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Insurance Co stopped talking
#11
they have to have medical evidence to support such a decision whether to accept or deny.

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........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
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#12
(06-06-2014, 10:43 PM)Rebos Wrote: I have called an attorney and asked to see him next week. Things have gotten worse for me. I am going to the ER or clinic tomorrow. My hernia is getting unbearable and the case manager (nurse) would not contact the insurance company to see if they decided to send me to a general surgeon. I have decided to use my insurance and get help. Can they treat me me for a work comp issue then decide it is not a work comp issue? I am DONE....my attorney can figure it out. I am sick.

Yes they can deny your injury at any time. Often times these nurse case managers who act like they are there to help are actually undermining, and gathering evidence to deny the claim. I have read a few are not like that, but they usually do not last.

I would ask your attorney his advice about the nurse case manager. In some states, they can get rid of them. I do not know your states laws on this.

If you have another avenue to get treatment, and the insurance company is denying part of your claim, you can use that insurance. I would discuss this with your attorney first.
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.
 
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#13
You can go to the ER or clinic but be sure to tell them you are claiming this is work comp so it is on the record that way. And remember they may or may not do much for you. They may try and help with the pain and they could do more.
 
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#14
(06-06-2014, 10:43 PM)Rebos Wrote: I have called an attorney and asked to see him next week. Things have gotten worse for me. I am going to the ER or clinic tomorrow. My hernia is getting unbearable and the case manager (nurse) would not contact the insurance company to see if they decided to send me to a general surgeon. I have decided to use my insurance and get help. Can they treat me me for a work comp issue then decide it is not a work comp issue? I am DONE....my attorney can figure it out. I am sick.

If your having that much pain and you feel your in need of medical attention, I would go to the hospital or urgent care facility. What you are describing about your body parts is serious. It can cause permanent issues if you wait. Insurance or no insurance, if my husband was in your condition, he would be going ASAP to the ER.
WC or no WC, if you feel you are in need of immediate assessment, you need to be seen. Hernias are nothing to be fooled around with. It's a protrusion through the muscle that can lead to tissue death and a lot more complications.
And yes, as Manley2 states, make sure you tell them that it is related to WC. If you go to a public hospital,they can't turn you away. It's illegal. They have to treat you.





 
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#15
(06-07-2014, 11:59 AM)Scooter123 Wrote:
(06-06-2014, 10:43 PM)Rebos Wrote: I have called an attorney and asked to see him next week. Things have gotten worse for me. I am going to the ER or clinic tomorrow. My hernia is getting unbearable and the case manager (nurse) would not contact the insurance company to see if they decided to send me to a general surgeon. I have decided to use my insurance and get help. Can they treat me me for a work comp issue then decide it is not a work comp issue? I am DONE....my attorney can figure it out. I am sick.

If your having that much pain and you feel your in need of medical attention, I would go to the hospital or urgent care facility. What you are describing about your body parts is serious. It can cause permanent issues if you wait. Insurance or no insurance, if my husband was in your condition, he would be going ASAP to the ER.
WC or no WC, if you feel you are in need of immediate assessment, you need to be seen. Hernias are nothing to be fooled around with. It's a protrusion through the muscle that can lead to tissue death and a lot more complications.
And yes, as Manley2 states, make sure you tell them that it is related to WC. If you go to a public hospital,they can't turn you away. It's illegal. They have to treat you.
Went to ER today and they said all they could do was try to manage pain. Very knowledgeable nurse, however the doc was an ER doc and really did not know what to do after he read my MRI and Dr's notes from Wed. He said that it was not a life threatening hernia as I was not throwing up. He felt the testicle/groin pain was related to my back He said he did not want to get in the middle of the insurance company and the doctors....I feel the practicing doctors on ER rotation passed due to WC. He said to se my GP and gave me meds (I do no do them) At least it appears not to be a bad hernia? I plan to stay down through Monday, at least that helps if I do not move. I am going to meet with my lawyer to get me out of talking to the insurance company and the nurse if Iowa law permits...
“The more you can escape from how horrible things really are, the less it's going to bother you...and then, the worse things get.”
― Frank Zappa
 
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#16
Hopefully you get the care you need. Obviously it wasn't done at the ER.
 
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#17
The ER did what I figured they would do. They try to help with the pain and they made sure nothing was life threatening. And really that is the job they are there to do. They are not going to get in the middle of what your problems are and are they work related but they are a place to go if the pain gets too bad and for that they should be able to help
 
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#18
(06-08-2014, 02:11 PM)Manley2 Wrote: The ER did what I figured they would do. They try to help with the pain and they made sure nothing was life threatening. And really that is the job they are there to do. They are not going to get in the middle of what your problems are and are they work related but they are a place to go if the pain gets too bad and for that they should be able to help

My pain is increasing and the ER was hope to get some relief as well as peace of mind...which I did. I am staying in bed as long as I can until I meet lawyer and surgeon Wed. I don't eat or sleep well. Want to thank everyone for getting me to get my lawyer active.
“The more you can escape from how horrible things really are, the less it's going to bother you...and then, the worse things get.”
― Frank Zappa
 
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#19
Things have seemed to go for the worse in terms of what I am to do or not do. I have retained an attorney who will get actively involved once they deny my hernia surgery or stop funds. He said that is really the only two areas where he can hit them.

So today I saw another neurosurgeon who looked at my MRI and said rather quickly that this is a slam dunk and I can fix you. He said a spur(which I saw) has protruded severally onto the siatic nerve thus causing pain/numbness. He said that the last surgeon missed it and focused on the bulging disc. He said fusion would clean out the disc area and clean up the spur but it would be over kill and I should just do the. spur. I will probably say no as I have had 3 laminectomies and know I have bone spurs with degenerative back disease. At 60 I cannot try a procedure separate from the disc bulging which will be back.
My personal Dr. told me that surgeons are leery to do procedures that have more risk on WC cases in favor of those with with little risks.

Here is my plan: Get a 2nd opinion on my own and get my hernia repaired. I have te right to a 2nd and deny a procedure. If I except the surgical procedure they will look at any success and make this new Dr who just met me today come up with my number...

My luck I will be in trouble for not agreeing to the surgery .Two other Dr's said that my disc site from the surgery was not cleaned out properly whic is why fusion will take care of it all. Sorry folks to be rambling. I am so depressed I do not wan to be around people or leave my home...DONE!
“The more you can escape from how horrible things really are, the less it's going to bother you...and then, the worse things get.”
― Frank Zappa
 
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#20
(06-12-2014, 01:05 AM)Rebos Wrote: I am so depressed I do not wan to be around people or leave my home...DONE!

those are clear signs of depression taking hold.
without professional help it will become chronic and even more debilitating then the physical injuries. get a referral for counseling asap.
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.
 
Reply
  


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