Legal Question in Workers Comp in California

my claim is currently denied. I paid for prescription because I could not wait for the carrier to approve them. Can I send the receipts to the adjuster so I can get reimbursed?

Asked on 10/03/18, 6:37 pm

1 Answer from Attorneys

Nancy Wallace Nancy Wallace Atty at Law

No. When the whole claim is denied, the adjuster cannot pay anything at all. If just the physician's request for the one medication was denied, you can appeal that in writing to the reviewing physician and file the form for the Independent Medical Review (the IMR). right now, 91.6 % of IMR requests are denied, Maximus' nameless, faceless 'doctors' don't approve even 9% of what hurt people beg for, so the best bet right now is to get a report from your primary doctor explaning in great detail how and why you were hurt on the job, and file for a trial to prove the injury IS work-related. AND if you have no idea where to start to get that done, you need an experienced lawyer to do that immediately.

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Answered on 10/04/18, 5:08 pm

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