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  1. #1
    Join Date
    Feb 2009
    Posts
    2

    Default Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    Is it a good idea for my husbands employers Workers Comp Representative to go on a doctors visit with us????????????????


    My workers compensation claim was made in the State of: Oklahoma!

    My husband was injured at work in June 08. He has been following all of his doctors recommendations. He injured both of his knees falling off of a truck. he has never had any trouble with his knees nor accidents of injuries of his knees.

    His doctor has diagnosed him with Chondromalacia. Stage 3. Doctor completed a arthroscopy of his left knee. Stated that he needs total knee replacement on both knees but is too young. Said that he will go ahead and do a second arthroscopy of his left knee and will not even touch his right knee until he sees how his left turns out. Says he will never heal from this. Will just be about pain management.

    Doctor said that he is not going to be able to return to work at the same job. He will require a sedentary job. He will need job training for this. Since all he has ever done is manual labor.
    Insurance Claim Rep wants to go to our next doctors appointment. Why????
    Last edited by fcb; 02-21-2009 at 12:33 PM.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    No, you don't have to allow a claim rep in the exam room with you at the appt.
    But the ER/IC does have the right to a discussion with the PTP whether you are there or not. They are the ones paying the bills, and have the ability to control the medical in a claim.

    If you want, you could have the appt/exam with your doctor, and then let the CA/NCM into the room for the discussion with you present.

    One way or another, the CA/NCM is going to have access to your doctor, and medical records.
    Having the NCM there (after the exam) may help to expedicate any requested treatment submitted by your treating physican.

  3. #3
    Join Date
    Jan 2009
    Location
    tn
    Posts
    92

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    under workers comp laws in tennessee you have the right to a private doctors appointment. now after the appointment they can recieve information about your visit and treatment. dont know if this is the same in your state. good luck to you.

    if its intemidation they are trying, i would have my att. at the appointment as well...lol go get em... hope the best for yall..

  4. #4
    Join Date
    May 2007
    Posts
    408

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    I would NEVER allow a NCM/CA into the same room with me and my Doctor period!
    To start with, It saves the IC money.
    When a NCM has to schedule a seperate consultation with your Doctor, it cost bigtime but what should we care?
    I can promise you most NCM/CA is NOT looking out for the IW's best interest.
    They are looking to end your case ASAP.
    As much misery as WC IC's have put most of us thru, I say make them make there own damn appointment UNLESS you are wanting to expedite the ending of your claim.
    I never allowed this. My spinal surgeon told me he charged these people a minimum of $250 dollars to talk with him.
    Its no money out of your pocket.

  5. #5
    Join Date
    May 2007
    Posts
    408

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    Quote Quoting this is awful View Post
    under workers comp laws in tennessee you have the right to a private doctors appointment. now after the appointment they can recieve information about your visit and treatment. dont know if this is the same in your state. good luck to you.

    if its intemidation they are trying, i would have my att. at the appointment as well...lol go get em... hope the best for yall..
    In some states such as Louisiana, you cannot have your Attorney present with you at a exam performed by a WC Doctor such as a Second Medical Opinion.
    Thats what my Attorney told me.

  6. #6
    Join Date
    Jan 2009
    Location
    tn
    Posts
    92

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    Quote Quoting smackman View Post
    In some states such as Louisiana, you cannot have your Attorney present with you at a exam performed by a WC Doctor such as a Second Medical Opinion.
    Thats what my Attorney told me.
    just another reason why workers comp is bent towards the insurance companies and employers. money talks folks... period. were just fresh meat, when we get hurt bring the next person in... and it keeps going and going.

    will stop at that blood presure going threw the roof.. good luck my fellow comrads, we have our work cut out for us!!

  7. #7
    Join Date
    Feb 2009
    Posts
    2

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    Quote Quoting BvIA View Post
    No, you don't have to allow a claim rep in the exam room with you at the appt.
    But the ER/IC does have the right to a discussion with the PTP whether you are there or not. They are the ones paying the bills, and have the ability to control the medical in a claim.

    If you want, you could have the appt/exam with your doctor, and then let the CA/NCM into the room for the discussion with you present.

    One way or another, the CA/NCM is going to have access to your doctor, and medical records.
    Having the NCM there (after the exam) may help to expedicate any requested treatment submitted by your treating physican.
    Thank you for your opinion. Our Claims Rep has had a double hip replacement from the same doctor and has a personal medical relationship with him. So far she has been exceptionally helpful. I do not have any reason to suspect malice from her wanting to be there. However, she does not represent my husband she represents his employer. I am not sure what her motives are.
    Thank you.
    fcb

  8. #8
    Join Date
    May 2007
    Posts
    408

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    Quote Quoting fcb View Post
    Thank you for your opinion. Our Claims Rep has had a double hip replacement from the same doctor and has a personal medical relationship with him. So far she has been exceptionally helpful. I do not have any reason to suspect malice from her wanting to be there. However, she does not represent my husband she represents his employer. I am not sure what her motives are.
    Thank you.
    fcb
    .Be extremely careful.
    Remember, She represents his employer.
    My Attorney's have touched on this "lovey dovey" attitude of some CR/NCM.
    NEVER put your Trust in these people.
    I have never disrespected one but I have always kept them at a "cables tow" away and I have had 4 different ones not counting Voc. Rehab.

  9. #9
    Join Date
    Jan 2008
    Location
    New Oxford, Pa. USA
    Posts
    430

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    Her motives are to listen in and afterwords speak to your dr. and see what else besides surgery can be done or blame it on the possiblity it was a condition there before his accident that they can claim not to pay or pay just partially. Do not let her in the exam room with you I can bet (2 cents) that all I have left after w/c) that she will want to speak to your doctor alone at some point and probably have things changed. The snake was so sweet and it got Eve to eat the apple.

    Anyway that's my last 2 cents worth lol.

    Nipper

  10. #10
    Join Date
    Oct 1971
    Posts
    3,373

    Default Re: Workers Comp Claim Rep Wants to Go to Doctors Appointment with Us?

    dickholland
    the dept of labor monitors ins company practices
    Is that right, hmmmm where did you get that info from, Id like to know more
    Tony
    Moderator
    We reserve the right to forbid any user from participating in this forum, and to close any user account, at any time, for any reason. In the interest of the community, this may be done without prior notice or warning.
    http://www.workerscompensationinsura...inks/index.htm

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