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  1. #1
    Join Date
    Mar 2012
    myrtle beach,south carolina

    Angry Is It Legal for the Insurance Company to Delay Surgery

    I know we are suppose to keep these questions short and to the point, but give the new guy a little break.
    I was injured over three years ago, it was reported immediately ,I was rushed to hospital. I went to followup visit with wc Dr. who referred me to orthopedic dr. who after multiple tests, scans, injections, therapy, and drugs, decided I needed to have surgery to repair three disc in my neck and two in my lower back. Well the WC carrier decided they did not like his determination and refused to pay for any more visits. My att. filed motions and requested hearings. the week of the hearing the carrier decides they will continue paying for treatment but I had to go to a different Dr. of their choosing. I did and a year later after more MRIs, scans, therapy injections and drugs they can to the same conclusion, I needed surgery to rebuild now 4 disc in my neck and now I have 4 bad disc in my lower back, ( With a large family I was still working during all of this to keep a roof over our heads). The WC carrier refused to pay again and refused to authorize any treatment. My Att. filed motions, requested hearings etc.. One week before hearing Wc IC called my att. to offer cash to me to forget claim, I refused, day of hearing they offered more cash to not proceed, I refused. Commissioner ruled that Wc Ic was to authorize all treatment, and in event Dr. took me out of work TTD payments were to be made. That was last Oct. Here we are in March and only after more motions and filings for hearings for them to show just cause, Hearing was about to be set, did they agree to finally authorize surgery and TTD payments. How can they be allowed to drag this process out as long as they have with no regard to the well being of the injured party?? Is there no laws to protect us against this practice?? Help!!!

  2. #2
    Join Date
    Oct 2006

    Default Re: Is It Legal for Them to Delay

    yes, there are laws and there is also a process to apply them.
    that is the court system and what you are involved in.
    both parties have rights that have to be adhered to; the right of due process includes the right to gather evidence and the right to appeal.

    if you disagree with the way your atty is handling your claim, you can file a complaint with the state bar and change attys at any time.

    if you want to complain about the legal system or go outside of it, contact you legislators and congressmen.
    check your local media;some areas have media outlets that handle consumer complaints and investigate bureaucratic delays
    Last edited by .SH; 03-14-2012 at 04:47 PM.

  3. #3
    Join Date
    Feb 2007
    Charlotte, NC

    Default Re: Is It Legal for Them to Delay

    You should complain to your state legislators about the problems with this process. They created it. In theory they can fix it for injured workers.

    Oh, wait. You are in SC. Your state legislature is controlled by Republicans. They are not going to fix it to help injured workers. They may "reform" it so that it slants more towards employers and insurance carriers. That is what Republican state legislatures are doing in the rest of the country. Last year, they did it in Oklahoma and NC. I think Indiana got it too.

    You guys will need to elect some new people to your legislature--people known as "Democrats"----for this situation to get better for injured workers. Since your fellow citizens in SC insist on letting the Repubs control your state government, the old adage "you made your bed, now you have to lie in it" applies to injured workers in SC so far as workers' comp is concerned. Unfortunate but true. Politics matters.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

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