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CA-PTP submitted request for treatment with no response from IC. What now?
(01-24-2014, 02:23 AM)A cure for pain Wrote: So.....
I had a request for an MRI and a nerve study that went unanswered for TEN weeks!!!
I called my adjuster and her supervisor dozens of times each and neither ever replied once. My doctor and the specialist I was seeing were both dumbfounded as to the delays. it even says on my specialists report that they didn't understand why they weren't recieving approval.
I finally told them I was driving down to their location if I didn't get a response in by the end of the week. I lost it, I yelled and screamed into the phone that they can't just ignore me until I go away. I finally got approval that week, but never a phone call...

I don't know if you are represented by an attorney or not. If you are pro-per filing for an expedited hearing on this issue would have gotten the attention of your adjuster. There are information and assistance officers, two at EVERY WCAB to help injured workers. All you would need is your doctors report and the fax/mail proof of service page. Filing for an expedited hearing is easy and the I&A officers will help you fill out the paperwork if you need help. You can also request penalties for this BS, possibly 5814 penalty. You can still take this issue to court and request penalties on this. You can go back up to two years on ignored/late UR under the Sandhagen ruling. The next time this happens, I recommend call an I&A officer.

They will ignore you if there is no possibility you will take this issue to court.

Some claims adjusters are illegally ignoring and delaying UR in California. To stop this you need to file an expedited hearing and then state you will be requesting penalties at future hearing, as you cannot get penalties at an expedited hearing. Trust me this works a lot better than yelling and screaming.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.

Messages In This Thread
RE: CA-PTP submitted request for treatment with no response from IC. What now? - California_Help - 01-24-2014, 01:09 PM

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