Q: I had a mri last September. When the results came back, my wc doctor was on a month vacation, so I had to wait for his
return. He read the MRI results and then submitted it to the WC Insurance company to respond, if it was accepted or rejected. I got NO reply/response from the insurance company for SIX more months. It was declined for surgery. It stated on the report that they (insurance co) did NOT receive it until March,,, six months. It seems that it must have gotten lost or whatever and it was declined! How long does or should it take for a reply (yes or no) as to the response?
A: Five (5) business days. Something else is going on. If you can prove the insurance company received the request from your doctor and did not respond within. Five business days you should be able to get the surgery authorization.
A: I suggest you consult with an experienced workers compensation attorney. The whole Calif Workers Comp System is a complete Joke & Sham controlled by the insurance companies and their puppets in Sacramento. You may also contact the Calif Applicant Attorney Association and ask for a list of their members and specialists. I wish you well in this ridiculous industry controlled by Insurance Companies.
3 users found this answer helpful
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.