WC challenges

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WC challenges

Postby guest » November 28th, 2005, 5:07 pm

I have for the last two years been dealing with a rejected injury claim. The back injury was verified and presumably accepted. It turned out however that the insurance company waited until the last moment to reject the claim( for 90 days I had no reason to expect anything but acceptance). I was shocked and began asking around to learn more about my rights. I started with the internet and read all I could about WC law, including this site. I talked with the state ombudsman and sought their assistance but finally gave up and sought legal representation( the best I could find). The attorney filed an appeal and after many months of delays, including the insurance attorney deciding to take a vacation resulting in us going to the end of the hearings line, we finally pevailed in front of the hearings officer. My claim was reinstated and I thought it was all over. Boy was I wrong! The insurance company waited until the very last minute to assert its appeal rights and sought a hearing before the court of appeals. Do you see a pattern here?--- they are trying to starve me out! This term is very familar to those of you that have experienced a claim denial. The sad part about this tortured dance is that the case is now in the hands of three appeals judges and their decision is final. If they choose not to see the merit of my claim I am stuck with a severely damaged back a potential career ender( truck driver). The sad part is that but for friends no one seems to want to hear about what I have gone through. Its one of those situations where no one wants to listen because they dont care until a similar situation drops in their lap. I guess changing the law is the only way of streamlining this process but judging from the general apathy of the public and the insurance companys love of complexity dont hold your breath. Without legal assistance I would have been hung out to dry. I might lose but it wont be without a fight.

I understand your grief

Postby nativespecialty » December 10th, 2005, 8:43 pm

I have been on disability since late 2002 for a herniated cervical and lumbar disks. L&I stopped my time loss after I attempted to return to work part time and failed ending up in the hospital and very ill for the next 9 months. My private insurance carrier sent me notice last month they were not going to pay my disability benefits anymore, but I can appeal. In the meantime, just before the holidays, I have been left with zero income! I am single. I have had three mediation phone conferences with L&I in the past several months. The first two they delayed because they didn't have all my records. They are trying to starve me out. So I applied for unemployment benefits. This is "pending", however my doctor would not release me to full time work so I doubt if I am eligible. With no other choice, I will have to get a job knowing I cannot physically handle it for long. Then they will say "see you CAN work". I am damned if I do and damned if I don't. All you can do is to keep fighting the system! Hang in there!

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