Threaded Mode | Linear Mode

carpal tunnel boy · 06-30-2009, 01:48 PM

I have been diagnosed with CTS as a result of repeteitive movement at work and surgery is recommended. I would rather not file a w/c claim and just pay my 20% of the $3000 surgery and get back to work in 3-4 weeks. I did not list on my info sheets with the doctor that it was work related but I did tell him the type of work that I was doing. Will BCBS deny paying and force me to file a w/c claim?

Thanks for any input,
Capal Tunnel Boy

~~Still in Limbo~~ · 06-30-2009, 02:02 PM

I Understand Your Concern, with All of the Horror Stories on Here, but the Choice is Yours, and if Your Ins. Co. Denies the Surgery, You May then have to File a w/c Claim. The Only concern, and this is My Opinion Only, if Work Related and very Clearly so, it's a Shame that another Ins. Co. should have to Cover the Burden. Sorry, I Forgot to Welcome You to the Boards, and as I Said, the Decision is Yours unless BC/BS Denies Your Surgery. Best of Luck in what You Decide, and I Hope Your Recovery is Quick!! Wink

1171 · (This post was last modified: 06-30-2009 02:25 PM by 1171.)

depends on what the doctor's opinion is.
in most states in not necessary for the worker to file- the employer & doctor have most of the responsibility.

Manley2 · 06-30-2009, 03:55 PM

I would think that if they find out it could be WC they are going to not pay it or if they pay the bill and find out later they will want paid back. One problem I can think of is the time limits on reporting this. If this is only going to be a small surgery bill and a few weeks off I would think it would not be a big deal for WC to cover it. The one thing you didn't talk about was losing 3 or 4 weeks pay while you are off. You may have vacation to cover it or can afford to take that much time off. What happens if this is not the case? Something screws up and you need more surgery and more time off? If your returned to work with any restrictions will the employer go along with it? As the other post said it's up to you but please think thru everything. And I may not even came up with everything that could happen

Bummer Knees · 06-30-2009, 04:03 PM

I had carpal tunnel surgery earlier this month for the left hand and decided not to add the left hand to the wc claim.

The left hand was an overuse injury but I decided not to wait for work comp. I do have BCBS and Medicare and was told BCBS would pay for the surgery.

Call the 800 number on your insurance card to findout if the insurance company will pay for the surgery.

The reason I decided to use my private insurance was because I have a work injury of the other hand and have been waiting for approval from the judge for some time so that it may be added to the claim. The hand surgeon told me 2 weeks ago I have estimated 10 weeks left before I lose use of the right hand but still I have to wait for the judge's decision before I can receive medical treatment.

I do understand your thinking.

Manley2 · 06-30-2009, 04:50 PM

I can understand his thinking to but I had a fellow worker that needed surgery on both hands. One was fine after that surgery but they other didn't get any better. Now he was looking at another surgery and more time off plus he had to be on restrictions until he got it fixed. Again he is the one that has to decided but just remember to think everything thru. Hope what ever you do it works out for the best

fencer11 · 06-30-2009, 06:56 PM

I think with a situation of carpal tunnel, that Blue Cross would probably not spend the time and money to say it is workers comp. If the surgery is only $3000 and your paying 20% of that, I would think they would just cover it. As far as going the Blue Cross route instead of Workers Comp, "my opinion only" is go with Blue Cross and just get it done and back to work, the struggles of WC are not worth it. Good luck with whatever you decide, keep us posted. And welcome to the forum.

Bummer Knees · (This post was last modified: 06-30-2009 10:56 PM by Bummer Knees.)

Manley2 that is a chance I slelected to take.

I still am having nerve pain in the left hand, hope it is just the healing process.

I did some checking today with BCBS and carpal tunnel is an outpatient surgery and preauthorization is not required by the facility doing the surgery.

I have BCBS in Kansas, may be different in other states.

Manley2 · 06-30-2009, 11:26 PM

Yep it all a chance anybody takes and just hope I've given him somethings to think about. The surgery may only be $3000 but what about all the office visits? My insurance doesn't pay a dime for any office visit so that could be something to think about to, and is that $3000 the whole bill or just the doctors bill? I just had some medial branch block shots in my back for three levels. The total bill so far for just that is over $4000. That was for about 30 mins of work and not even in an operating room. Bummer I hope your nerve pain does go away with time and I hope carpal tunnel boy makes the right move.

~~Still in Limbo~~ · 07-01-2009, 11:43 AM

As the Others have Stated, and I Mentioned also, it's a Decision and Chance You are Taking using BC/BS. If You Heal Well and Quickly, You are Fine, if there's Complications, You will have to Continue to Pay Your Deductibles and Co-Pays, until it gets Straightened Out, and if there is Permanent Damage, You won't have anything to Fall Back on. Again My Very Best,and I Hope everything Goes Well!! Wink