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Gatekeeper · 07-13-2009, 09:36 PM

Hello everyone, I am from Michigan and I was hurt on the job last Sept. and my comp benefits were disputed in Feb, they say its not work related but my Ortho says otherwise, also I have 3 witness, got a Lawyer and he went to my hearing and comp was a no show. My trial is in August and I need 3 disc's replaced and after that I must find another career cuz I am a mechanic and my Doc says after surgery I will not have the mobility to work as a mechanic. I am using my blue cross to cover the surgery. Should I wait for the trial or just have it and go from there with my comp dispute?

backache · 07-13-2009, 09:51 PM

Hi Gatekeeper and Welcome to the forum. I am so sorry to hear about your injury, but you have come to the right place for help. Unfortunatly I don't know the answer, but I'm sure one of the people who know all of the rules and regulations will be on shortly to answer your question. Good luck and take care. Backache

Gatekeeper · 07-13-2009, 09:53 PM

backache Wrote:Hi Gatekeeper and Welcome to the forum. I am so sorry to hear about your injury, but you have come to the right place for help. Unfortunatly I don't know the answer, but I'm sure one of the people who know all of the rules and regulations will be on shortly to answer your question. Good luck and take care. Backache

Thanks, does the fact that they did not show up for the hearing mean anything?

backache · 07-13-2009, 09:58 PM

I'm going to PM a couple of people who may be able to answer all of your questions and have them read your thread. Also if 1171 comes on they will be able to help you out I'm sure.

Gatekeeper · 07-13-2009, 10:01 PM

backache Wrote:I'm going to PM a couple of people who may be able to answer all of your questions and have them read your thread. Also if 1171 comes on they will be able to help you out I'm sure.

Thanks! and god bless you

jayne · 07-13-2009, 11:27 PM

after comp disputed my claim...I let my personal insurance pick up I needed to be fixed...My personal knew it was a disputed claim and they went after WC to get it paid for.....get yourself fixed but dont ever lie about where and when you got hurt be up front and honest with your personal IC they will take care of it...good luck

1171 · (This post was last modified: 07-14-2009 02:32 AM by 1171.)

if you know blue cross will cover it and comp is denying everything then I'd go ahead and get it taken care of.
litigation can be a night mare of delays and false starts and waiting.
there is no guarantee you'll get a clear decision in august.

Have you had a second opinion/consult?
failed back surgery is the scourge of the medical community and once you go under the knife you can never go back- be very, very sure.

blue cross will file a lien and collect from the comp carrier once the legal decision has been made.

without knowing what kind of legal appearance was scheduled it difficult to tell but i would not think a no show means much since it was easily rescheduled without any decision.

Gatekeeper · 07-14-2009, 06:08 AM

1171 Wrote:if you know blue cross will cover it and comp is denying everything then I'd go ahead and get it taken care of.
litigation can be a night mare of delays and false starts and waiting.
there is no guarantee you'll get a clear decision in august.

Have you had a second opinion/consult?
failed back surgery is the scourge of the medical community and once you go under the knife you can never go back- be very, very sure.

blue cross will file a lien and collect from the comp carrier once the legal decision has been made.

without knowing what kind of legal appearance was scheduled it difficult to tell but i would not think a no show means much since it was easily rescheduled without any decision.

Thanks for the input but the hering was not resceduled, the magistrait set a trail date based on what my lawyer said. Also their legal representation has not once returned a call from my lawyer or even a letter.

Cycler · (This post was last modified: 07-14-2009 07:36 AM by Cycler.)

GK:
To amplify 1171's statement, The odds of any kind of meaningful recovery from a three level fusion, if I take your description correctly, are very low while the odds of a lifetime of severe and unrelenting pain are unfortunately quite high as most of the regulars here will tell you.

On the other hand, the odds of improvement without surgery are quite good given correct therapy,( cervical stabilization, not isometrics and stretching) and a good dose of time, typically 6-12 months, all the while avoiding activities that clearly aggravate the neck pain.

Rather than a surgeon you may be better off under the care of a Physiatrist/Rehab specialist who does not have a procedure to sell you. The fact that you may not be able to work at your profession during non-surgical recovery is no different than not working because of surgery right ?

Bummer Knees · 07-14-2009, 11:18 AM

HI Gatekeeper

My first court hearing was for accepting the claim & seeking medical treatment.
The attorney for the insurance company and my employer did not show in court and they did not respond to certified mail of the hearing.

Ther lack of response made for a stronger claim for me with the judge issuing an order for medical treatment.

I also have BC/BS. I would call their office and speak with them about your questions.

BCBS has told me they will not pay for medical treatment if there is an accepted wc claim.

Hope this helps.
Bummer Knees