Advice Please...

[sunbird]

Hi to all, I'm a newbie here with an old problem...I've been on Workers Comp since the late 70's and receive medical coverage for the permanent disability for lifetime. Now that I am in need of back surgery, the employer is saying NO you were dropped in 1988 for failure to appear; this doesn't make sense, since I have never received any notice of any kind. The employer says maybe the attorney received notice and didn't follow-up (which also doesn't make sense), and also the attorney has since died. Just recently the employer has paid for medications and physical therapy, but nothing major in all of these years until now and now that we are talking neurosurgery the employer is saying we lost this coverage back in 1988. I also think this is a self-insured employer based in Illinois.
Would appreciate any advice or thoughts or past experience you may have had. Just anything.......TIA, :(Sunbird

[jayne]

call your state WC board they can tell you.....

[fireball]

sunbird, what state are you in and do you have a case number

cheers!!!!!!!!me!!!!!!!!!!!!!!

[fireball]

subird, i just reread and you thought it was in il based ins--did your case take place in il? if it did you can pull your case up online under the illinois industrial commission--go to cases--if it is an il case the case number should start with an o7--it will give you all the details dates of hearings etc. however usually when you settle a case for lifetime medical your settlment papers that would of had to of been approved by ehatever state w/c board you are in will state lifetime medical. thats all you need. in some states w/c can go back to the commission once you have returned to work to get the settlement changed if they can prove you are no nlonger disabled and of need of lifetime benefits---being that they are still paying for meds and physical therapy it sounds like medical is still open. im surprised your company is involved as far as the settlement goes--usually they are only told what restrictions are put on you---no money amount of settlement or choice of life medical. and who did you request the surgery from--your employer regular insurance or directly to the w/c that settled your claim let me know

chers!!!!!!!!!!!!

me!!!!!!!!!!!!!!

[sunbird]

thanks for your input, my w/c is in the state of illinois. i beleive the co. is self insured. i still receive a small w/c every month. the co. says my w/c medical was dropped in 1988, but at that time i was having medications filled on a monthly basis and for several years later . i was never notified of being dropped until now. once they found i may need surgery they say it was dropped. i never did receive any settelment papers. i am trying to get imformation from the court house in the city in illinois where this took place.
Sunbird

[fireball]

sunbird, your in luck the one area i know most is il. your attorney papers should have a case number written on them--it should be a number like 07 1234. you do not have to go to the court house where the papers are filed all you have to do is look up illinois industrial commission. if you do not have your case number there is a phone number to obatain it. you said no settlement papers were signed. that means that your case would continue to come up for review every 2 months for 3 years--at which time either party can ask for stipulations to be dropped. if in fact they did drop the medical but are still oaying for meds etc it sounds llike at least your case is still somewhat open. since you did have an attorney at the time he would of been the one to notify you of any upcoming dates and it was his responsibilty to attend them. i know you have said he has since passed but didnt someone in his office take over your case---and did that law firm ever collect money from you for the case(in il they do not collect un til the settlement papers are signed and approved by the w/c board. if for some reason the attorney office screwed you then i would be the first to pick up the phone and call them--there is a system in place in il for attorneys who fradulently misreprsent clients. if possible (and you can send me a pm) let me know the city and what law firm you had or have. i will do my best to quide you through what is due to you--private ins or nnot if the company has more than 35 employees they are governed by the il industrial commission--let me know

cheers!!!!!!!!!!!!!

me!!!!!!!!!!!!!!!!!!!

[1171]

all comp benefits disputes can be brought to the Illinois work comp commission for resolution. you should file for a hearing on the coverage issue.