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  1. #1
    debbie Guest

    Default Comp Adjuster Denies Medical Treatment

    after waiting for months for a dr to diagnios my injury,[ iwas injured in march of 2003].the present dr i was seeing said i was fine and didnt know what else to do for me ,[gee i wonder if they are paid to say that]? .finally after a long wait of many months and in pain with no income i was approved to see another dr. three days before the appt. it was canceled dr didnt want to see me? finally i was approved with a new dr .just needed the appt to be approved .in the process i was handed over to a new adjuster and was denied .prior to this injury i was injured in 2001 had surgery for cts ,despite the surgery i still had numbness and tingling .went back to work four months later with no restrictions ,and was injured by a combative patient same wrist .i have a burning sensation in my wrist along with numbness and tingling and muscle spasms .dr denied any meds for pain . to me this is insane to be denied proper medical care. rating was 2%disabilty,i have no feeling in my middle finger whatso ever ,i know when my case is done and over with it will be made public of the gross neglect on injured workers.

  2. #2
    adjuster Guest


    What reason did the new adjuster give for canceling/denying the medical care? He has to give you a reason for this. Are they now trying to say that the condition is not related to the recent accident but due to the 2001 accident?

  3. #3
    debbie Guest


    he said i already had a one time change of drs and to speak to there lawyer. they didnt say if it was related or not. the change of dr wasnt true.

  4. #4
    debbie Guest


    adjuster, called dr office and it was approved ,they said they havent heard of any changes .appt is for this friday i will let you know what happens

  5. #5
    rickandkryss Guest


    I truly believe the only way changes will ever occur is if injured workers speak up about there situations. Let us know if the doc appt changes.

  6. #6
    mel Guest


    Debbie, your symtoms resemble RSD.......good luck

    Adjuster, in your opinion, how long can the insurance wait to approve a Dr visit before it can be viewed as negligence? Treated this summer and pain has gotten first wanted to go back to same Dr, then decided to ask to change Dr's. Neither have been approved and pain cont's. Reh nurse cont to request apt and then a change of Dr to no avail. Have also been on attorney, I am tired of bing ignored. It is an injury to elbow that needs treatment.

    Also do you have any sites that show WC cases and outcomes.

  7. #7
    debbie Guest


    thanks mel good luck to you to,i was wondering the same question my self?

  8. #8
    rickandkryss Guest


    When I was waiting for approval, I contacted them once a week t check on the status of there decision. It only took me 1 month to get my second opinion approved.

  9. #9
    adjuster Guest


    Most states have statutory time frames that define how long the adjuster has to authorize medical care. As far as I am concerned if they do not authorize within the time frames allowed and they have all the information necessary to make the decision then they are being negligent. Of course that is my opinion only.

  10. #10
    anon Guest


    Yet, all the necessary info is still up to debate. That is the loop hole. They then send you to their doctor who gets them the necessary info that they are looking for to deny. Let's be truthful here.

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