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Msa /WC california
#1
1171 I have a few questions about the IC not wanting to fund the MSA because the number is to high so they say.. IC is trying to get the QME to write a report saying I don't need surgery again because they don't like the numbers, I understand that they don't have to fund it however what would be the next move if you know !!!

Thanks for your time
 
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#2
your atty has to defend the QMEs opinion or help the QME stand by his prior determination.
the only other thing that might work is to accept the surgery now and confront them with paying for it soon.
if there is no buy out agreement then the default is periodic PD payments and open medical.
using that open medical can make a them realize the settlement is in their best interest as well. the more medical they have to pay now the more attractive a C&R may look.
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
Thanks 1171 for the information, I did receive an email from my attorney and she was saying that she started the process for future medical, my issue is that the IC deny everything, I can't even get nerve testing or another MRI. But now Medicare is asking for conditional payments and apparently seed fund for the MSA. So this should become increasingly confusing for me .

Thanks for your help and time as always
 
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#4
They are not going to put $$$ in the settlement For what they believe they can deny and not pay out in a medical award. They are only going to pay for what is necessary under the regulations whether its in a settlement or afuture medical award.
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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#5
1171 thanks! Unfortunately I believe that to be true and I spoke with Medicare this morning and I can't go see a doctor on my own because I have a WC insurance, so I'm stuck in the system! Ugh! !!
I'll certainly be reaching out soon I'm sure
Thanks again and so grateful for this forum
 
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