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Some questions on the system
#1
State: Utah

So I have been getting benefits but the insurance company has been delaying things non stop. They have denied my meds and a person in HR said they might be terminating my benefits. They gave me a letter saying they admitted liability for my hand months ago.

Now I know they have to petition and send you a letter, my question is can they just stop paying you benefits. Or do you have to go to court first and you get paid until the judge/jury says they are terminated. Asking this because when a family lives month to month on a check its tough and we would be evicted and have to move out of state to live with family.

 
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#2
there are a number of events that can be used as evidence to stop benefits.
they don't have to go to court to stop them any more then you had to go to court to start them.
for example:
if an injured worker who is off work returns to work, the disability payments can be stopped without going to court.
if an injured worker who is off work is released to return to work by a doctor, the disability payments can be stopped without going to court.
if an injured worker who is off work is reported to be at Maximum Medical Improvement by a doctor, the disability payments can be stopped without going to court.
More on the work comp system in Utah here:
http://laborcommission.utah.gov/division...laims.html

if you move out of state, it could be difficult to get a doctor to accept Utah work comp fees for treating you.
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
(10-08-2013, 05:43 PM)1171 Wrote: there are a number of events that can be used as evidence to stop benefits.
they don't have to go to court to stop them any more then you had to go to court to start them.
for example:
if an injured worker who is off work returns to work, the disability payments can be stopped without going to court.
if an injured worker who is off work is released to return to work by a doctor, the disability payments can be stopped without going to court.
if an injured worker who is off work is reported to be at Maximum Medical Improvement by a doctor, the disability payments can be stopped without going to court.
More on the work comp system in Utah here:
http://laborcommission.utah.gov/division...laims.html

if you move out of state, it could be difficult to get a doctor to accept Utah work comp fees for treating you.

I am not at MMI, my doctor that my work and the insurance company told me to go to has me on light duty, and my work has no light duty. The only reason I would have to move is if they terminated my payments. I have no reason for them to stop them, my accident had 5 witnesses. I had a few diagnoses that were wrong or possibly not related to the work injury. Doctor states in his notes delayed recovery (not sure what that means)

Other than that and the insurance company's delaying medication, denying it, and not allowing same diagnostics tools and giving my doctor a headache. Maybe the lady in HR is blowing smoke and im paranoid but this is my family's only income and I hate not having control over anything.

Thanks for the info, so in short if they say the diagnoses is not related to my injury and terminate benefit's before MMI/return to duty I would first be able to fight it in court?

 
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#4
there are often disputes about whether you are off work or at MMI or released.
If they deny/stop any comp benefit, you can appeal to the comp court.
you can go to court second; not first.
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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#5
(10-08-2013, 06:16 PM)1171 Wrote: there are often disputes about whether you are off work or at MMI or released.
If they deny/stop any comp benefit, you can appeal to the comp court.
you can go to court second; not first.

Say they stop comp benefits does that mean all wage replacement/medical that was being paid ends right then and there. Then say it takes well over a month to get to court, all that time without payment would make us get evicted and have to leave making it hard to fight in court.
 
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#6
I was terminated for missing time while I was healing for a surgery. My benefits continued, even though I am no longer employed by the employer I worked for when I was hurt
 
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#7
(10-08-2013, 06:38 PM)Spuz Wrote: Say they stop comp benefits does that mean all wage replacement/medical that was being paid ends right then and there. Then say it takes well over a month to get to court, all that time without payment would make us get evicted and have to leave making it hard to fight in court.

each benefit has it's own requirements; disability is not the same as treatment. they can stop either or both if the requirements aren't met. when they stop a benefit they should tell you why.
yes, it is difficult to appeal from out of state and it often takes many months to resolve.
if that happened, a Utah comp attorney could help.

there is a list of attys on the website I posted
http://laborcommission.utah.gov/division...rkers.html

you should contact the Ombudsman at Industrial Accidents Division from the site I posted for help with a specific problem.
Utah Labor Commission
Industrial Accidents Division
160 East 300 South, 3rd Floor
P.O. Box 146610
Salt Lake City, UT, 84114-6610
801-530-6800
In-State Toll Free 1-800-530-5090
Fax: (801) 530-6804
Email: iaccd@utah.gov

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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