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wc insurer approval delay
#1
Question 
My WC company has been good about approving my case & paying for an expensive surgery & pain management program. However, I am in CA (living under the stupid WC "Terminator") and now the insurer is pressuring me to sign a "Compromise & Release" and give up future medical payments. My WC attorney says that most of her WC clients who have chosen to continue on with medical payments (Stipulation) are getting such delays (> 3 months) in approvals for doctor's visits, treatments, meds, etc. that they may as well have gone for the financial settlement. She is also saying that if I don't take the latest offer ($100K - but I will need expensive future care, so this is a joke), the insurance company will not only withdraw the offer, but the approvals for future medical care will start to take so long that in effect I'll have no care whatsoever, unless I pay for it out of my own pocket. What are other people's experiences with this? I called the business manager from the pain management program I attended and she said to keep the medical, as she agreed that I'll probably need future surgery (again - :-( ).
 
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#2
you need to find out if your atty will take the treatment disputes to court on your behalf. if you read between the lines it sounds like strong representation on those issues might be in doubt.
I suspect they want their fee and move on to the next case.
many workers endup having to be their own advocates and enforcers of the UR rules; not many are prepared to take on that role.
just something to think about.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
Thank you
 
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#4
if you even begin to release your medical now make sure and know for sure that you qualify for ssdi. if so- and if you have not already applied and do so after the contract is settled medicare will pay your medical bills
make sure your ducks are all in a row the after expenses with medical add up and it is not something to lightly give up with out recourse
good luck

cheers!!!!!!!!!!!!
 
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#5
Thanks very much - I haven't been able to qualify for SS yet and my WC attorney knows this, as she is helping me with this too.
I'll try to hang on to the medical as even 4 QME evaluators have said I'll need future medical care.

Thanks again and best wishes.
 
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