Do You Get a Lawyer "Just in Case"

[madiandcindy]

So far, I have not had anything denied, however my doctor told me after I went to the ortho specialist that he "thinks" that the insurance company will deny/ challenge my neck since we (meaning him) didn't mention it originally, the issue is I have had bad pain in both hands, wrists and right shoulder, the MRI for wrists and shoulders were approved as well as the emg/ nerve tests, the ortho said I have CTS on both hands, rotator cuff tendinosis (spelling) and cervical radiculopathy (c6 distribution) which most means double crush syndrome, he requested an MRI for my neck to see extent of damage, my treating doctor seemed surprised and said he would request the now 3rd MRI in 4 weeks, he said he is not sure if this will be compensable? I have had the most severe pain in my hands and shoulder, I didn't complain about my neck because it didn't hurt, if that pain is radiating from my neck, from cervical distribution how would I know that to tell my treating doctor what it is? I thought it was odd when he said, well you didn't mention your neck? The ortho has asked for approval of injections for both hands and shoulder also. I guess the treatment for any cervical issues would come after the MRI results. My concern is that I do not have an attorney now because I was advised that I should obtain one only if I start getting denials, that being said I did have a conversation with my adjuster at the very beginning of my claim and now the nurse case manager is always calling me asking for info. Should I seek an attorney now or wait to see how it goes? It's just that I have read so many of your stories I am nervous of making the mistake of talking to the adjuster/case manager and having them use it against me since I no Nothing about WC.

[tony]

When the IC brings in a "nurse case manager" it's time to retain legal counsel.
Case managers are hire by the IC to close your case as soon as humanly possible, they do not have your interest in mind.
You'll need a lawyer to act a a buffer between you and this so called case manger, they can and will become very aggressive.

Consult a lawyer pronto!!

Tony

[madiandcindy]

OK, got it, what the nurse case manager told me is that my employer's insurance pays for the case manager and he is there to make sure all my prescriptions and care goes by smoothly, and that he is there to help me, it sounded too good to be true. Thanks.

[tony]

OK, got it, what the nurse case manager told me is that my employer's insurance pays for the case manager and he is there to make sure all my prescriptions and care goes by smoothly, and that he is there to help me, it sounded too good to be true. Thanks.

Oh don't worry, they'll go by - by real smoothly if they get their way. Don't be obvious but fend them off the best you can, be careful what you say, offer no info and avoid chit chatting.

Tony

[airdale]

OK, got it, what the nurse case manager told me is that my employer's insurance pays for the case manager and he is there to make sure all my prescriptions and care goes by smoothly, and that he is there to help me, it sounded too good to be true. Thanks.

Oh yea the old " were from the ins. company and were here to help you"!!!!!..... and the check is in the mail!!!!

[maxcrucial]

any major injury to a worker i would say run dont walk to a lawyers office.
it your body and without a good lawyer you will get the wrong end of the deal.