[Kedward7]

I have been dealing with Work Comp for almost 10 years now. My 10 years will be up this year. I had surgery and now have a 7% loss in my shoulder and had to retire from law enforcement. After 10 years of chronic pain, should injections, medications and creams they wanted me to go in for an MRI. I did and now surgery has been recommended again. I have been told that they don't have to allow me a second opinion. They also said that if the doctor says that the surgery it deemed necessary that I have to have it or they will no longer pay my medical benefits. I find it a little suspicious that they have waited until my 10 years is about to end. I say this because according to them, should the surgery not go well and I have any increased loss of use, they are not responsible for an additional damages...well they will pay up until the end of the year. Oh and they also just noticed that I have also been over paid (TPD) so they don't have to pay me anything right now until September. So technically I won't even be eligible for anything until Sept-Dec. Is there anything that I can do? Should I wait until September to have the surgery in case I have to miss days of work? Thanks

[1171]

I'm sure I understand. necessary treatment for work comp injury is lifetime.
not sure who the "they" is that is threatening you. it's your choice to accept or decline the risks of surgery.
I can't provide legal advice but it sounds like the insurance carrier wants to "play hard ball" and it may be time to obtain legal representation.

[1171]

edit:
..."I'm NOT sure I understand..."

[Kedward7]

It is my case worker for Risk Management aka Work Comp. I was told that if the surgery is deemed necessary and it could alleviate them paying for injections and medication then I have to have the surgery or they will cancel my medical benefits.
Thank you for your response. Have a great day!

(04-11-2018, 07:26 PM)1171 Wrote: I'm sure I understand. necessary treatment for work comp injury is lifetime.
not sure who the "they" is that is threatening you. it's your choice to accept or decline the risks of surgery.
I can't provide legal advice but it sounds like the insurance carrier wants to "play hard ball" and it may be time to obtain legal representation.

[1171]

mostly baloney.
the work comp provisions on cooperating with medical treatment do not abridge the rights of patients to accept or reject medical advice or exercise reasonable judgement on the risks of surgery. physicians are required to counsel patients on the risks of certain treatments so they may make informed choices. comp laws do not remove that right.
again any comp administrator that engages in such intimidation, threats, and generally bullying of uninformed workers needs to be avoided.
lawyer up; these tactics won't stop.