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Thread: workers compensation ? help!

  1. #11
    Rx = prescription.

    Zambi, do you have a nurse case manager assigned to you by the workers' comp company that you are covered by? Many companies assign one when someone has a catastrophic disability, and this person's responsibility is to coordinate identification of your care/equipment needs with the specific WC policy your employer has. If not, you should inquire about getting such a case manager assigned. I know several who work for USA WC companies and provide case management services for clients who live in other countries (mostly Latin America).

    (KLD)

  2. #12
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    That's very interesting, thanks KLD. I'm currently dealing directly with the complex claims director. I'll ask!

  3. #13
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    [QUOTE=Zambi;1836016]
    Hacknsack44 you may be able to help me actually. Did you need a doctor to state that you needed a new van and wheelchair every five years? Does it mention a particular model, or value? I don't think my doctor is going to want to write a letter about mobility equipment to an insurance company ? they tend not to want to put anything but medical diagnoses into writing. Which leaves me a bit stuck.

    No, that was the nurses job. She did all the research to figure out what I would need for the rest of my life. When it is time for a new wheelchair or vehicle I contact my adjuster and she contracts the DME they use. It usually goes pretty smooth. I get to pick what wheelchair and vehicle I want .

  4. #14
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    Quote Originally Posted by nmireles View Post
    Workers comp in Arizona accident since 93 T-10 Para. I settle a long time ago for a lump sum from accident. Chose a lump sum instead of receiving monthly payments. In the settlement they agreed to cover all of my dme medical equipment, urological all stuff necessary for me to be in this wheelchair. With the exception they wont' do any home modifications or vehicle modifications. They will cover any thing that my Dr. writes a Rx for and I mean anything. I don't abuse the system so my case manager even calls me just to see if I need anything. With my lump sum settlement I purchased a an annuity. They pay me every month tax free for the rest of my life. I don't have to claim it as income pay no taxes at all. It's for life and does not pass on after my death.
    I'm guessing with your injury level you do not need attendant care or just a few hours here and there. What happens if need it 24 hrs 7 days a week in the future? Just curious?

  5. #15
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    thanks again to you and KLD. They are going to provide me with a nurse assessor now. I wouldn't have known about it if you hadn't have told me

  6. #16
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    KLD – I just wanted to write with an update, and a massive thank you. Since your advice, and being able to identify a nurse assessor, they have worked to comprehensively assess my needs and present that in a compelling way to the insurance company. Since then, I've got a top of the range powered wheelchair, wheelchair accessible where I can ride upfront, big turning system, physiotherapy sessions and much more. I struggled for ages by myself trying to figure things out and it's only thanks to your advice and the other guys he replied that my life has completely changed. I can't really thank you enough. I just hope something wonderful happens in your life in return!

    Quote Originally Posted by SCI-Nurse View Post
    Rx = prescription.

    Zambi, do you have a nurse case manager assigned to you by the workers' comp company that you are covered by? Many companies assign one when someone has a catastrophic disability, and this person's responsibility is to coordinate identification of your care/equipment needs with the specific WC policy your employer has. If not, you should inquire about getting such a case manager assigned. I know several who work for USA WC companies and provide case management services for clients who live in other countries (mostly Latin America).

    (KLD)

  7. #17
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    Finding legal representation in the US remotely from the UK

    Hi all


    Further to my other post regarding my Foreign Voluntary Compensation/Foreign Voluntary Workers Comp (FVC/FVWC), wanted to update to say I was successful in obtaining vehicle, new wheelchair and various other things from the insurance company thanks to your advice. I'm very grateful to you all.


    Now, the insurance company wants to settle the claim. This type of policy is quite unusual but is basically equivalent to Workers Comp. I am British, but worked for New York City-based employer. I don't know where to begin trying to find legal representation to settle this claim. I don't know if they have to be in NYC or can be anywhere in the US? Does anyone have any ideas or recommendations? Google turned up only one firm https://www.brownsims.com/practices/workers-compensation/
    like I say don't know if it matters that they are based in a different state?


    Many thanks in advance

  8. #18
    Workers' compensation (WC) is a state program in the USA, so it is best to obtain legal counsel from an attorney in that state. In California an attorney has to be certified by the Workers' Compensation Board to represent you before them. No clue if this is a requirement in NY.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  9. #19
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    Quote Originally Posted by Zambi View Post
    Now, the insurance company wants to settle the claim. This type of policy is quite unusual but is basically equivalent to Workers Comp. I am British, but worked for New York City-based employer. I don't know where to begin trying to find legal representation to settle this claim. I don't know if they have to be in NYC or can be anywhere in the US? Does anyone have any ideas or recommendations? Google turned up only one firm https://www.brownsims.com/practices/workers-compensation/
    like I say don't know if it matters that they are based in a different state?
    If all of your medical is covered in the UK and you plan on staying there maybe setting is the right thing to do. Here in the US most people on Medicare or Medicaid have to fight for the simple things. They get very little if any attendant care help. It's horrible.

  10. #20
    I'm Workers Comp. in Washington for 46 years. They offered me the same talk of settlement. That entailed them not being responsible for bills and DME equipment. It was like 50 grand or so. Not a bad sum of money back then. Thankfully, my counsellor for L&I suggested I fight for compensation. Which I did. Your lifespan may be a long one. If I had taken even a million dollars settlement, It's a drop in the bucket what it would have cost me to live 46 years post. You're best bet is to contact a sci support group or similar to get their recommendations. I'm sure a Floridian in the know will post.

    Don't sign anything without having it checked out. Ensure it's all in writing including DME and health related issues considered. I would have been screwed had I trusted them. They've been great since.

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