Q: Judge ordered back benefits to be paid by insurer and reasonable medical treatment. Its been 41 days without a check.
I live in Pennsylvania, from what I understand they have 20 days to pay the back benefits. My lawyer contacted their lawyer and he has no idea what the deal is with the insurer and why they have't paid. My lawyer is filing penalties against them as we tried to make contact several times with no reply. Can the insurer just ignore the Judge and not pay or just somehow keep me waiting until I am living under a bridge? In short how long can they drag this out? This whole thing has been a nightmare and even after "winning" my case they are still giving me grief. I just don't get it...
A:
I am sorry to hear the problems that you are having with your Workers Compensation Claim.
As you are represented by Counsel, these questions are better opposed to your Attorney.
Under Section 406.1 (a) of the Act, the Workers Compensation Carrier is required to make payments within 21 days of the acceptance of your Claim. I believe that said Section also applies to Judicial Decisions. If payment has not yet been made, your Attorney should proceed with the filing of a Petition for Penalties and can also place both the Employer and its Workers Compensation Carrier on notice of a Default Judgment in accordance with Section 428 of the Pennsylvania Workers Compensation Act, as amended. I find this latter "threat" typically prompts payment promptly thereafter.
The issue of payment of medical bills and/or "pre-authorization" for your surgery is a separate issue, and may require the filing of a prospective Request for Utilization Review and/your Petition to Review Medical Treatment and/or Billing.
Please discuss these issues with your Attorney, and if not satisfied, you are always free to locate alternative counsel.
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