My workers compensation claim was made in the State of: North Carolina
On March 1, I fell at work and broke 3 ribs. Immediately after I began to feel symptoms of a hiatal hernia I had had surgically repaired over 4 years ago. Until the accident I was fine. Well every step with the insurance company has been a battle but the surgeon they chose and sent me to said that the reinjury of the hernia was more likely than not caused by the rib accident. I just received notice from my insurance company that they are denying my claim and their only reasons were two words Hiatal Hernia.
How can they do that, if their chosen Dr. said the hiatal reinjury was most likely caused the accident? My understanding is that in the state of NC the cannot deny a claim because of a pre-existing condition if it was aggravated by the injury. They can check all my medical records and see that since I had the surgery 4 years ago I have not needed medication or treatment in anyway for the hernia . Every Dr. I have seen I have told about the accident and my recurrent symptoms immediately following the surgery.
I have hired a lawyer but of course I just got this denial and he is gone for the weekend so I will be worrying for the next two days. I am supposed to get an endoscopy done next week to see if surgery is feasible and now they won't pay for it and I can't afford the co-pay from my private insurance. Is this just one of their tactics?
Any words of encouragement would be most welcome.