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CA- Case settled now what to do about my insurance co.
#1
Hello from CA! I filed my case 10/08 and backdated the DOI to 10/07 which is when I was DX'd by my regular DR. I have been on medication, paid for by my priviate ins carrier begining 10/07. I just received my award notice from the WCAB stating 100% industrial causation and granting future medical. My CA says I can pick a Dr. from their group and they will pay for my Dr appts and perscriptions/treatment as needed. That sounds great and easy in theroy, but I work with other people that have had a horrible time even getting their required medication in a timely manner. I've decided that I WILL use the W/C Dr (I have yet to select) and take full advantage of "future medical". I do feel however that I should call my priviate ins co to tell them that responsibility for my condition has been accepted by another ins co (W/C). My CA attempted to disuade me from doing so saying that it would complicate matters. I imagine it would complicate things for him because he is on the hook for my out of pocket costs and my ins co costs going back to 10/07. My question is how would this complicate things for ME? My question is that if my CA denies medication or treatment for my condition, or otherwise significantly delays it..... can i go back to my regular Dr/ins for the meds/treatment? I need my pills daily (no, they are NOT narcotic) to help control my condition, which is still poorly controlled..... I do not have a lawyer, I have somehow navigated this horrible maze with the help of sites like this and with hours of reading. Thank you in advance for any input/advice you may have.
 
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#2
generally care/coverage denied by comp is available under standard health insurance provisions --provided coverage is current.

whether your health carrier files a lien for reimbursement is up to them.

about the only negative I can foresee from such a filing is you might have an easier time negotiating a future lumpsum buyout (compromise & Release) if you have the leverage of a potential large medical lien as a bargaining chip.

the comp court has continuing jurisdiction to enforce it's awards as long as your claim exists.

glad you got thru the process relatively unscathed.
Smile
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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