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SCS
#1
NYS-Just finished a 7 day trial with the Nevro SCS with 60% pain relief. Just waiting for my pain management Dr to do a referral to my neurosurgeon. My question is if the Judge ruled in my favor for SCS trial with a minimum of 50% relief can the carrier still deny the permanent placement?
Thank you for the help
 
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#2
Yes but they would likely be at high risk for penalties, depending on strength of the evidence they would have.
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
Update: I'm scheduled for surgery September 26th and still haven't had the carrier deny or approve the surgery or the MRI of thoracic spine. Request from my doctors was on 9/5/17 and I understand they have 30 days to make a decision or the comp board will make a ruling. I just received an IME appointment from the carrier for 9/20/17. If the IME says I don't need the SCS what would be the next step ? I assumed that if the comp board ruled in my favor to have the Nevro trial and I received 60% relief it would be automatically approved for the permanent implant. Guess I was wrong
 
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#4
Again looks like the carrier may use the IME opinion to support an appeal of the judges decision.
You know that in the legal system each party always has the right to appeal any decision don,t you?
That makes the state Supreme Court the last stop for any decision. Nothing is quick or final in the litigation arena.
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
Keep in mind that your lawyer can send you for an IME too, you just have to pay for it.
Could be worth it in the long run
 
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