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NY Claim in CA
#1
I have a work-related injury dating back to October. I am a NY employee, but was in CA at the time and am currently. My employer refused to allow me a CA claim, but I had a doctor willing to do the NY paperwork. Or so I thought. After I reached out a few weeks ago asking why the paperwork hadn't been filed with the NY Comp Board (to which they responded "just wait, sometimes it takes time for the system to update") the doctor texted me last week that they were not willing to do the paperwork anymore and how sorry they were. I've basically recovered, so finding a new doctor now isn't entirely possible. Am I just going to have this claim thrown out at this point? And do the visits then get submitted to my normal health insurance provider? Appreciate any insight. I have been trying to learn as much as I can about this system, but it's pretty daunting.
 
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#2
I would have medical information from the treating doctor sent to the comp carrier along with their billing.
If the claim is denied, the doc can send it to the health care provider.
You are lucky this is just a simple minor claim. You should talk to your employer or the comp carrier to get an explanation of how to handle a future injury. If this was serious disabling njury, you could be “left in the cold” without treatment or income. Take this as a warning. If you can’t get benefits, you may not actually be covered for a work injury.
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
(02-10-2021, 01:21 PM)1171 Wrote: I would have medical information from the treating doctor sent to the comp carrier along with their billing.
If the claim is denied, the doc can send it to the health care provider.
You are lucky this is just a simple minor claim. You should talk to your employer or the comp carrier to get an explanation of how to handle a future injury. If this was serious disabling njury, you could be “left in the cold” without treatment or income. Take this as a warning. If you can’t get benefits, you may not actually be covered for a work injury.

This is really helpful, thank you. I believe the doctor sent the paperwork/billing to the carrier, and got pushback that the information wasn't sufficient. I think the doctor is frustrated with the process and doesn't want to continue dealing with an unknown NY WC system. So at that rate, the carrier has some level of paperwork, but it's the NY board that doesn't seem to have any. At this point, I do not have any indication from the carrier that my claim has been denied, but I assume it's coming. Is it fair to say that the worst case scenario if my claim is denied is that I'd be on the hook for whatever my health insurance company doesn't cover? That is my understanding. And should I be having a conversation with the carrier preemptively? Or wait until they've decided it's denied. Thanks again!
 
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#4
Without knowing what “exotic” information was too much for the doctor to do to get paid, it sounds like the doc should eat some part of the liability.
I would wait to hear from the carrier. You can get to the decider by waiting for a claim number and a name. One approach would be to cajole the adjuster into reaching out to the doc’s office insurance clerk and get enough paperwork to solve the issue. Sounds like a communication issue. The right people need to be in contact with each oher.
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
You do not need to see a new doctor, it is better to wait a while and visit again to receive your insurance premium. I was also injured in an accident and I went several times to get my right.
 
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