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  1. #21
    anon2600 Guest

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    Since your WC case is settled, you will have a problem getting the WC IC to pay for anything that is not spelled out in your future medical award, if there was one. Unless your doctor, again can write a report/request for treatment that will provide EBM for the medical necessity for the medication/treatment.

    "who do you think is makeing the decision to charge me a doctor or some one with no medical background trying to cut corners?"

    IF you are referring to the Utilization Review process, only a MD with a license to practice in your state can delay or modify your doctors request for treatment. A claims adjuster can approve, or a nurse case manager, but not deny (as a rule, states have different rules regarding the UR process)
    Your having to see a doctor monthly might depend on what the medication is you are taking. Some meds cannot be refilled with out seeing a doctor...ie. Class III, opiate meds used for pain control. Also, you can't get these by mail.

    It is easier to get medications approved vs treatment.

    If your WC claim was still open you would have a much easier time trying to accomplish what you are seeking. And easier if it wasn't so old a case.
    I realize you are trying to minimize your monthly outlay. Perhaps you could try some of the 'free' medication offers advertized on TV.(?) They help people with difficulties paying for their meds. Here is the url for one of the sites...
    http://www.astrazeneca-us.com/conten...ance/pparx.asp

    "There is a lot I dont under stand even after 13 years"...things change all the time, some affects you, some doesn't...but it is important to keep up with your case, it's going to be with you for the rest of your life.

  2. #22
    dryfuss Guest

    Default

    I got that and still get meds paid.Its only for 3 years at $14:00 a mo. so thats ok

  3. #23
    roy Guest

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    Receved a letter from Casper & Casper We are going to court with in the next 6 weeks I am tring to get my money back for my brand nane drug and to get it paid for by Workers comp. This mounth it cost me 131.43 co payment for non perfered drug when you put that with others 240.00 month hope lawyers can help I am on my wifes insurance and there co payments keep going up do you think I have a chance at the hearing

  4. #24
    sh Guest

    Default

    probably will depend on the strength of your medical evidence as to drugs effectiveness and whether a generic is available.

  5. #25
    Join Date
    Apr 2019
    Location
    Louisiana
    Posts
    4

    Default Re: Is This Settlement Offer Okay

    You need to be careful bc you are entitled to be a informed before any settlement offers made and you must agree to it, not your lawyer, sounds fishy to me,

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