My workers compensation claim was made in the State of: Ca.
My case has been settled for over 20 years and I now reside in a different state. This past year the workers comp carrier has had their utilization review company review all my meds every 3 months and they are denying meds I have used in the treatment of my brain injury since the onset of my brain injury. No medication has changed, there are no new meds and my primary DR., who they accept, wishes me to continue with the same meds I have been on as they work for me. Yet work comp states they must follow their UR review and deny to pay for my meds. These same meds were settled as medically necessary when my case was settled, by the judge, with my disability payments bi weekly and the medical ongoing. Is what they are doing legal? Do I have any recourse?
Also they asked if we wanted to settle and close the medical aspect of my case, I said I was interested. When their outside consultant told them the amount my medical case should settle at, they decided they didn't want to settle it. Can we push them to settle my medical and continue with my disability payments bi weekly?