Surgery denied

Made brown

Well-Known Member
Sometimes you also have to jump through hoops. Physical therapy before surgery. Ive said it before here, your arm could be hanging from your shoulder by a single tendon and you will get ibuprofen and TAW.
 

rod

Retired 20 years
Sometimes you also have to jump through hoops. Physical therapy before surgery. Ive said it before here, your arm could be hanging from your shoulder by a single tendon and you will get ibuprofen and TAW.
Only the super rich get timely and expert medical help in the USA. The rest of us spend hours hours waiting in little rooms for a doctor to show up only to tell you that he wants to pass you on to someone else (so they can get a cut of your insurance money). Basically health care in the USA is a racket. Doctors are so afraid of getting sued for maltreatment they tend to not want to what they should.
 

oldngray

nowhere special
Only the super rich get timely and expert medical help in the USA. The rest of us spend hours hours waiting in little rooms for a doctor to show up only to tell you that he wants to pass you on to someone else (so they can get a cut of your insurance money). Basically health care in the USA is a racket. Doctors are so afraid of getting sued for maltreatment they tend to not want to what they should.
It would be much worse if we had socialized medicine here. Instead of waiting for hours it could be for weeks or months. Which is why the people with money come here to get treated.
 

rod

Retired 20 years
It would be much worse if we had socialized medicine here. Instead of waiting for hours it could be for weeks or months. Which is why the people with money come here to get treated.
Oh I know it could be worse (Canada) but it also could be a whole hell of a lot better.
 

Big Rigger

Well-Known Member
So friend’r up my elbow at work. Went through the process for their doc etc etc. doc said we need to do surgery and today get a call and it says denied bc a doctor somewhere else it’s not medically necessary. Need some insight what to expect from here on out. Obviously getting lawyered up. But it’s frustrating that someone hundreds of miles away has a say when they have not even seen me.
What state are you in??
 

Big Rigger

Well-Known Member
Btw...they normally deny all wc claims. As you were told GET A GOOD ATTORNEY from a reputable large law firm in a big city. Forget the small town representation. Ask stewards from a hub who they use. After you win that hang on for the ride. After you are totally healed up file for the settlement award for your body being injured on the job. It's a percentage of your body and it is normally a minimum of $3000.
Again, what state?
 

BigUnionGuy

Got the T-Shirt
But it’s frustrating that someone hundreds of miles away has a say when they have not even seen me.

Happens all the time.

Without a physical examination, all they are doing is reading the diagnostic codes from the first doctor.


And the company doctor was on your side ?

Kind of shows you how much UPS cares about you....

Contractually you can go to a 3rd doctor.

As long as the contractual language is followed.

It's not automatic.


Section 3. Third Doctor Procedure

"The Employer reserves the right to select its own medical examiner or doctor and the Union may, if it believes an injustice has been done an employee, have said employee re-examined at the employee’s expense. If the two (2) doctors disagree, the Employer and the Union shall mutually agree upon a third (3rd) doctor within ten (10) working days, whose decision shall be final and binding on the Employer, the Union and the employee. Neither the Employer nor the Union will attempt to circumvent the decision of the third (3rd) doctor and the expense of the third doctor shall be equally divided between the Employer and the Union".


 

born2Bwild

Well-Known Member
LM denied my surgery using the opinion of a doctor that never examined me or seen the MRI. They sent me to IME doctor and he agreed with my doctor.
I wonder if it is the same doctor. dr Fo**&$#
point is GET YOUR OWN DOCTOR AND LAWYERUP.
 

BrownMonk

Old fart Package Car Driver
So friend’r up my elbow at work. Went through the process for their doc etc etc. doc said we need to do surgery and today get a call and it says denied bc a doctor somewhere else it’s not medically necessary. Need some insight what to expect from here on out. Obviously getting lawyered up. But it’s frustrating that someone hundreds of miles away has a say when they have not even seen me.
Comp is based on State law. As bad as the company is, this is a liberty mutual call.
 
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