WC Insurance - after the settlems payments

[RAnn]

In Sept 2004 DH's WC case went to court and was settled with the determination that he is 100% disabled. Though not pleased with the monetary results I realize in NJ that it is not arbitrarily set numbers - basically we get what we get.
Since DH's accident the insurance company has been a real pain in the behind-the clerks made decisions based on their feelings as far as payments. It was a constant struggle to get the bi-weekly amount and reimbursement for perscriptions.
The settlement papers signed by the judge are very specific as to what is to get paid:
-Any treatment recommended by Dr X (DH's pain management doctor)
-Any perscriptions relating to his injury and mental stability
-Bi-weekly payments.
Well-Dr X has been trying since before the settlement to get DH approved for an electric stimulator in his back. Insurance Co keeps denying - they even had DH go to "their" doctor again and he wrote a report saying DH is not disabled.
We did get them to pay Walmart for perscriptions so we do not have to get reimbursed however they still refuse to pay for an anti-depressent that was ordered by Dr X.
And-to top it off - they have now stopped paying his bi-weekly checks!
Our attorney has contacted ins co atty and they don't even listen to their atty -refusing to honor court papers. Then this week our atty tried calling ins company and couldn't get a "live" person. Our atty keeps saying we'll have to take them back to court but why is this so hard? Granted the bi-weekly pmts only stopped 2 wks ago but at this time of year every penny counts. But the other stuff has been going on since the beginning.
Is there anything else to be done? (I kind of have a feeling that "this is your life Charlie Brown" and this is the way it will be until forever)
thanks
RA

 

[Beth3]

The only thing that can be done if the WC carrier is not complying with the settlement agreement and not acting in good faith is to go back to court. (Actually, it will most likely be a hearing within the WC Division with an Administrative Law Judge.)

I don't know why the WC carrier is giving your husband the run-around but the State has the authority to levy fines upon the WC carrier and even revoke their license to operate in your State if they get ticked-enough and if this is an on-going pattern of how they handle their WC claims and flout settlement agreements approved by the State.

Good luck.

 

[RAnn]

Thanks for the response but the problem seems to be that our lawyer isn't doing anything - he keeps making promises to file a motion but never does. It takes constant phone calls to "catch" him in the office otherwise he never returns phone calls. (I might also add that prior to the settlement we were going with the head of the practise, after the settlement he has delegated us to a "lesser" atty.-he knows what's going on though).
Is there any incentive for these guys to work? They got a lump sum pmt at the settlement but who will pay them for their time now? We certainly can't.
Can we find another lawyer? Would anyone actually take this on?
thanks
RA

 

[Beth3]

Of course you can find another lawyer. You hired this guy and you can fire him.

I suggest you consult with several other WC attorneys and if you find someone you feel will more adequately represent you, you may sever your relationship with your current attorney. Something will have to be worked out regarding any fees-to-date that you owe him however. Discuss that with your new attorney.

 

[RAnn]

I didn't want to hear about "any fees to date" - we were under the impression that after the lump sum it would never cost us anything for any continued legal work pertaining to the case. (I just don't know if we were stupid but I thought I remembered asking the lawyer once about it). WE've never received any bills.....
That's the problem - if we go to another lawyer I'm sure he will want some sort of retainer. No $$$ for anything.
So I guess we're just stuck with what we got
thanks
RA