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  1. #1
    Join Date
    Feb 2009

    Angry Benifits Unfairly Cut Off

    Hello everyone I am new to the forum and appreciate everyone's stories and experiences. I have been on workmans comp since October 07 for multiple ankle fractures that happened at work. Workmans comp started right away and payed benefits and doctor's bills with no problems. I eventually had a scope which didn't really do much and was left still in pain and needed additional medical attention. I finally saw one of workmans comps specialists and he said that I would need a subtalar fusion to fix the issues I have been having. After doing a lot of research I came to the conclusion that this surgery was not worth the risk associated with the it.

    I was then put on permanent restrictions and went home and waited for any word from my job to get me back to work or from workmans comp to settle the case. At this time I hired an attorney and let him try to make any negotiations.

    My case worker found a job that I could do from home and I was forced to accept job or lose all benefits. I soon there after began a job making phone calls for a company verifying business information. I did this job for around a month and then received a phone call from my supervisor saying that I had a complaint from a customer and that I was temporarily suspended for until it could be further investigated. I was very suspicious and jotted down all numbers i had called that day just in case. I soon received a letter stating that because of the complaint I was fired from my job. My case worker called and told me I would be put back on full benefits, which she did and I had no problems for around a month.

    My lawyer sent a demand to the case worker to try and settle the case. The told my lawyer that she would take it to her supervisors and get approval from them in a few days. A week went by and no word from the case worker and my lawyer made several attempts to reach her and she just wouldn't reply.

    Around three weeks after she last spoke to my attorney I received a dispute of benefits and was cut off all together. The dispute was based on that I called a catholic store and was swearing at the lady who answered and that I had purposely sabotaged my job.

    I knew something was fishy from the moment they told me that I had received a complaint. I went through the numbers that I had dialed that day and found the one that I had allegedly swore at. I talk to the same lady and she had called my supervisor but it had nothing to do with how I had treated her, but only to have her number removed from their call list. It was obvious that they cooked up an excuse to cut off my benefits.

    I tried to call my case worker and try to explain that it was simply not true and that I had proof that it never happened. To my surprise my case worker was no longer there and a new one had been assigned to me with no prior notice. She was totally unwilling to hear my situation and basically told me to get lost and file the proper papers for a dispute.

    What a scam! Case worker needs to clean her closet before she leaves and probably cuts anyone and everyone possible. The lady who I had called sent my new case worker a emaill explaining the situation on how I never did anything along their accusations and of course nothing is being done.

    It makes me sad to see that there is case after case where workmans comp cuts the injured worker off for any reason possible just to starve them out and make them settle for pennies on the dollar. Now I am forced survive for months until I can get a court day while receiving no benefits.

    Is there any recourse?

    I am pretty sure they can do as they please and I have to sit back and take it. I tried to file a complaint through the state and of course they directed full circle back to workmans comp who told me to file papers for the dispute.

    There has to be a way to hold these people responsible and make them pay for their wrong doings.

    Shouldn't there have been an investigation into this alleged phone call I had made to this lady to verify that I had actually committed the offense? She had never been contacted. One phone call could have proven my innocence and it wasn't worth the effort to them.

    Any ideas?

    Thank you to anyone who will be willing to reply.

  2. #2
    Join Date
    Oct 2006

    Default Re: Benifits Unfairly Cut Off

    providing proof is what the legal system is for. you need to the take the issue before the Board of Magistrates,1607,7...919---,00.html

  3. #3
    Join Date
    Feb 2009

    Default Re: Benifits Unfairly Cut Off

    My lawyer sent a form to request a hearing, but I am not sure exactly what it is called. I just really want to press the issue that they intentionally cut me off and had no proof to do so. I know I can go to court and prove my innocence, but it still doesn't hold anyone personally responsible for manufacturing false pretenses for denying my benefits. If this was any other corporation than the insurance agency someone could be held responsible.

    To be honest with you I have nothing but time now since I have to sit and wait for my hearing, so why not try to make some noise. I will contact anyone possible to try and get this problem fixed.

    I am probably the typical jaded injured worker and want to make these people pay for there indiscretions.

    Wasting my breath maybe, but time I have plenty of.

    Any Ideas?

  4. #4
    Join Date
    Oct 2006

    Default Re: Benifits Unfairly Cut Off

    start with the complaint page at the state insurance department.
    send detailed written complaint to the supervisor and manager.
    contact the employer with complaints about the carriers behavior.
    If you are in union take the matter to them.
    public officials and representatives are also a good source for investigation of bad buisness practices.
    corporate officers of the carrier and employer as well as members of the board of directors often take an interest in their organization's behavior.
    do all these in writing. followup repeatedly with each one. you may get one response you can take to the others to get each to respond. it's likely this has occurred before.
    the legal system is only capable of dealing with the merits of the claim and not the personal behavior of any party--that's best handled outside the court.

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