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Can't see doctor without insurance??? - Printable Version

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Can't see doctor without insurance??? - shefallsdown - 01-17-2017

I have been unable to find a single doctor/clinic that will take my worker's comp case because I don't have insurance. (Well, I do, medicaid, because hello I've been unable to work for 3+ months.) I was "allowed" one visit with a doctor today who agreed I was at MMI but wouldn't rate me and did a half-ass APF to get me through another month (I'm not even sure he faxed it in). I've run down the list of other clinics and their providers either won't rate - even orthopedic departments - or don't even work with worker's comp (that was the majority of it). The specialists who did all my MRIs don't rate. 

My first doctor (who won't rate) told me I wouldn't get anything. My doctor today said he'd just send me to an IME (!!!).

I'm so lost at trying to get rated. As it turns out, not many workers comp doctors can rate....the insurance thing is just another blow to the whole process.


RE: Can't see doctor without insurance??? - 1171 - 01-17-2017

what about direct pay from you? if you want your own report from a doc of your choice you may have to pay up front. the employer may yet contest the rating with one from their own IME.
you might find the name of some doctors that can rate from the legal decisions data base you used ealier.
if they are that rare, there should be some common names mentioned in recent decisions.


RE: Can't see doctor without insurance??? - shefallsdown - 01-17-2017

(01-17-2017, 02:05 AM)1171 Wrote: what about direct pay from you? if you want your own report from a doc of your choice you may have to pay.

Great minds. I tried that, but I'd have to drop my Medicaid which is illegal, and they just shrugged their shoulders. Not exaggerating I do direct pay for my non-work comp stuff because in the end its cheaper than insurance + deductible + cost of visit. I also don't want to work with this doctor because he actually does IMEs part-time. He was fair today, but won't rate his own patients. For obvious reasons I can see now.  

I didn't ask about direct pay over the phone with other clinics, but I assume they'd respond the same way. 

I do have the option to opt-in to a blue cross/shield plan for February, but there's more of an issue of doctors not doing the ratings than overall taking insurance.

I ended up trying to Google 10 different ways and found about 5 chiropractors that specifically say they'll do ratings. I sent them all emails. Paying for that is fine, partially because it'll be much more favorable.


RE: Can't see doctor without insurance??? - 1171 - 01-17-2017

if you prefer a chiropractor to do the rating then I,d try your county or state board of chiropractors, they should be able to give you some names
http://www.chirohealth.org/

or
also there is an Approved IME search function on the L&I website
https://fortress.wa.gov/lni/imets/
http://lni.wa.gov/ClaimsIns/Providers/TreatingPatients/IME/default.asp

Im not sure either source will help with your insurance issue.


RE: Can't see doctor without insurance??? - shefallsdown - 01-17-2017

(01-17-2017, 02:18 AM)1171 Wrote: if you prefer a chiropractor to do the rating then I,d try your county or state board of chiropractors, they should be able to give you some names
http://www.chirohealth.org/

or
also there is an Approved IME search function on the L&I website
https://fortress.wa.gov/lni/imets/
http://lni.wa.gov/ClaimsIns/Providers/TreatingPatients/IME/default.asp

Im not sure either source will help with your insurance issue.
They should be just taking L&I, the insurance was only a problem with 3 clinics - the other 20 or so just didn't have anyone approved to rate.

Those are good links, also, if you Google "ABFP (city/county/state)" you'll find doctors also certified to rate. Not sure going the IME route is ideal, they're inherently pro-employer (like my doctor was today.) That said, I found my psych IME to be a 180 from the horror stories I read about. Maybe it's just a different beast than the physical ones.


RE: Can't see doctor without insurance??? - 1171 - 01-17-2017

It's not your nsurance; it's not your claim. It's not health insurance; it's not taxpayer or government provided social services. It protects the employer from your civil suit. You and the employer are not equal partners in the process. Some of the costs for the injury are born by the employee. It is no fault insurance. The employee gets something up front igenerally without long court delays in return for much lower fixed benefits.

It can be frustrating for employees trying to make work comp something it's not.