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  1. #1
    Join Date
    Nov 2007
    Location
    ALABAMA
    Posts
    1

    Default Workers Comp Stopped Paying Medical

    Can Workmans Comp Stop After Paying All Medical After 2 Months, Has Never Recieved Any Compensation. Problems With Satety Issues. Also Doctors Just Did 3rd Surgery On Arm Plate Broke Loose From Bone , So What Do We Do To Pay

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Question

    they can stop any time they have reason to believe the treatment is not related to the industrial injury.

  3. #3
    Join Date
    Dec 2006
    Posts
    2,165

    Default Re: Question

    Blackwell, a little more information is needed.

    First, did you report the injury and fill out the appropriate Forms of First Report of Industrial Injury?

    Did your Employer submit THEIR forms to the Work Comp Carrier, notifying them that you sustained a work injury?

    Was the claim ACCEPTED by Work Comp?

    What are the "safety issues" that you alluded to, and how do you think they caused/contributed to your injury at work?

    HOW did you get injured?

    Has Work Comp advised you as to the REASON that they are suddenly no longer authorizing medical treatment?

    I am assuming that you were unable to work as a result of the injury and ensuing surgeries, and from your post it looks like you have NOT received Temporary Total Disablity Benefits?

    In Worker's Comp, your Doctor must confirm that your injury WAS related to your employment (arising out of/ course and scope of employment) in order for the Carrier to accept your claim.

    If your injury has been accepted, and you develop complications, either due to the progression of the injury, or treatment of the injury, like surgery and the plate breaking or a screw backing out of the bone, causing the plate to become unstatble and break, these are called "compensable consequences", and again, your Doctor needs to "link" the causation of the consequent injuries to the original injury in his written reports to the Carrier, and back it up with scientific evidence that supports his opinion.

    When requesting TREATMENT, the WC carrier must APPROVE it. Most WC carries run "treatment authorizations" through "Utilization Review". Authorization for treatment is usually based on ACOEM Treatment Guidelines, for the "acute phase" of the injury (up to three months duration) and the "Chronic Phase" (more than six months duration).

    If your Treating Physician does NOT submit his treatment requests per ACOEM Guidelines, and/or you have an unusual condition that requires a "deviation" from ACOEM Guidelines, then he MUST substantiate the treatment request with "Evidence Based Medicine" for your particular injury, otherwise, it is likely that the treatment request will be delayed or outright DENIED.

    It is important to understand this process, and it also important for you to LEARN all you can about Alabama WC Laws! This will allow you to become more PROACTIVE in your case...

    Here is the link for Alabama
    http://dir.alabama.gov/wc/benefits.aspx

    Also, you should consult with several EXPERIENCED Certified Workers Comp Attorneys. The consultations are usually free. With your injuries and complications, you probably will need an experienced attorney to get your WC case back on track so that you can receive treatment and TTD benefits.

    Steel is very well-versed in Alabama WC Law, and maybe she will jump in soon and offer you further information.
    Last edited by Charles Stevens; 12-16-2007 at 08:35 PM.

  4. #4
    Join Date
    Nov 2007
    Posts
    3

    Default Re: Workers Comp Stopped Paying Medical

    POST YOUR STORY OR QUESTIONS,,ITS FREE
    WWW.IHATEINSURANCECOMPANIES.COM

  5. #5
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: Workers Comp Stopped Paying Medical

    Not much at all to add Mr. Stevens. You did an excellent job in making all the points that need be made. Especially learning all that there is to learn about the state WC laws. Thanks for the flowers just the same.

    Steel
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

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