Q: Can WC deny my future medical? My case was settled and won in 1996!
Took future medical on certain body parts as my settlement and now they are denying what my neurosurgeon says I need. They are now denying my medications as well. How can I fight a case that's already been won? What can I do?
A: Actively campaign against your Assemblywoman, State Senator and Governor, because the law they put in to 'fix' workers comp let's adjuster deny all the injured workers' treatment! The California Labor Code forces the worker to see the insurer's doctor, then let's the insurer deny the request of their own doctor...then you can only appeal to 'Maximus' in the Independent Medical Review, and more than 80% of the IMRs are denied ... denied by nameless faceless 'doctors' at Maximus. You don't get to know which doctor at Maximus denies your treatment, you can't find out if they are currently licensed or have malpractice actions against them or where they studied. The doctors the adjuster uses to deny the Network doctor's request can be out of state or of the wrong medical specialty. Just any MD can write to the adjuster that the Treating Doc's request should be denied, then the faceless Maximus doctor writes that the request should be denied, then YOU GET NO TREATMENT. Why injured workers re-elected their assemblymen and state senators for this torture is a complete mystery.
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