Redding, CA asked in Workers' Compensation, Health Care Law and Insurance Bad Faith for California

Q: Can you sue a insurance Co. for not given you the care that you were awarded by a judge.Im 2 years with out a urologist?

I'm 100% disabled with W/C. I have gone 2 years without a urologist because nobody will take W/C. I was awarded it along with other things from a judge.I don't know if the insurance company is responsible or the Workers Comp system because not getting the right care is deadly.So could I sue the insurance company, Workers Comp or the state of CA for not getting the care that was awarded/promised to me? I can not believe that this happens to so many people and all I want is the care I need to stay alive! I would like to know who should be responsible for the stuff I have had to endure because the insurance company and the W/C appeals board has left me hanging in waiting for more or less for me to die!! It's wrong on so many levels and it's time light is shed on this injustice going on in CA.

2 Lawyer Answers
Domingo R. Castillo
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Answered
  • Workers' Compensation Lawyer
  • Indio, CA
  • Licensed in California

A: I agree with our comments and understand your frustration with the broken California workers comp system. It's broken for the injured workers of Calif but the insurance companies are very content and happy with it. I'm not sure if you ever had an attorney on your case but we would like to assist you on your case. We have offices in Riverside, San Diego and Imperial Counties. Please call us at your convenience to answer more of your questions and assist you on your issues on obtaining fair and quick medical care. We can assist you on getting a Urologist right away along with any other medical speciality within the Medical Provider Network. We have over 35 years of combined experience and have recovered over $250,000,000 in settlements, disiability, medical and mileage benefits for our clients. Please feel free to call me.

Very Truly,

Domingo Castillo Esq.

Castillo & Associates

(800) 497-9774

(760) 863-4800

(619) 281-4400

Offices in San Diego

Riverside and Imperial County

Nancy J. Wallace
Nancy J. Wallace
Answered
  • Workers' Compensation Lawyer
  • Grand Terrace, CA
  • Licensed in California

A: Sue in Civil Court for a Workers Comp law violation? NO. Can you File an Application for Adjudication of Claim with the Workers Compensation Appeals Board and get a WCAB (state) case number, and then file a petition for penalties for unreasonable refusal to provide medical treatment per Labor Code 4600? Yes. That's sort of 'suing'. IF YOU WERE AWARDED a specific visit with a specific urologist 2 years ago, you should have secured a lawyer and pursued sanctions (fines) for tactics designed solely to delay and harass by now... but i'm pretty certain that is not what happened. When a judge's order states 'future medical treatment' and is NOT an order from a judge that any and all requests are automatically authorized... 'future medical treatment' orders are just the right to fight in court over each treatment request. It's insane. It's the law your assemblywomen and state senator put in per Senate Bill 863 and nobody gets any treatment now (not even the san bernardino terrorist shooting victims) but nobody campaigns against their assemblywomen nor their state senators not the governor. SB863 put in a system where the insurer's Medical Provider Network doctor writes a REQUEST FOR AUTHORIZATION (RFA Form) plus a medical report for your urology referral, then the insurer sends it to a reviewing doctor and that doctor 'non-certifies' the recommendation 86% of the time, then you are to file a Request For Independent Medical REview , the IMR. then the IMR denies the treatment, and the insurance company gets to use that against you to keep denying that treatment for ONE WHOLE YEAR. It's the law. People should be picketing and campaigning against every state senator, but they do nothing. And they get no care. And nothing changes.

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