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Denied
#1
If you receive a letter that your claim has been accepted but they need to review ttd benefits but get another letter a few days after that claim is denied because of no witness and reporting was inconsistent. Are investations done that quickly?

The injury was reported on the same day. Human resource was notified 10-15 minutes afterwards. There was also a witness but unclear how much he witness.

Is their investigation only base from the employers words? At the time, ER dr and workers comp doctor both said it was industrial injury.

Can this be a bad faith denial since it is beneficial to both employer and ic?

Thanks
 
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#2
Sometimes just a phone call.
The “witness” reason is bogus; you are the only witness that is necessary.
Ask for an itemization of the inconsistencies in writing. This denial sounds like fraud.
Bad faith is generally too difficult to pursue early in the claim.
False statements used to deny a claim is fraud and reportable to your local district atty
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
It’s been a while but I’m just retracing timeline and events. I was following all of the doctors restrictions which is the doctor that employer sent me to. They denial letter came shortly after I was terminated.

Since then I’ve had sdi and qme doctor saying it was industrial related. Found out that qme retired or no longer works so disputing his report that he didn’t follow any guidelines.

Thanks, I will request for that information. I also don’t recall the adjuster asking any questions regarding injury and how it happen. Seems liked the two of them did it to put me through misery. I never got proper treatment and I believe that made my injury worst.
 
Reply
#4
Sometimes just a phone call.
The “witness” reason is bogus; you are the only witness that is necessary.
Ask for an itemization of the inconsistencies in writing. This denial sounds like fraud.
Bad faith is generally too difficult to pursue early in the claim.
Making False statements to deny a claim is fraud and reportable to your local district atty.
Knowingly using false statements to deny benefits is also fraud.
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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