Surgery not approved or declined yet

[kartim]

I'm in Wisconsin.

I have surgery at 11:30am tomorrow. (Tues, Aug 31)
As of earlier today, WC has yet to make a decision to approve or not the surgery. The adjuster claims they are waiting on the IME report. I saw the IME on July 12.

I'm to have my wrist scoped and/or fixed depending on what the scope shows. Should I go through with the surgery or am I going to give WC a reason to decline based on what the doctor finds/fixes?

[bronco54501]

kartim Wrote:I'm in Wisconsin.

I have surgery at 11:30am tomorrow. (Tues, Aug 31)
As of earlier today, WC has yet to make a decision to approve or not the surgery. The adjuster claims they are waiting on the IME report. I saw the IME on July 12.

I'm to have my wrist scoped and/or fixed depending on what the scope shows. Should I go through with the surgery or am I going to give WC a reason to decline based on what the doctor finds/fixes?

Usually they dont set up surgery unless they have aproval first...
Do you have another ins you can use for this...?? I'm from wisconsin also, and I have turned in some things to my private ins that was wc, and later they submitted the bills to them.. It is best to have all this figured out ahead of time, and if the IME is against you you may have problems later and may take a lawyer to get this taken care of... Maybe you can put off the surgery for the ime to come back, sometimes it takes time.....

[1171]

both
have the surgery; let them fight about it whether your health insurance or comp should pay after wards.

[AQA]

when I had a surgey and WC had not finalized thier part.

When I was given the paperwork to sign before the surgery. I never signed the one that said I would be responsible if the IC did not pay.

When ever I had an issue at the pharmacy about getting my meds. I always had them run it through my personal insurance. I would then call my personal IC and let them know whats going on. From that point, it was an issue between my personal IC and WC.. Not me.

[Bad Boy Bad Boy]

Go for the surgery, and see what happens.

I remember one time, I was naked, on the table, IV's installed, and sheet over my body, when I was told no surgery not been approved, and had to go home. Next time, still not approved, Neurosurgeon took it upon himself to say it was an emergency surgery, and just performed it, the WC Insurance paid it.

[kartim]

Thanks for all of the replies and I'm sorry for not getting back to all of you. I went ahead with the surgery. The Dr did a scope and found/repaired a torn ligament, torn cartilage and released a tendon. I'll be in casts and splints for about 2 1/2 months then at least that much of therapy.

I'm now receiving WC checks, however my employer reported my wage incorrectly and they sent too much money. Now I'm working with them to figure that out. Why can't things be simple?

[1171]

because too many are involved and you're not paying for it.
things were much simpler when we paid for our own medical.
funny though--no one wants to go back to that......