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  1. #1
    Join Date
    Jul 2012
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    16

    Default Request for Mediation Letter

    My workers compensation claim was made in the State of: Montana
    I am wondering if anyone has had to write a letter to the WC Adjuster because of medical benefits being delayed. I do not have an attorney representing me as of yet but I talked to my attorney and he told me to start a mediation process...see if that will get my medical benefits reinstated. He is willing to take my case but doesn't want to step in until he absolutely has to. I have been recieving medical benefits for a year now with seeing my orthopedic doctor and physical therapy. 7 weeks ago my WC adjuster required me to have an IME....but as of yet she has not recieved the results of the IME so she will not allow me to continue physical therapy. I didn't realize it took so long to get the IME results back....but according to the adjuster the IME doctor is backed up and it could be a few more weeks.
    I am wondering if any of you have had to write a letter to your adjuster requesting medical reinstatement. According to the state WC board I have to write a letter requesting my demands....send it to WC adjuster and wait 15 days before I can file a motion for mediation.
    Does anyone know what I put into this letter? Do I just mention the medical benefits or do I have to mention something about a settlement?
    I JUST DONT WANT TO SUBMIT LETTER REQUESTING MEDICAL BENEFIT REINSTATEMENT....AND THEN COME TO FIND OUT THEY WONT OFFER ME A SETTLEMENT DOWN THE ROAD BECAUSE I DIDN'T PUT IT IN THE REQUIRED DEMAND LETTER.

  2. #2
    Join Date
    Oct 2006
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    9,078

    Default Re: Request for Mediation Letter

    "I request medical benefits be authorized and approved for my work injury immediately.
    I consider this request as meeting any pre-requisite for filing a motion for mediation."


    there is no list of what should not be included in a request for benefits.
    you don't need to put everything in the letter just to be safe. there is no requirement that you put settlement information in your letter. there is no bar to raising settlement issues later if it was not included in your pre-mediation request.

    you can also use the claims assisstance bureau:
    http://erd.dli.mt.gov/wcca-bureau.html

    more information on use of mediation:
    http://erd.dli.mt.gov/workers-comp-c...tion-unit.html
    Last edited by .SH; 07-06-2012 at 01:28 PM.

  3. #3
    Join Date
    Jul 2012
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    16

    Default Re: Request for Mediation Letter

    Thanks SH!!
    This is all new to me....so I guess I was reading more into it than I needed to. Do you know on average...approximately how long it takes to get IME results back to the adjuster? Should I wait a little longer to send the demand letter or move forward immediately?

  4. #4
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,762

    Default Re: Request for Mediation Letter

    Mediation is a settlement process. Sounds like you may need a medical motion.

    You can settle a case anytime along the way.
    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 and Board Certified Specialist in NC Workers' Compensation Law

  5. #5
    Join Date
    Jul 2012
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    16

    Default Re: Request for Mediation Letter

    Quote Quoting complwyr View Post
    Mediation is a settlement process. Sounds like you may need a medical motion.

    You can settle a case anytime along the way.
    Thats what I thought.....but when contacting my personel attorney...he told me to start a mediation process. I also called the state WC claims assistant bureau and they told me the same thing.....start mediation process!!
    I just want to make sure I continue to get my medical benefits so that I can feel normal again. I lost my job almost a year after the injury (While I was still receiving medical treatment)...employer gave me unemployment...but the way I'm feeling I can't perform my job to maximum capacity if and when I find a job. I worked all the way through my injury up until I was terminated.....so I have never received any WC payments.
    I just don't know what I should do!!!
    Last edited by diyflunkie; 07-06-2012 at 02:43 PM.

  6. #6
    Join Date
    Apr 2012
    Location
    Oregon
    Posts
    347

    Default Re: Request for Mediation Letter

    You need a wc attorney not just any lawyer. You should have been receiving wage loss and a wc atty would know this.

  7. #7
    Join Date
    Oct 2006
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    9,078

    Default Re: Request for Mediation Letter

    Quote Quoting diyflunkie View Post
    Thanks SH!!
    This is all new to me....so I guess I was reading more into it than I needed to. Do you know on average...approximately how long it takes to get IME results back to the adjuster? Should I wait a little longer to send the demand letter or move forward immediately?
    if you keep waiting you'll show them that don't really want treatment anyway- your treatment is not really that important to you.

    you decide how you want to be perceived.
    Last edited by .SH; 07-06-2012 at 08:27 PM.

  8. #8
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
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    3,762

    Default Re: Request for Mediation Letter

    Unless your "personal attorney" is an experienced work comp attorney, he may not be giving you the best advice. And getting legal advice from the state agency is always a poor idea. If you need legal advice, you have to get it from the right person. In your situation, you need to be talking to an experienced workers' comp attorney.
    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 and Board Certified Specialist in NC Workers' Compensation Law

  9. #9
    Join Date
    Jul 2012
    Posts
    16

    Default Re: Request for Mediation Letter

    Quote Quoting complwyr View Post
    Unless your "personal attorney" is an experienced work comp attorney, he may not be giving you the best advice. And getting legal advice from the state agency is always a poor idea. If you need legal advice, you have to get it from the right person. In your situation, you need to be talking to an experienced workers' comp attorney.
    Thanks for the advice...I will be contacting a W/C attorney!!

    - - - Updated - - -

    Quote Quoting complwyr View Post
    Unless your "personal attorney" is an experienced work comp attorney, he may not be giving you the best advice. And getting legal advice from the state agency is always a poor idea. If you need legal advice, you have to get it from the right person. In your situation, you need to be talking to an experienced workers' comp attorney.
    I received an email from my adjuster today telling me that I will no longer be receiving benefits.
    My injury happened when I was running to get behind the front desk ( I was the GM at this hotel ). My foot stopped on the tile and I kept going. I only had about 6-8ft to go before I ran into the corner wall. It was the small convenient mart right next to the front desk....that was L shaped and I ended up shoved into the corner walls landing on my left knee, arm and chin....with my right side twisted behind me. The pain in my left knee was so excruciation I could only feel that pain for many weeks. I was the GM and lived on property....which I had to work the front desk M-F 6am-6pm....and I figured that I probably just bruised my knee and it would go away soon. Well it didn't and by the next month I was getting sharp pains shooting down my right leg. When I was able to go to the doctor...they contributed it to my right side being twisted back when I fell. My doctor ordered an MRI and it showed I had 2 bulging disks with a small tear....and the pain in my right leg was referred pain. This has gone on for 1 1/2 years with therapy....injections in my lower back....therapy....therapy!!! Finally an IME was ordered and know they are saying the symptoms are not related. When I filled out my 1st report....I just put down what I was doing and when I fell I came down on my left knee (by the way the knot on the bone is still there and tender), arm and chin....as that was the only pain that I was experiencing right at that time. I didn't realize that the fall would effect me the way it did. I am contacting a W/C attorney.....do you think I can fight this decision that the adjuster submitted.

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