Q: I was injured on a job over 10 years ago and I my doctor wrote me out 0% disabled with the possibility of surgery needed
Again in the future. Its now the future but, who's responsible for the surgery?? There was never a timeline put on the paperwork
A: You need to seek legal counsel with a competent Workers Compensation Attorney. If the matter was Stipulated with Medical Open for the Future, you will probably need to go through the insurance carriers Medical Provider Network of orthopedic doctors. However, most of them are not on your side so a good attorney should be able to get you connected to a good MPN doctor. Good Luck.
A: The insurance. Will you get the surgery if you request it? NO. You will need to get a PTP (within the MPN) which based on his medical opinion will decide if you need surgery. If he states you need it he will make request for authorization to the insurance. Insurance will send it to Utilization Review which a doctor that has never seen you will decide if you need it. Most likely he will decide against it. You can then appeal the decision of the UR and send it to Independent Medical Review. Another doctor has never seen you will decide if it is necessary. Most likely he will decide against it. You can try to find an attorney to take your case however most likely than not he will not take it because there is nothing for him to get paid on since you have a 0% indemnity and it has been over 5 years since DOI to re-open. Good Luck.
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