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AM Trust NY WC Eye Injury. PLEASE HELP
#1
Hi All,

I Would appreciate any advice someone can provide.

My Eye got injured back in January.
I have gone to their doctors to avoid paying out of pocket first but nothing seems to get better.
So I went to a doctor of my own, recommended by a friend. They didn't see anything in my eye so she recommended that I see a Neurologist.
When I went to the Neurologist they sent me for an MRI.
I called AM Trust and they said I need to go to their neurologist but he said everything is fine and that I should keep on using the drops and take Motrin.
I can't understand why they would say that after 6 months since the injury I am still having pain. Especially since I have a letter from another Neurologist that says we need an MRI.
They are not offering any type of solution to the problem either.

They have switched adjusters on me several times throughout this claim. Each of them has literally no time for me and even call me right before "appointments" so that they can keep the conversations short.
They never even asked me for receipts of all of the expenses that I paid for out of pocket or a log of days that I had to take off to go to appointments.

My employer wasn't really helpful they just pushed me off to the insurance company and doesn't seem to know or want to know anything about anything.

The various adjusters at Am Trust each played a different role as time went on in the case to the point that some even asked me questions that should have nothing to do with any of this. Questions like where did you go to school? etc.

At this point I finally asked them how I am going to get paid for all of my out of pocket expenses and so they finally gave me an email address (after weeks of trying) where I should send everything to.
They are supposed to get back to me but they did say they won't pay for my transportation to the doctors that they didn't approve. They said they won't pay me for the first 3 days that I was out (which doctor wrote on report immediately after the injury). They responded regarding those 3 days: "there is a 7 day waiting period in comp, so we do not owe for the three days work missed" I really don't understand that or know if that is true.

I just keep on getting this feeling that they are toying with me because they can tell that I don't know exactly what I am entitled to.

To sum up I really want to solve the issue with my eye and figure out how to get paid for all of my out of pocket expenses.

Thank you all in advance for any feedback/advice or knowledge that you can provide.

Please feel free to ask me anything!

Thanks
SD2018
 
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#2
After you’ve been out of work for 2 weeks, the waiting period can be paid
http://www.wcb.ny.gov/content/main/onthe...nefits.jsp
There is an advocate who can provide specific information about the New York comp rules:
http://www.wcb.ny.gov/content/main/Worke...edWkrs.jsp
They are only going to provide benefits for doctors authorized by the comp board:
http://www.wcb.ny.gov/content/main/onthe...nefits.jsp

To check out the information you are being given, Review the information on the state website or contact the advocate. Waiting periods and authorized doctors are part of most work comp programs.
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
#3
First look like you will need an attorney like 1171 post the insurance an employer dont learn that their cost will increase when you are force to hire a lawyer.

Now second dont know about NY but probably yo will be able to choose a doctor by your self. one time The only condition is that that doctor acept workers comp case.
Did you tell the doctor that you was a WC case.
Did you notified the adjuster before going to this doctor
If both are yes you should not have any problem

My advice if there denied any get a lawyer
 
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