what do i do when the doctor asks for surgery and the worker comp adjuster denies approval?
Question:
Answers:
Do NOT waste time thinking of "Appealing" the adjuster's decision. That will only allow more time to pass. I would request a Hearing.
AS LONG AS your settlement is NOT a full compromise (where you surrender future benefits), THEN you should STILL be entitled to your medical benefits (unless your state stops your medical benefits after you reach MMI because you were rated).
Ask your attorney to petition for a Hearing. I do not know how badly you need the surgery. IF you are in a lot of pain, then you / your attorney could request an EMERGENCY HEARING.
It appears that your surgery was ALREADY APPROVED BEFORE? THEN the adjuster withdrew the approval?
If so, this may ALSO be a basis for a Bad Faith lawsuit.
Sure wish I knew what state your claim is in. You can also contact the State Workers Comp Board. Ask if they have an Ombudsman. The Ombudsman's job is to help guide Injured Workers. (They cannot give legal advice tho').
If you want to check out a Forum type discussion panel that is hosted by attorneys, check out http://www.Prairielaw.com
If you want to check out workers comp resources, then check out http://www.GettingWorkersComp.com
Good luck.
Other Answers:
Appeal it! They have to have a way to appeal the adjuster's decision. Also, you might want to see ANOTHER doctor. Your DR sending you back to work with a back injury sounds too strange to me. Good Luck!
I hate to say this, but, just live with it. I was making $50,000 as a nursing assistant and now my back aches all the time and my leg gets weak. the QME gave me 25% for lifting plus 50% for standing, bending. this came out to $17,000. they paid it, I am still in pain and cannot return to my old job. how could he give you a high ppd rating and say go back to work?
that does not seem right?
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