After denying all tests for my elbow injurys the insurance company authorized 2 seperate surgeries as one. They only gave 6 weeks for the surgeries then didnt send the doctor a copy of authorization. Now with 2 weeks left the insurance are pushing for surgery to get done. The doctor is backed up 3 to 6 months for surgeries .This is after the judge ordered a weekly ttd rate of 787 and 22,000 back pay. Is 6 weeks typical for surgery ? And what if they never sent the authorization to the doctor ? And its 2 selerate surgeries to be done at seperate times the doctor clearly stated that. In his request yet they approve both to be performed in only 6 weeks. ? Is this legal .And they are refusing to raise my ttd as ordered by wcab judge. My attorney is making it seem my fault. I'm the one that went around him to ask the insurance approves surgeries so I could hopefully return to work.
I agree with Mr. Rutyna. This is your second post of the day on this issue. The main advice, again, is to have a face to face, sit down appointment with your lawyer to clear the air and develop a path forward.
1. No attorney likes it when the client end runs the attorney and communicates with the other side directly. By doing such, you are mocking your attorney, jeopardizing your attorney-client relationship, and reducing his or her negotiating power with the other side: I would not be surprised if your lawyer tells you to look for another attorney and then files a lien on your case for the reasonable value of his or her services;
2. Utilization Review, which reviews and either approves or disapproves all authorized treatment requests for work injuries in California, puts expiration dates on approvals of treatment. Nothing unusual in your case;
3, Utilization Review doctors second guess treating doctors constantly and modify or deny treatment authorization requests. This reality of Utilization Review is the brutal world that workers' compensation doctors, attorneys, and injured workers face daily;
4. Did an Order from a Workers' Compensation Administrative Law Judge actually issue raising your TTD rate? If so, is the Order or decision on appeal? Without reviewing all the case documents, no one here can determine if something is amiss, but something tells me you are not disclosing all the relevant facts and procedural matters.
Good luck on obtaining the proper treatment.