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02-26-2010, 12:54 PM
Post: #1
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Done
Ok So I had mediation, settled on an amount and now I get to go see a real doctor.
The first offer they gave me was so rediculous. I mean come on, Work comp must get such a big discount on everything. They tried to tell me in the past 2 1/2 years they only spent (on medical) 23000.00(that doesn't include the monies they have given me) I find that hard to believe with 3 surgeries, and 9 months of PT 3 days a week and all the meds and other test like x-rays, MRIs, arthrograms, a bone scan, blood tests and a shrink. Oh but they also forgot all the money they have paid to my attorney and oh their own attorney. just at my mediation my attorney had his fees in there of 10,000.00 (seperate from my settlement, Which he gets a percentage of also.) The first time he went to court, he got paid 10,000 for fees and such. So I know they have had to spend more then 23000. with all the other stuff. They don't look at it like that though. I could have walked out keeping my case open till the day I die, but I just wanted the w/c off my back. One other thing, If they do infact pay so little to medical providers and such, why the big fuss about authorizing stuff, especially from Doctors, they send you to????????? I am glad its all over and I will be happy to be seeing a real doctor that doesn't get paid pennies on the dollar and is willing to fix me. Ok I am done I have had capsulodesis scaphoid, capsulodesis lunotriquetral joint wrist, debridement of triangular fibrocartilage all in my right wrist and a tendon sheath release(that was just one surgery) & a lunotriquetral fusion Plus now a wrist fusion |
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02-26-2010, 12:56 PM
Post: #2
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RE: Done
that is why it is so hard to get a good Doc in WC they pay pennies on the dollar
;)Workmans comp is not a road you want to travel alone.You need a good lawyer,a great family and good friends to lean on.If you make it thru without losing everything you have worked for all your life,you have come out ahead of the game..... 
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02-26-2010, 01:42 PM
Post: #3
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RE: Done
I am so happy your happy.
But, I ask, how you going to get a doctor (a real Doctor) to treat a work comp injury now? Your healthcare insurance wont cover it. So, do you mean, you will pay for a (real Doctor) now from your settlement money? Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor. |
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02-26-2010, 03:07 PM
Post: #4
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RE: Done
Bad Boy Bad Boy Wrote:I am so happy your happy.This is so true. My healthcare provider will not touch my work related injury. The only way they will pay for anything concerning my injury would be when a MSA is exhausted. Do you have a Medicare setaside(MSA)? 2011 Lexus Convertible |
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02-26-2010, 08:14 PM
Post: #5
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RE: Done
No I will pay for the doctor out of my settlement. I have already seen him and he is looked over all my records and is going to do the surgery I asked my original w/c doctor to do.
I have had capsulodesis scaphoid, capsulodesis lunotriquetral joint wrist, debridement of triangular fibrocartilage all in my right wrist and a tendon sheath release(that was just one surgery) & a lunotriquetral fusion Plus now a wrist fusion |
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02-26-2010, 08:42 PM
Post: #6
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RE: Done
Cookiecrum Wrote:No I will pay for the doctor out of my settlement. I have already seen him and he is looked over all my records and is going to do the surgery I asked my original w/c doctor to do. Why no MSA(Medicare setaside)? This all seems wrong but I am from the outside looking in. You need surgery for your work related injury almost immediately after you settle? 2011 Lexus Convertible |
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02-27-2010, 01:58 PM
Post: #7
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RE: Done
Only if Cookie is on SSDI is there a Set-Aside Free Bird!! I'm not Sure if They are or Not. I'm Glad You're Happy and Settled, and are going to get the Care You Need from a Dr. You Trust!! Best of Luck with All!!
Failed Back Surgery, Chronic Pain, Totally Disabled. Knowledge is Power, Especially in the World of w/c. Learn as Much as You can about Your States w/c Laws, and don't Fight Battles alone, They Use Attorney's, and so Should You!! |
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02-27-2010, 02:42 PM
Post: #8
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RE: Done
Still in Limbo Wrote:Only if Cookie is on SSDI is there a Set-Aside Free Bird!! I'm not Sure if They are or Not. I'm Glad You're Happy and Settled, and are going to get the Care You Need from a Dr. You Trust!! Best of Luck with All!! This is true. My bad. http://www.cms.hhs.gov/workerscompagency...taside.asp CMS Review Threshold It is not in Medicare's best interest to review every WC settlement nationwide in order to protect Medicare's interests per 42 CFR 411.46. (Ref: 7/23/01 Memo Q1©) A WCMSA is not necessary when resolution of the WC claim leaves the medical aspects of the claim open. A WCMSA may be submitted to CMS for review in the following situations: The claimant is currently a Medicare beneficiary and the total settlement amount is greater than $25,000; OR The claimant has a "reasonable expectation" of Medicare enrollment within 30 months of the settlement date and the anticipated total settlement amount for future medical expenses and disability/lost wages over the life or duration of the settlement agreement is expected to be greater than $250,000. 2011 Lexus Convertible |
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