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And The Fight Begins.... NY
#21
That is really strange because so many injured workers I have come across use Medicare for denied treatment. They do have to send Medicare a copy of the denial and then Medicare covers on conditional payments. Maybe things are different where you are located? I don't know. Maybe an injured worker who has done this will respond on exactly what they do to get it covered.
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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#22
Well... 2 papers from Comp today... first is saying the "An objection was received from the Claimant's attorney for a proposed decision in this case that was sent to you on 6-20-19. The proposed decision dated 6-20-19 has been cancelled and the action set forth in that decision will not be taken. Case is continued for a hearing, notice of date and time will follow".... (this was from all those denials of injections and MRI's)

2nd paper says Hearing date Aug. 7th..

This is a Part 4... what would that entail? Was shocked that the Carrier approved a EMG for my lower back and right leg.. get that done on the 29th...
 
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#23
I am surprised they approved the EMG but not MRI.

Well at least things are moving forward. You have been through the ringer.
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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#24
Had the EMG today... no nerve damage in the legs... which was good news... But the doctor who did the test says I really need that MRI.. All the problems are stemming from my lower back/tailbone area and she is going to put in a request herself with that report.
I emailed this to my lawyer and told him if he wants a report, he has to request that himself....
 
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#25
Do you have numbness is legs or feet?
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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#26
When the nerves are really pinched, right leg from hip to toes go numb.. left leg has been acting up slowly.... Besides that slide down my cellar stairs last year, last month the right leg went and I landed on the coffee table... I say it feels like when you get a Novocaine shot and you feel nothing.... when it wears off, you get the pins and needle feeling and the achy feeling, that's what it is with my leg and hip.. pain starts from lower back/tailbone area, heads to right hip and continues down the leg..
Other than that, always feels like I have either a hot poker or a screwdriver constantly being jabbed between bone and twisted....
 
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#27
Well, when your lawyer tells you the judge wants you to be seen again and have a C-4 filled out... THEN you get the comp paper in the mail saying:

Decision: Upon claimant's request, the Board has reviewed the carrier's denial of a Variance request for MRI of the Lumbar Spine. The treatment/test is denied because the treating medical provider has failed to meet the burden of proof and the opinion of Dr. "A" is credible. The carrier is not liable for payment of the service. No further action is planned by the Board at this time....

So I guess it's time to start the process of closing out medical. I am now up to:
Surgeon's - 2
Pain Mgnt - 3
EMG Dr. - 1
PA's & Nurses - too many, lost count....

Since the carrier is just going to keep denying everything and the judge is with them.. no since continuing this...
 
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#28
Nothing will happen Quickly; it maybe a year or 2 before you see a settlement check.
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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#29
I figure as much... I'm also tired of wasting the doctor's time... they want to try this or that and it's denied... Love the looks I get from any of them when I say "It'll just be denied".. like I'm lying about it....
I have an appt. tomorrow with my PA at pain management.. Gonna show her the paper from Comp and just let her know if she still wants to put in for the injections, be ready for the denial...
 
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#30
I recommend printing out the guidelines for injections for lower back and give it to her ahead of time. If she includes the things needed in the guidelines in her request it should be approved. JMO

There is a disconnect between many doctors and the treatment guidelines that are used. They need to include the things in the guidelines or the IC will use one little thing missing to deny the request. Doctors do not seem to have the time to look them up. They are easy to find on the link I provided you.

I hope you can settle and be done with this crap.
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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