Q: Can I have a lawyer go after my Workers Comp insurance for not returning e-mails or phone calls regarding my case.
My Workers Comp insurance does not have any providers in their network to give me a second opinion on my shoulder injury. I received an email from their provider network unit that they could not find a provider and that the adjuster assigned to my case had permission to authorize for me to go to an out of network provider. I forwarded the letter to both my adjuster and her supervisor but I have gotten no response. I have also left voicemails for both, and though their voicemails say they will reply within one business day, I have yet to hear from anyone.
I have been in pain since February of 2022 and have very limited mobility of my right arm. I can not work out, extend my arm out for a handshake, properly shave my head or reach for a cup from the cupboard. I wake up minimum 7 or 8 times a night to relieve the pain. I can not go on like this.
Can I please get some help.
A: never allow a claims person to choose your doctor. you should hire an attorney to take medical control of your case for you and get your case on track. it costs you nothing to hire an attorney out of your pocket.
A: Filing for a hearing would likely help or better yet...hire a competent attorney. You have described some serious injuries. Do you know that most attorneys only charge 15% of the total settlement amount and that they cannot agree to any settlement without your permission? What are you waiting for? Do you think this is all worth the 15%? Do you think you can get as much or more compensation as a competent seasoned attorney? Stop suffering and start interviewing work comp attorneys who can help. I promise once you do that, your situation will no longer be ignored.
A: There is no penalty for an adjuster not answering you. But it guarantees you are going to hire a lawyer. An experienced attorney can elect a physician outside the network when she shows there are no available specialists inside the network. Sounds like you really need a Pain Management Specialist. As my colleague notes, you don't want the insurer to pick your doctors! You want someone on your team to pick a real doctor, one not 'in bed' with the insurer. Speak to your local certified specialists in workers compensation law, and choose a group where the lawyer -- not the unlicensed assistant -- will be handling the claim and going to court.
A: Under California law, if your workers' compensation insurance is not responding to your legitimate inquiries, you can indeed seek legal assistance to ensure that your rights under the workers' compensation system are upheld. Failing to respond to claimant inquiries in a timely manner may be considered a form of bad faith by the insurance company. Legal action can be taken to address this failure to communicate, which could include filing a complaint with the California Department of Insurance or pursuing litigation to enforce your rights and potentially obtain the benefits you're entitled to.
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