Workers Comp Denies Approval for Surgery

[nancyann]

I fell down the steps at my work and landed on right arm on Jan 7 2011.
3 friends witnessed my fall and filled out reports.
I was sent to company Dr and he just put a cortisone shot in my elbow.
Over a year later and 3 more shots my arm got worse and worse.
I was sent to a orthapedic Dr and he ordered a MRI and a nerve test.
Results were ulnar nerve damage and torn muscle tissue from the bone.
Dr said i would have to have surgery and heres where the trouble began.
Workmans comp approved my arm but denied surgery.
I hired a Attorney and they are gonna file for a hearing, which they said could take
Up to a year.
After result of MRI i was put on (no use of right arm) duty.
I am a cushion sewer and now im being shifted around to different plants doing
Crappy jobs and treated like a outcast.
I am in bad pain and need help .

[complwyr]

Tell your lawyer. The lawyer is the only person who can help you at this point.

Discuss with your lawyer these two ideas:

First, if the carrier accepted the claim for the elbow injury, then there is a presumption that any treatment needed for the elbow is related to the accepted incident. We call this the "Parsons presumption." See if you lawyer will consider filing a "medical motion" to get you the surgery you need.

Secondly, if the first idea is not something your lawyer thinks will work, then ask your lawyer to file for an expedited hearing. You don't have to wait a year for a hearing.

If your lawyer acts like he or she does not know what you are talking about, then you may not have the right lawyer. Good luck.

[nancyann]

My lawyer sugessted i go ahead and have surgery and pay for it myself then workmans
Can compensate for it later.
Well my husband worked for the same company and he carried the insurance and
They gave him a permanent lay off so now he's on unemployment and we don't
Have insurance.
I tried Medicaid and was told we made more then 500 a month and we would
Need 2000 worth of medical bills in order to get it, well i don't have any bills
Medicaid told me to see if Dr would do surgery and they would pay after useing
My surgery bill...Dr office said no that i would have to be treated as a no insurance
Patient and i would have to pay 1,800 up front.
Well im broke, husband on unemployment my company cut my wages almost in
Half because they put me on a different job because i can't use right arm.

[complwyr]

Contact your lawyer's office and try to set up an appointment to go in and sit down with the lawyer and discuss all this with him. You need to make sure he knows what all is going on. Don't assume that he knows all the facts.

[nancyann]

I have told my lawyer everything i know.
And they act like theres nothing they can do but file for a hearing and i was told it could take up to a year.

[complwyr]

The lawyer has to work through the process the law sets up. He can't take a gun over to the insurance office and make them do anything.

[nancyann]

I realize that and im sorry if i sound pushy, it's just that im scared for me and my family and when i heard it could take a year i thought about all the pain and how hard it would be on me.
The stress alone from this company is enough to drive a person crazy.
I am meeting with my lawyer tomorrow and i hope he has good news.
Thank you your help and listening to me...again i aplolagize for sounding pushy.

[complwyr]

Glad you are meeting with the lawyer. That is the right approach. Good luck. BB