51 year old male in the HVAC industry for 30 years. Sustained 2 injuries with in a week- slipped and fell and lifted a HVAC unit. Claimed W/C saw the Occupational MD and she stated nothing wrong with me but scoliosis which I never knew I had.
Leg going numb and am working extreme limited duties (office work) . Had a consult with W/C specialist who wrote in report needs xrays but nothing done. Asked for MRI but being ignored. Contacted another MD in network and now getting run around. Mean time leg getting worse and basically have no MD to go to. Now W/C asking primary MD for all records from birth- this is the first injury in 28 years- do I have any rights to medical care??
Answer
Yes, you do have the right for medical care. Your best bet at this time would be to consult with a local workers comp attorney. Good luck.
Answer
A completed Request For Authorization form demanding a test must get an answer in 7 days (well, 5 business days). If you got the UR denial, that means the doctor did do the Request form. If you have nothing in writing from the insurer, the problem is doctor failing to fax the RFA Form to the adjuster.
You need to research a lot more doctors in the MPN; only about 2% are real doctors with real practices. 98% are 'in bed' with the insurer and won't file the forms right and won't ask the adjuster for any tests or real help.
Sometimes with scoliosis it's better to pick a group that has a chiropractor who refers to an Orthopedic Surgeon . Most Ortho Surgeons are scheduling 6 weeks out now in mid September because of vacations, but you might get a chiropractor to do a real RFA for an MRI to see where the nerve-root impingement is causing the femur nerves to be pressured.
THIS is where a local Certified Specialist attorney will be of great help; never pick the 'fight for you' guys on TV, do some real homework and find the right local guy who knows the real doctors in your area.
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