comp insurance - Disabilities Message Board

jaydar · 01-14-2009, 04:26 AM

workers comp has been screwing me since 2002.They've denied fusion surgery recommended by 5 doctors(approved the surgery with one doctor after I had already fired him)
Anyway I've had no life for nearly 7 years.Can't walk more than 50 yard without severe buttock/leg pain.
They do have a court order to care for my back.
My lawyer says he needs their denial in writing before he can take it to the judge.I can't imagine there is no such paperwork.
Anyway I'm disabled and have medicare,so I'm thinking about getting surgery that way and then having lawyer take the billing to court for reimbursement.
The problem with that is,until it's ajudicated,a portion of the bill willbe my obligation.
Has anyone had his surgery through medicare?
If so, what were total costs and your part?

Devon07 · 01-14-2009, 06:58 AM

what state you in?.laws vary from state to state..your attorney should have been able to get your surgery much much quicker than years.....it should be as easy as getting it done within 6 or 7 mo TOPS!......some IC fight hard but with court rulings and even court appointed doctors have to approve.

Get a new attorney and I wish you luck workers comp is one of the most corrupt systems in the world! Im assamed!

Devon

jaydar · 01-14-2009, 11:19 AM

I'm in Florida but the claim is Massachusetts.Medicare is a Federal benefit.
I just need to have some idea as to how much surgery/hospital will charge,and my portion.I'll need to be paying down my obligation until court sorts it out,to preserve my credit.

Devon07 · 01-14-2009, 12:38 PM

I understand Medicare is a Federal benefit......but you said;

workers comp has been screwing me since 2002.They've denied fusion surgery recommended by 5 doctors(approved the surgery with one doctor after I had already fired him)
Anyway I've had no life for nearly 7 years.Can't walk more than 50 yard without severe buttock/leg pain.
They do have a court order to care for my back.
My lawyer says he needs their denial in writing before he can take it to the judge.I can't imagine there is no such paperwork.

I wanted to offer some extended advice but couldnt without the state you're in....I didn't go through Medicare so I have no numbers for you.

Good luck,
Devon

BeHappy2 · 01-15-2009, 12:50 PM

Jaydar, reading your post sounds so similar to my hubby's situation.
w/c denied fusion surgery even though he has 4 docs saying he needs fusion surgery. This has been going on for 2 years, i can't imagine your length of time gone by. I agree that w/c is one of the most corrupt situations.
i have a suggestion for you, since you do have medicare can you get itemized statements from surgeon of cost of all involved with the fusion surgery and ask medicare what they will then pay?
I hope you get some answers from all soon, and as far as firing w/c attorney we've been through that route too. This is hubby's 2nd attorney and we do now see it's all a waiting game for the person in pain.
Wish you all the best, please keep us posted on what comes of this.

BeHappy2