HELP! NY WC case

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Posted by Elaine on September 12, 1999 at 17:18:18:

I hope someone can help me in regards to my dilemma. I have an open 1994 WC case. From the onset of my initial injury my comp carrier has used one delay tactic after another in providing medical treatment and they are currently withholding treatment for established injuries. The initial injury was rather minor and only required a simple surgical procedure. But due to the court and comp carrier delays and the lack of approving immediate treatment this injury became serious and I needed a major surgical procedure.I continue to wait for a decision for another injury site. The comp carrier has blatantly refused the courts order for authorized treatment. I have waited for months even up to a year for medical/surgical intervention. I'm in desperate need of surgery, medical tests and PT. My expenses and medical reports are constantly disappearing from my file within the comp carriers facility. I live on pain and sleep medication and in counseling for depression. I have been on disability since Dec96.
I'm a Manager for a Fortune 500 company and had been placed under the supervision of a Disability Mgr. to handle my claim. In the interim I have pleaded on several occasions to this Mgr. for support and help in getting the necessary medical care I need so I could return to work back in 1997. He had conveyed to me "there was nothing he could do to expedite my treatment or obtaining wages the comp carrier had failed to pay me for 3 months". Then in 1998 he stated to me "that he was going through the same problems with other claims and more so since the company had terminated their contract with the comp carrier in 1998". As far as I know he never even contacted the comp carrier in my defense. I contacted our comp dept and spoke with a case worker, she was more concerned with how I obtained her name and number then she was with my situation, she could not do anything either. At this point I contacted the Regional Comp Mgr. and explained my situation with the treatment and wages. He called the supervisor at the comp carrier and told them to call me in regards to my wages, not a thing about my medical treatment. My pay was still delayed. Not once did the Disability Mgr. advocate in my defense for getting the necessary medical treatment I needed. The only correspondence I have received from my Disability Mgr. since 1996 is a letter I received May 7,99 advising me if I do not return to work full duty with or without restrictions I will be terminated on June 30,99 as per company policy. I feel the comp carrier has deliberately dragged this on intentionally because they are aware of my companies policy and knowingly knew I would be terminated in 30 months.

I currently have a lawyer who has been handling my case since 1995. Not much has been accomplished. I have received 5 letters of correspondence in 4 years. I worked out of state from 1994-1998. My letters and fax transmissions go unanswered,I never know whats going on with my case,my meetings aren't productive, I receive a 3 minute pep talk prior to a hearing, pertinent issues are never addressed with vigor at the hearing, I'm still waiting to be reimbursed for medical/travel expenses from 1994 to present, outstanding medical bills are never addressed and my doctors are frustrated because they don't understand why my lawyer is not aggressively pursuing this case so I can receive the medical care I need. My lawyer was aware of me losing my LTD benefits and possible termination back in Feb99, I received no response. My lawyer is supposedly submitting letter's monthly for a priority comp hearing since Jan99. I have not had a hearing since Aug98. On my last visit I asked for a copy of the latest IME report for my records, he stated he "didn't have it, I guess I should get it". I do not call my comp carrier for IME reports anymore due to their rudeness and humiliation. I have asked my lawyer what my RIGHTS are and he responded "that I don't have any"? He also communicated to me that "I cannot hold my employer or the comp carrier responsible or liable for my disabilties, this is NY and thats the way it is". I found out through another source (not my lawyer) that I was entitled for SSD benefits, I had applied in the spring of 1998. I have not received a determination at this time.

As you can see I have been my own advocate through this ordeal. My lawyer and employer have failed me. I'm in desperate need for a competent lawyer who will work as a team to obtain what I am entitled to. I do not want to become another statistic due to my comp carrier and my employers negligence and unprofessional way of treating an individual with legitimate injuries. Maybe the comp carrier should focus on the individuals who they are crippling instead of the few who are defrauding the system.

I feel the comp carriers intentional and negligent practices has caused my health to deteriorate, my personal life has been affected, pain, despair, emotional distress, worry, anger and disappointment. Their conduct has been beyond all bounds of decency and unconscionable.

I didn't expect this to be so lengthy but I felt the issues I needed to raise would give you a clear portrait of my situation for any assessment.



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