #6
RE: Denied Med refills again
You answered my milliondollar question? Thank You
Oh yes I talked to my worker, and told her of my symptoms of withdrawl, (well my possible Smile sympoms) and she had it cleared within an hour. It will be nice not to have to worry about going through this so much.
I don't have an attorney and Im on social security disability, can I do this on my own behalf ? If not would it be worth it to hire an attorney ?
Thanks Again for the great answer
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10-10-2007, 08:22 PM (This post was last modified: 10-10-2007 08:24 PM by WCisBS.)
Post: #7
RE: Denied Med refills again
Smile
Workers comp court does not require an atty.
Shy
I can't speculate whether one would represent you for just the penalty issue especially since you don't know why it was stopped. If the carrier has a good reason then there's likely no penalty. New Utilization Review rules have a number of requirements and that could be the source of legitimate delays.
You should request a written explanation for the delay.

you can read the full text of the penalty code including exceptions here
http://www.leginfo.ca.gov/cgi-bin/displa...5800-5816.

you may wish to file a complaint with the audit unit
http://www.dir.ca.gov/dwc/Audcomp.pdf
Smile
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