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California date of injury May 2009 no TTD benefits paid.
Ok I had my deposition this week. I went in very nervous, my lawyer said don't be nervous your case is very straight forward we should have your benefits within a week of this deposition. Ok great I thought. Well then we get into the deposition and mid-way through the other lawyer for the WC insurance said that the claim had been denied. My lawyer said since when we have not received notice and it is past 90 days. The other lawyer said as of 08/06/09. My lawyer was mad. He said on what grounds the other lawyer said that we had not proven it was work related. My lawyer said "Have you read all the medical reports it is definitely work related. The other lawyer said it is Denied lets finish the deposition. My lawyer said he was going to call motion to something I am not sure what. My lawyer said I want benefits for my client today. the other lawyer said I can't do that. So now what? Oh by the way the day after the deposition, the Denial letter came in the regular mail not certified mail as it states in the letter and the letter was dated 8/4/09 the 90 day mark was 8/09/09 but it was post marked 8/17/09 so how is that notifying within the 90 days? The letter may have been dated before the deadline but it was not postmarked and delivered within the 90 days. So here I sit still with no income, and still unable to work.
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I am sorry this happened. The same thing happened to me. At my Depo it was questioned why I never rec'd a "Notice of Denial" within the 21 days alloted in my state and they IC Attorney claimed they "mailed" it. I did not receive any income until 14 months after being injured. I ended up winning my case and settling so I am one of the somewhat happy endings. Still have a broken body but am glad to be out of the system. I tell you this because nothing works quickly in the WC system. You will probably have to wait until a Judge makes the decision now and in the emantime depos will be taken from Dr. and possible your employer and any witnesses. It's all very time consuming with attorney's having other clients and the court system. Best of luck. I'm sure someone else will see this who can maybe shed more light on the situation.
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What was your injury?
Did you use the $10,000 in medical prior to denial of the claim?
What is the reason on the letter that the claim is denied?
Let Go, and Let God......
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capricorn Wrote:I am sorry this happened. The same thing happened to me. At my Depo it was questioned why I never rec'd a "Notice of Denial" within the 21 days alloted in my state and they IC Attorney claimed they "mailed" it. I did not receive any income until 14 months after being injured. I ended up winning my case and settling so I am one of the somewhat happy endings. Still have a broken body but am glad to be out of the system. I tell you this because nothing works quickly in the WC system. You will probably have to wait until a Judge makes the decision now and in the emantime depos will be taken from Dr. and possible your employer and any witnesses. It's all very time consuming with attorney's having other clients and the court system. Best of luck. I'm sure someone else will see this who can maybe shed more light on the situation.
thank you. I hate all this waiting. It does not pay the bills or rent in the mean while. I am waiting for approval for State Disability but it will be no where near 2/3 of my income as I have not worked enough in California to build up SDI income.
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make sure your atty files for Penalties.
They are tracked by the audit bureau and carriers with frequent penalties are liable for huge fines.
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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chrischris Wrote:What was your injury?
Did you use the $10,000 in medical prior to denial of the claim?
What is the reason on the letter that the claim is denied?
Low back injury MRI shows disc herniation, but WC insurance claiming prior degeneration is cause not incident that occurred at work. Thing is I had no pain and was able to do my job prior to injury and after injury I have pain and cannot work. So I do not know what the problem is and why denial. Denial letter just states denied because I did not prove injury was work related. although Dr states otherwise. So both my lawyer and I are confused as to why the denial. And I am not sure about the $10,000 I had very little treatment at all prior to denial 6 Physical therapy visits, probably 12-14 DR/PA visits, 3 regular x-rays and 1 MRI and medications that is it.
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1171 Wrote:make sure your atty files for Penalties.
They are tracked by the audit bureau and carriers with frequent penalties are liable for huge fines.
I will ask, my lawyer is strictly a work comp lawyer so hopefully he is doing just that, but I will follow-up with him.
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So does anyone know the process from here? AME, Work Comp Judge? Can they call an emergency hearing? Can I/should I continue my medical appointments now that my claim has been denied? I do not want to be responsible for the medical bills especially since I have NO income. I know my lawyer is working on it but he never tells me anything until the very last minute and I hate the not knowing.
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08-21-2009, 02:43 PM
(This post was last modified: 08-21-2009, 02:51 PM by 1171.)
the strategy is up to you and your atty; there is no one path for every case.
they would not call for an emergency hearing as they are not paying for anything and their liability is not increasing.
your health care provider should accept the treatment since you have a written denial from workers comp.
a common response is that your atty will file for an expidited hearing.
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.
Posts: 77
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1171 Wrote:the strategy is up to you and your atty; there is no one path for every case.
they would not call for an emergency hearing as they are not paying for anything and their liability is not increasing.
your health care provider should accept the treatment since you have a written denial from workers comp.
a common response is that your atty will file for an expidited hearing.
thank you, just to clarify what you wrote: health care provider should accept the treatment? So continue going to appointments until other wise notified by my attorney? I do not have other health insurance
