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How to get L&I surgery oked that claims manager keeps denying Ortho Specialist has requested 3 times?Answer
If your claim manager keeps denying L&I surgery that has been requested by an Ortho Specialist, you can try the steps below to increase your chances of getting the surgery approved:
Understand the process: Familiarize yourself with the specific rules and guidelines of your state's L&I system. Each state may have different criteria and requirements for approving surgeries. Knowing these rules can help you make a stronger case.
Gather supporting documents: Collect and organize all relevant medical records, including letters from your Ortho Specialist explaining the necessity of the surgery, X-rays, MRI reports, and any other diagnostic test results. This will provide evidence supporting your need for surgical intervention.
Consult another Ortho Specialist: Consider seeking a second opinion from another Ortho Specialist to confirm the necessity of the surgery. Having two expert opinions can strengthen your case.
Communicate with your Ortho Specialist: Discuss the denial with your Ortho Specialist, and ask them to provide additional documentation or clarification of why the surgery is necessary. Ensure that all the necessary information is being shared and that your Ortho Specialist is aware of the denial.
Understand the reasons for denial: Contact your claim manager or insurance company to get a clear understanding of the reasons for the denial. This will help you address any specific concerns or requirements they may have.
Write an appeal letter: Prepare a formal appeal letter explaining why the surgery is required, citing medical evidence, specialist opinions, and any other relevant information. Clearly address the reasons for denial and provide a compelling argument as to why it should be approved. Ensure the letter is concise, respectful, and well-organized.
Follow the appeals process: Submit your appeal letter to the appropriate party or department, following the specific appeals process outlined by your state's L&I system. Be mindful of any deadlines and requirements for submission.
Seek legal advice if necessary: If you have exhausted all your options and continue to face denials, you may consider consulting with an attorney who specializes in workers' compensation or L&I cases. They can guide you through the legal process and represent your interests.
Remember, each situation is unique, and the process may vary depending on your location and specific circumstances. It's important to consult with professionals who specialize in workers' compensation and L&I cases to ensure you're following the right steps and have the best chance of getting your surgery approved....Read More
I was in a car accident on Valentine's day this year, I was the passenger in a Uber we were hit traveling around 50-60 mph by a drunk driver who then proceeded to drive off. At the time I didn't think I was injured it's only been the last cool days that I've been noticing significant signs that there was probably damage what should I do?Answer
AnonymousI suggest you seek medical attention as soon as possible. Even if you didn't feel any injuries right after the accident, you could have underlying medical conditions that need to be addressed. Delaying medical attention can worsen your condition and affect your chances of receiving compensation for your injuries. You should also contact a personal injury attorney to help you navigate the legal process, particularly if the driver who caused the accident was under the influence of alcohol. An attorney can help you gather evidence, negotiate with insurance companies, and ensure that you receive the compensation you deserve....Read More
AnonymousThis is a serious breach of duty and the affected individual may have grounds to pursue a medical malpractice claim against Kroger and the pharmacist responsible. It is important to consult with a personal injury attorney who specializes in medical malpractice to evaluate the case and determine the appropriate legal action to take....Read More
There are several law firms and attorneys in Bellingham, WA who specialize in personal injury law, including but not limited to:
Tario & Associates P.S.
Brett McCandlis Brown & Conner
Bill Coats Law
Adelstein, Sharpe & Serka LLP
Lustick, Kaiman & Madrone, P.S.
Carmichael Clark P.S.
Hinton & Associates P.S.
Law Offices of Tom S. Maronick Jr PLLC
Law Offices of Meg M. Anderson.
Law Offices of Thaddeus J. Eklund, P.S.
These firms and attorneys represent clients in a wide range of personal injury cases, including car accidents, slip and falls, medical malpractice, wrongful death, and more....Read More