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Can recoup wage benefit after 2nd opinion?
#1
Background: Several months ago, I was diagnosed with epicondylitis and radial tunnel syndrome. After being under the care of my family doctor (along with occupational therapy) for 1-1/2 months with little improvement, she sent me to an orthopedist. As a result of my total dissatisfaction with his assessment releasing me back to work (which ended my wage loss benefit), I requested a second opinion. It took two months to get into this second orthopedist, as he is very busy due to his great reputation (unlike the first, who it took only a few days to see). The orthopedist giving the second opinion said that I was not ready to go back to work in any capacity (and this was 2 1/2 months after the first proclaimed me ready), thus reinstating my wage loss benefit. Question: Since my WC caseworker has "accepted" the assessment/report of the second opinion saying that I am not ready to go back to work, is this in effect acceptance/agreement that the first orthopedist's assessment/report was incorrect? The reason that I ask this is that I feel I should be able to recoup wage loss benefits between the date the first orthopedist released me back to work and the date that the benefit was reinstated due to the second opinion. (FYI, I live in Montana.)
 
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#2
I'm not Familiar with Montana Laws, and I'm Sure Someone should be along to Help You with More Info. Soon, but I Believe You should Receive Back Pay for the Time Missed! Best of Luck!!Wink
 
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#3
often times a consult will offer opinion on many different aspects of the case.
I'm not sure what exactly the carrier is agreeing to.
are you clear as to eactly what the second opinion doctor put in the report or just what you thought you heard them say to you? sometimes they are different.
is the carrier agreeing to everything the second consult says or just parts of their opinion?
you need to get the written report and confirm the medical opinion and make sure that is what the carrier is agreeing to.
if it's clear that the consult approves disability for the intervening time, then they should pay disability retro-actively
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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#4
1171 Wrote:often times a consult will offer opinion on many different aspects of the case.
I'm not sure what exactly the carrier is agreeing to.
are you clear as to eactly what the second opinion doctor put in the report or just what you thought you heard them say to you? sometimes they are different.
is the carrier agreeing to everything the second consult says or just parts of their opinion?
you need to get the written report and confirm the medical opinion and make sure that is what the carrier is agreeing to.
if it's clear that the consult approves disability for the intervening time, then they should pay disability retro-actively

Sorry to have taken so long to thank you for your reply to my question, 1171. I have another appointment with the second opinion doctor later this week. I will talk further with him regarding my desire to recoup the wage loss benefits. No doubt, he has a great deal more experience with WC cases than I do (which is next to none)!
 
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#5
actually doctors are not a good resource for legal information any more then a lawyer would be for medical.
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
1171 Wrote:actually doctors are not a good resource for legal information any more then a lawyer would be for medical.

Perhaps I should take advantage of mediation that is offered through the state...
 
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#7
yes mediation can resolve the issue if they are still denying disability payments.
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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