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Louisiana Hernia at work questions
#1
Rolleyes 
I have a desk job, am 48 but I helped moved employee cubicles and pulled a tendon, I thought that was it, I went to WC Doc, pumped me full of anti inflammatory and therapy. 1 day a week visit to doc, WC stopped therapy, said they did not want to do it there, but continued to go to doctor there. hurt worse due to waiting 3 weeks for new therapy place. I had no bending range of motion, could not tie shoes stomach hurt. 4th Doctor visit, not on anti inflammatory belly button is tender and Doc looked at it and told me I needed to go to a Doctor? I complained he waited on a 1010 form and gave me a surgeon referral weeks out. Well stomach swole and hurt so bad, to hospital I went. Hernia. Gallager Basset then called me and was horrible to me saying it would not be covered and she knows, and do not go to the real Surgeon appt. I said I am and she pretty much cursed me out. She called back and then said she was sending a Nurse Case Worker. Case Worker did not show, Surgeon looked and says it needs to come out, 1 day op. Case worker called and said she needs to talk to the doc. He is a real doc and wont talk to her. I am hurting and been waiting 2 weeks and case manager told me to pay for it until she can find time to talk to doc.
They want to deny it saying it was not work related, how can that even work? Never had one before. They said I did not notice it fast enough? What is law on hernias in La?
Help. Thanks.
 
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#2
its the same for all injuries.
contact your employer and tell them about the adjusters behavior. It's the employers claim and they should know about abusive adjusters.
If you have health insurance, have the doctor do the surgery under their coverage. get a workers comp atty to get you your disability payments.
write a letter to the claims manager about your treatment by Gallagher Basset. send a copy to
Office of Workers' Compensation Administration
P.O. Box 94040
Baton Rouge, LA 70804-9040
Telephone: (225) 342-7555
Fax: (225) 342-5665
owca@lwc.la.gov
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
(06-26-2019, 10:13 PM)1171 Wrote: its the same for all injuries.
contact your employer and tell them about the adjusters behavior. It's the employers claim and they should know about abusive adjusters.
If you have health insurance, have the doctor do the surgery under their coverage. get a workers comp atty to get you your disability payments.
write a letter to the claims manager about your treatment by Gallagher Basset. send a copy to
Office of Workers' Compensation Administration
P.O. Box 94040
Baton Rouge, LA 70804-9040
Telephone: (225) 342-7555
Fax: (225) 342-5665
owca@lwc.la.gov
 
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#4
Thank you I will do. I only missed the day I had to go to the hospital and they led me to believe that since my job does not consist of lifting regularly it’s not covered. Thank you. I can’t wait I have been going to work hurting.
 
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#5
you'll be out of work 6 weeks post surgery and they'll owe you disability.
since you have medical confirmation of immediate treatment and documented history of lifting at work you have a good case for filing a fraud complaint against them for denying and delaying surgery.
http://www.laworks.net/WorkersComp/Fraud...udForm.asp
after you complete the fraud report make sure to send a copy to the claims manager and your employer.
they really really hate having any body else know how they operate and having complaints in writing. even if nothing comes of it ; it'll twist their tail a bit....Wink
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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#6
Update, after weeks of workmans comp not talking to me or the Gallagher and Bassett or their caseworker, I get a call that the caseworker is finally getting to talk to the surgeon Monday in which I am welcome to go. I already had the pre op surgery stuff from Surgeon, but they never would approve it, as it seems the Doctor did not want to talk to caseworker about my hernia.
Worried as to if this is a good thing or bad, the hernia is in the belly button, so it does not look bad until it pokes out, but causes a great amount of pain.
How soon after I wonder can I expect a decision? I had an appointment with a lawyer, but since I am going to work I do not know how much is in it for him.
I did not want him to take it over if I am getting the surgery, but the Workmans Comp has been horrible. Wondering what to expect?>
Thanks in advance.
 
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#7
There is no telling how long they will string you along. Benefits delayed is benefits denied. Did you file your fraud report? IF you do nothing, its likely they will also....

Maybe these guys can speed things up:

Office of Workers' Compensation Administration
P.O. Box 94040
Baton Rouge, LA 70804-9040
Telephone: (225) 342-7555
Fax: (225) 342-5665
owca@lwc.la.gov
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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#8
I had thought this might come to a close but it sounds like not. I just don’t know how they could wait longer after she talks to the Doc. On the fraud think, I can really file that against a person or company? I had no idea.
 
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#9
(07-03-2019, 08:17 PM)william32 Wrote: I had thought this might come to a close but it sounds like not. I just don’t know how they could wait longer after she talks to the Doc. On the fraud think, I can really file that against a person or company? I had no idea.

Fraud works both ways. If employer or carrier plays false in order to deny benefits, it can be fraud. If they have no evidence against your claim, its fraud to deny benefits. They can’t just makeup a reason.
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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