Case Denied! Just like that!

[praders1]

My claim was accepted about a month ago. My injury took place in March. I've received a couple checks one for retroactive and one for regular benefits. I just received a letter last week stating my claim has been denied due to lack of evidence of CT. Has anybody had this happen? I got a hold of my Attorney and he just said he needs to get a hold of their Attorney. He also said this could be a mistake on their end. In the mean time I don't have a check. Is there anything I can do on my end? It's been a week now and nothing back from Attorney. Really was counting on that last check, but instead the letter. Thanks

[1171]

you can apply for state disability. they'll pay on denied comp claims.

[praders1]

1171 Wrote:you can apply for state disability. they'll pay on denied comp claims.

Oh Thank Goodness for this forum! I didn't even think about that! Thanks 1171.

[Cycler]

What does CT mean in your post ?
Your history of prior back problems and the degenerative findings on x-ray etc will give the other side more than enough reason to fight your claim as the potential costs of losing far outweigh the costs of fighting you tooth and nail and they know they have a reasonable case. WHile Worekers comp is a No- Fault insurance system it is anything but cost neutral to the employer. Good luck.

praders1 Wrote:My claim was accepted about a month ago. My injury took place in March. I've received a couple checks one for retroactive and one for regular benefits. I just received a letter last week stating my claim has been denied due to lack of evidence of CT. Has anybody had this happen? I got a hold of my Attorney and he just said he needs to get a hold of their Attorney. He also said this could be a mistake on their end. In the mean time I don't have a check. Is there anything I can do on my end? It's been a week now and nothing back from Attorney. Really was counting on that last check, but instead the letter. Thanks

[1171]

In california "CT" refers to Cumulative Trauma as opposed to a specific injury.
california is fairly generous in allowing aggravation of underlying non-industrial conditions.

[praders1]

Cycler Wrote:What does CT mean in your post ?
Your history of prior back problems and the degenerative findings on x-ray etc will give the other side more than enough reason to fight your claim as the potential costs of losing far outweigh the costs of fighting you tooth and nail and they know they have a reasonable case. WHile Worekers comp is a No- Fault insurance system it is anything but cost neutral to the employer. Good luck.

praders1 Wrote:My claim was accepted about a month ago. My injury took place in March. I've received a couple checks one for retroactive and one for regular benefits. I just received a letter last week stating my claim has been denied due to lack of evidence of CT. Has anybody had this happen? I got a hold of my Attorney and he just said he needs to get a hold of their Attorney. He also said this could be a mistake on their end. In the mean time I don't have a check. Is there anything I can do on my end? It's been a week now and nothing back from Attorney. Really was counting on that last check, but instead the letter. Thanks

C.T. is Cumulative Trauma. I don't see how there is no evidence of CT if there has not been an MRI done since the reported injury. Thanks!

[Bad Boy Bad Boy]

Because they too are using what you had said once in your very first post;

((((On 3/19/2010 while working as a caregiver in Ca. I attempted to lift a pt. I immediately felt a sharp pain and burning in my back. I called my employer immediatley to report the incident. I had been to the Workers Comp. Dr. twice before in the past year, once for a fall, and once for an assault by a mentally unstable client who had brandished a knife. During the course of those visits I had mentioned my prexisting back condition ( disk protrusions L3, L4, L5- S1 which are at their maximum on the left side measures about 3mm and indents the S1 nerve root). the Dr. told me that my primary Dr. would have to address those issues. When I reported the incident I told them I was sick and hurt my back. My company is now saying I reported being sick but no mention of my back. They are now fighting the claim and have hired a P.I. I'm so confused as to what to do. Should I hire an Attorney? Should I even fight this? Oh by the way I'm new to this site and really can relate to a lot of the pain and frustration that people are feeling. I would love some advise.))))

From what you have wrote then, and compared to what you write now. It is as if you have 3 work comp claims going. The thing is, which claim is being denied?

[1171]

An MRI or other test is not the necessary evidence the comp system needs.
they need a medical opinion. maybe they have yet to get a confirming physicians
findings.

[Bad Boy Bad Boy]

1171, I am reading into their first post. From what I am reading, there seems to be 3 injuries noted. I wonder if any of the injuries are being covered? For if it's the back injury, they have one claim before the last claim. Meaning are they getting treatment for that one. Who really knows what is going on?

[Cycler]

An MRI wouldn't answer the question of causation. You already know it will look abnormal and it would have the day before the accident.

praders1 Wrote:

Cycler Wrote:What does CT mean in your post ?
Your history of prior back problems and the degenerative findings on x-ray etc will give the other side more than enough reason to fight your claim as the potential costs of losing far outweigh the costs of fighting you tooth and nail and they know they have a reasonable case. WHile Worekers comp is a No- Fault insurance system it is anything but cost neutral to the employer. Good luck.

praders1 Wrote:My claim was accepted about a month ago. My injury took place in March. I've received a couple checks one for retroactive and one for regular benefits. I just received a letter last week stating my claim has been denied due to lack of evidence of CT. Has anybody had this happen? I got a hold of my Attorney and he just said he needs to get a hold of their Attorney. He also said this could be a mistake on their end. In the mean time I don't have a check. Is there anything I can do on my end? It's been a week now and nothing back from Attorney. Really was counting on that last check, but instead the letter. Thanks

C.T. is Cumulative Trauma. I don't see how there is no evidence of CT if there has not been an MRI done since the reported injury. Thanks!