My fiance works as a union laborer, so he have a tough time corresponding with his insurance company during business hours. He doesn't really know how to use computers that resourcefully, so I do a lot of correspondence for him. Well roughly speaking a year ago his doctor said he should go to physical psychiatric help (there is a note within his chart showing it was medically necessary) for his unpromising back. The insurance company insisted they needed a notification from him stating what the injury was. Well nearby was no injury, of late wear and tear. So I wrote that his desperate back be exacerbated by his work. I did NOT write that he suffered an injury while at work. So now the insurance company say it's a workmans' comp issue and they are refusing to retribution the $2800 for his PT. What do we do? Is he now forced to sort a workman's comp. claim or can he prove to the insurance company that he is NOT seeking workman's comp? Is he now stuck next to the bill because I worded the letter inappropriately?
Answers: ...Keep at it, sometimes its a matter of communication. Insurance companies regularly check to produce sure they aren't paying for something that someone else should be paying for. I am sure it will just thieve a little more clarification to achieve it all straightened out. I am sure somewhere surrounded by the medical records it may voice that there be no specific injury (otherwise called "insidious onset") and that work lone worsened the symptoms (not caused it). Ask your providers (PT and MD if this say this anywhere in the chart, later get a copy and provide it to the insurance company.
He is probably stuck. If he tries to database a WC claim now, the WC shipper will probably decline it because he never reported an injury to the employer (required for WC). I suspect the insurance company is just trying to fob this bad on worker's comp. If they are basing their allegation solely on what you wrote, you should write them another reminder and point out that you are not a professional and you are not a care provider. In other words, report to them you mis-spoke. You should also get documentation from the physical analyst and anyone else stating that there be no injury, and that the back condition be not exacerbated by his work, if you can.
Try to find one person at the insurance company who you can speak to in the order of this case and ask them how they hold decided it's a worker's comp issue. That will assist you to know how to proceed. It also occurs to me that if your husband have an HR department where he works they could procure involved in this. They enjoy a vested interest in it not becoming a worker's comp baggage too.
Yes, that's your goof unfortunately. You told them it be from work so it became a worker's comp issue. Whenever you acquire a letter asking if someone else is responsible don't let somebody know them someone is if they're not. They won't want to pay when someone else is supposed. Would you?
Next time you get hold of a letter similar to that in the e-mail, have him overrun it out. He can't "not seek workman's comp" if the injury be due to his "work." They want the someone else to pay if someone else should rate.
Perhaps in the fall it is a workman's comp issue. Why are you fighting that?
Good luck.
They are assuming it's workers comp, because YOU told them it be!! Refer to the above - "exacerbated by work". That's what workers comp was. It's not an incorrectly worded letter - you flat out said, it be related to work.
What confuses me, is why they'd take YOUR word for it. You're not related to him. Unless he signed the tabloid, which means he AGREED to everythign you wrote.
You're surrounded by a pickle. It's too late to folder the comp claim.
See, it's not up to him to choose if he's filing it below comp or health insurance. He doesn't obtain the option. All workers comp claims MUST be file through comp, and his health insurance probably have an exclusion for anything work related.
He's going to have to appeal the claim - him, not you. He's going to hold to say that YOU give them the wrong information. It might get you within trouble, if you signed his name (that's forgery). That's the first step.
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Answers: ...Keep at it, sometimes its a matter of communication. Insurance companies regularly check to produce sure they aren't paying for something that someone else should be paying for. I am sure it will just thieve a little more clarification to achieve it all straightened out. I am sure somewhere surrounded by the medical records it may voice that there be no specific injury (otherwise called "insidious onset") and that work lone worsened the symptoms (not caused it). Ask your providers (PT and MD if this say this anywhere in the chart, later get a copy and provide it to the insurance company.
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He is probably stuck. If he tries to database a WC claim now, the WC shipper will probably decline it because he never reported an injury to the employer (required for WC). I suspect the insurance company is just trying to fob this bad on worker's comp. If they are basing their allegation solely on what you wrote, you should write them another reminder and point out that you are not a professional and you are not a care provider. In other words, report to them you mis-spoke. You should also get documentation from the physical analyst and anyone else stating that there be no injury, and that the back condition be not exacerbated by his work, if you can.
Try to find one person at the insurance company who you can speak to in the order of this case and ask them how they hold decided it's a worker's comp issue. That will assist you to know how to proceed. It also occurs to me that if your husband have an HR department where he works they could procure involved in this. They enjoy a vested interest in it not becoming a worker's comp baggage too.
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Yes, that's your goof unfortunately. You told them it be from work so it became a worker's comp issue. Whenever you acquire a letter asking if someone else is responsible don't let somebody know them someone is if they're not. They won't want to pay when someone else is supposed. Would you?
Next time you get hold of a letter similar to that in the e-mail, have him overrun it out. He can't "not seek workman's comp" if the injury be due to his "work." They want the someone else to pay if someone else should rate.
Perhaps in the fall it is a workman's comp issue. Why are you fighting that?
Good luck.
They are assuming it's workers comp, because YOU told them it be!! Refer to the above - "exacerbated by work". That's what workers comp was. It's not an incorrectly worded letter - you flat out said, it be related to work.
What confuses me, is why they'd take YOUR word for it. You're not related to him. Unless he signed the tabloid, which means he AGREED to everythign you wrote.
You're surrounded by a pickle. It's too late to folder the comp claim.
See, it's not up to him to choose if he's filing it below comp or health insurance. He doesn't obtain the option. All workers comp claims MUST be file through comp, and his health insurance probably have an exclusion for anything work related.
He's going to have to appeal the claim - him, not you. He's going to hold to say that YOU give them the wrong information. It might get you within trouble, if you signed his name (that's forgery). That's the first step.
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