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2 Denials, 2 Insurance Carriers

Discussion in 'Workers Compensation' started by lora000, Jul 23, 2018.

  1. lora000

    lora000 Law Topic Starter New Member

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    I'm a female in my 40’s from FL with no prior health conditions.

    In the past 3 years I hurt my lower back at work twice, first time in March 2015 and after 4 month I was released by the work comp DR to go back to work on full duties with no restrictions.

    The second injury was on January, 2017 and I returned directly to my work comp Dr. and instantly received treatment.

    Work comp doctor send me for 3 MRI in the past 3 years. The MRI results indicated multiple bulging discs, multiple central canals stenosis, multiple annular tears, inherited as well as fusion disc.

    Treatments included 1 cortisone and 2 Epidural, 18 physical therapy sessions and variety prescription drugs. Currently, I have pain in lower back radiating to my left leg and numbness in groin and inner thighs.

    The Dr. sent me back to work on light duties but employer did not have work for me and after 4 months they fired me. I'm out of work from April 2017 and still under work comp doctor restrictions.

    For the last year and a half the work comp doctor and the insurance company/employer treated my second injury as an extension of the first one.

    However, this was changed last month (June 2018) when I received letter from the 2015 insurance company denying my claim that on the date of my second injury the company I used to work for had different insurance carrier. The insurance company argues that the "major contributing cause" was in the second injury so this is not their responsibility.

    In the same time I received letters from the 2017 insurance carrier claiming that "there was no injury by accident that resulted from employment and failed to timely report accident" so they denied my claim as well.

    Currently, my case is denied by 2 different insurance companies and I'm not getting any compensation and or treatment.

    What will be the best way to handle this situation?

    Your help is greatly appreciated!
  2. hrforme

    hrforme Active Member

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    This is one where you probably need to be speaking with an attorney.

    Although I will ask if your employer specifically sent you to the doctor in 2017 for treatment and whether you followed that up through your employer/HR with either re-opening of the old claim with the insurance company OR starting a new one? Did all the paperwork from each treatment get sent to the insurance company and the employer?

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