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laminectomy- cancellation by adjuster
#1
hello everyone; I was supposed to have a level 3 laminectomy- diskcetomy on april 16, 2 DAYS before the surgery my doctor called
and told me that my surgery was cancelled by the wc adjuster
it seems to me that he was upset about my attorney not informing him about me changing doctors;I received the letter of approval from wc and then the adjuster denies it; is this legal? I spoke to my attorney and he told me we are requesting a court hearing
meanwhile I have to wait ; and the pain is not getting any better.my question is what can I expect from a court hearing? and also what happens if my surgery is denied...what happens next? i appreciate any help... thanks and god bless
 
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#2
the judge will determine whether it was an appropriate denial.
what happens next depends on your doctors treatment plan.
you did not indicate which state laws your claim is under as was requested at the top of this board so specific information cannot be provided.
In many states once treatment ends a rating is done and some additional disability benefits are provided. who knows if that's the case in your state.
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
forgot to mention that IAM in california. thanks 1171
 
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#4
I'm not sure whether your issue was a denial under Utilization Review rules or a denial of benefits based on liability for the injury.
you can find out about UR appeals here
http://www.dir.ca.gov/dwc/UR_Main.htm
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
WC accepted liability for my case; even my attorneys doctor stated that wc doctors aknowledged liability and said I would need the surgery done in order to improve; it seems the pain is getting worse
 
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#6
if the court upholds the denial then you'll have use other treatment options.
at some point you can settle and procure it on your own or thru other insurance.
If you switched to a Non - Network doctor then that could be the reason for the denial.
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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#7
thanks for your info 1171I appreciate it
 
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#8
WoW, you were lucky 2 days before surgery.

I was once on the cart naked, and drugged up, waiting to go into surgery when mine got canceled.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#9
I've only been denied while under a court order for treatment, no last minute like you and Bad Boy.

Called my attorney's office, lucky he was already in court and visited with the judge about what was going on, not a happy judge.

Phone call were made and things were taken care of.

I do hope things work out for you.
 
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#10
Reminder: Solicitations On This Board are PROHIBITED Unless your a paid Sponsor. If not sign up to be one, if one, then very sorry...

lyssagale12 Wrote:Hi guys,

It's up to justify judgment & on legal issue whether solicitor will help u for that.



Thanks


Regards
~~Lyssa~~
Lawyers In Maryland
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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