Eleven things every injured worker needs to know

Author Subject: Eleven things every injured worker needs to know
Chris Posted At 14:19:09 04/28/2000
http://www.aiadc.org/media/012400DCatt1.htm


Eleven things every injured worker needs to know and may wish to ask their nurse adjuster caseworker? [This may be served as a legal discovery.]


1) Is your doctor treating you under a managed care contract with your employer’s insurer?
IF YES!

2) Will your treating doctor be required to ask for preauthoriation before conducting any diagnostic tests or medical procedures?

3) Are there "financial incentive bonuses" for controlling medical costs that your nurse adjuster or your doctor(s) are eligible?

4) Are there "Gag Orders" that restrict your doctor from being candid and honest about telling you about other possible treatment options, your medical prognosis or other issues?

5) Is your doctor able to make "unrestricted" referrals to other doctors outside of this managed care network?

6) Does your insurance company believe you should have "all" the information to make an "informed consent" to any clinical treatment plan? [Do not accept the words "necessary information".]

7) Will a copy of your treatment plan be provided to you as soon as developed?

8) In your state, in the event of a dispute, are discussions over "medical utilization" or other "issues" conducted without you knowledge?

9) Are states personnel a party to these discussions without your presence or knowledge?

10) Has your doctor relinquished "control" over your medical care to your nurse adjusters and claims adjusters?

11) In the event that there is a dispute or "issues" of causality, medical necessity, changes in diagnosis, descriptions of how your injury occurred, even if "fraud is suspected" will you have an opportunity to respond before the "opportunity of medical repair is lost" so that you may seek other avenues of medical intervention?
unknown Re: Eleven things every injured worker needs to know (Currently 0 replies)
Posted At 19:33:50 05/02/2000

Why haven't you explained the 12th thing...Those Insurance Comapnies will do everything within their power to make your treating doctors appear to be liers! With all the BOGUS IME doctors in this state, it is all within a signing of a check away...
Yes, Insurance companies will "hire" and IME to lie for them...
Adding that 95% of the time an IME will WIN over your treating doctors!
There will be nothing you can do about it...
But bend over and smile!

terrejo Does every injured worker need a lawyer? (Currently 0 replies)
Posted At 14:04:27 05/24/2000

does every injured woeker NEED a lawyer? And how soon should one be hired?
Who pays for lawyer? Have any good lawyer referrals in Portland area?
Del Re: Hiring an Attorney (Currently 0 replies)
Posted At 14:50:55 06/16/2000

terrejo,
So others see your request, start a new posting from the main forum page. Once a posting is about a week old it doesn't get many visitors.

I know that WI doesn't recommend attorneys but injured workers can give you advice.

Here's some links:

How to Choose an Attorney.

lawyers.com Look Under Hiring a Lawyer for Advice.

How to Prepare for a Deposition.

Attorney Fees.

Attorney Referral Posting.

Del Re: Eleven things every injured worker needs to know (Currently 0 replies)
Posted At 13:23:43 06/18/2000

To correct any misunderstanding in the wording of my last post, I believe WI doesn't recommend "specific" attorneys.
My own views are that if an injury requires more than a few weeks off work or any type of surgery is required, you should hire an attorney. At present time, ins. companies are allowed 90 days to accept/deny a claim.

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