Work comp problems
#121364 - 11/12/04 04:39 PM
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Does anyone here know anything about work comp and the legal crap that goes with it? I have had months of trouble and finally today filled out a form with a law office that specializes in Work Comp. They never tell me anything and so things have been done that were not preapproved. Also they refuse to let me go to the chiropractor but my reg insurance will only pay for 50% of my visit since the rest is on the work injured area. BUT work comp never told me they weren't covering the 50% chiro visits and I pay him up front at every visit and so I have lost a lot of money. There is also an MRI from MARCH that work comp hasn't paid for. My insurance did and now I get bills fro almost $500 for my share! Work comp says don't worry about it but they haven't paid it either. Then today I had a shouting match with the nurse in charge of my case. She was just put on it and now I am finding out how I can't have the care I choose but only what is in their network. And no one told me this until about 2 weeks ago! So anyone have advice? I know nothing of officey kind of stuff.
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IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
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Oh, no!
#121366 - 11/12/04 05:16 PM
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Nelly
Reged: 08/06/04
Posts: 4381
Loc: Within stray mortar fire of DC
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That's terrible!! It sounds like you've been getting the brush off!! I'm so sorry you're going through this. I know how frustrating dealing with insurance is. I can't imagine what a bear workmen's comp must be. It sounds like you've gotta clear every little thing beforehand. Talk about a pain!
I totally understand being owed back money. I've spent about $4000 on doctor&dentist bills, and my work "forgot" to pay into my insurance for 5 months. So they retroactively cancelled me. All my coworkers are in the same boat. I'm owed back big bucks, but there's #1 no telling when insurance will finally catch up, and #2 no stopping my additional medical care, so I'm still paying out of pocket.
I hope your sit resolves itself quickley!! Stay strong, and don't let these bas***ds get you down!!!
~nelly~ 
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Thanks!
#121386 - 11/12/04 07:13 PM
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Man that sounds rotten for you too! Don't you hate this stuff?! I am still fuming about talking to that nurse. I thought about calling a supervisor and complaining but I will wait. She is atrocious, she doesn't let me speak and so I have to shout over her. The other one is nice but doesn't do anything with my concerns and problems. It makes me wish I had not made a claim at all, but it did get pulled/injured at work so I didn't want to lie. also I missed 10 days in March per the doctor and I did get paid for it so I wouldn't have if I hadn't made it a work comp issue. We'll see won't we. I guess it will be a learning experience no matter what.
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IBS-A for 20 years with terrible bloating and gas. On the diet since April 2004. Remember this from Heather's information pages:
"You absolutely must eat insoluble fiber foods, and as much as safely possible, but within the IBS dietary guidelines. Treat insoluble fiber foods with suitable caution, and you'll be able to enjoy a wide variety of them, in very healthy quantities, without problem." Please eat IF foods!
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I am sorry I can't help you just wanted to say that I wish I could!!! It sucks when stuff like this happens!!! I agree with what nelly said!!! Don't let them push you around!!!
Good Luck!!!!
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Heather7476
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Rotten service!
#121539 - 11/13/04 04:40 PM
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Nelly
Reged: 08/06/04
Posts: 4381
Loc: Within stray mortar fire of DC
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Oh, man that drives me crazy when someone in a service position can't show common decency!! Big props to you for gritting your teeth and bearing it! I can't imagine why someone with such a horrible attitude should be dealing with people who are sick and need help! There's a special place in pergatory for her!
Stay strong and don't give up! Fighting through the red tape and paperwork will be worth it (So I tell myself also!!)!
Best of luck to you!!
~nelly~
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Hey Girls, you're both in rotten situations right now, I'm sorry. I have worked in eye dr's offices for many, many years and have dealt with some crappy insurance things before. Nelly, your company is inexcusable for letting your insurance lapse!!!! If your company isn't moving in a very timely manner to sort the problem out, I would certainly be complaining about it! Since all your co-workers are in the same boat, maybe you could all get together and tell your employer if it isn't resolved very soon, you're all going to file a legal grievence or tell the people in charge, none of you are going to show up at work until its taken care. I realize you probably need your job and don't want to jepordize it but this is not right. You and your coworkers may want to consider calling a lawyer also if the company isn't resolving this.
I don't know a whole lot about workers comp. Unfortunately, I do know its up to the individual to know there own coverage, as far as what is and isn't covered and if you have to go to certain places. An insurance plan is an agreement between an individual and the insurance company, not the insurance company and dr's office. I know this is frustrating when your sick and need help but its not the dr's office's responsiblility to know your insurance plan. With that being said, it would certainly seem that if you were injured at work, than workers comp should be liable for anything not covered by your insurance. It would seem that your employer should be able to help you out on this matter since it did happen at work! I have had to deal with many rude people at insurance companies myself and its no fun at all! I hope you get this mess sorted out soon!
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Taking it one day at a time.....
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Thanks, Michele! We can't mobilize the coworkers in this office, since many are on their spouse's plans/don't care. It is very frustrating. We consulted a lawyer who seemed to think it was a contract dispute, that is, if we have it in our offer letter that they will pay insurance and they don't, then we have a "legitimate" grievance. They're all bastards, as far as I'm concerned, and we don't trust the bosses as a result. So. Frustrating.
~nelly~ 
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I agree, VERY frustrating!!
Its got to make it hard to go to work in an office like that! I thought there was some law that said something to the effect of, if your employeer was paying for your health insurance, they couldn't just drop you and leave you high and dry, that they had to offer you some sort of alternative. In Michigan, its called a cobra plan. Like when my hubby got laid off from his job we were given the choices of A) pay into the health fund $615. a month to keep our current coverage or B) pay almost as much for the cobra thing and have sucky coverage!! Wasn't much of a choice but at least we were given a choice! We have been paying the $615.00 a month now for a couple of years! Its a big chunk each month but it is good coverage.
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Taking it one day at a time.....
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It's just my boss's stupidity. He haggles and haggles, and refuses to pay anything on time. Then he's shocked that we're all cancelled. Also the company is headquartered in Dubai, UAE, and they're like 9 hours ahead of us. I always get the runaround when I call there, and he uses the excuse that since it's arab owned and run, they're not subject to american laws. We're all looking for other jobs. It's embarrassing and getting expensive to keep working here. But I'm not a job hopper, and I don't want my resume to reflect that (cos I've only been here 10 mos.).
SO frustrating.
~nelly~
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Well, I would defintely be looking for another job as well!! I don't known about the whole headquaters in another country thing but it just sounds like they are tyring to screw you guys!! I think any new employeer would understand why you quit after 10 months once you explained the situation to them! What is it that you do again?
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Taking it one day at a time.....
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