Semi to semi accident at work in Texas.
Pre-auth approved lumbar fusion surgery. Designated Doctor listed ruptured disc, radiculopathy and nerve damage as compensable The insurance company had a peer review done for the extent of injury and the Doctor said my claim is limited to a sprain. Now the insurance company is refusing to pay for the surgery that was deemed medically necessary by their pre-auth department, DWC ombudsman said she can't schedule a BRC because the Designated Doctors has already given his opinion, so there is no dispute. I am at a complete loss on all of this.