What can I do if worker's compensation won't communicate with my attorney? 18 Answers as of January 06, 2012

I slipped and fell at work on the school bus steps. I hurt my back and the xray and MRI says I'm fine but I can't function and I am in constant pain. The doctor says I have lower lumbar pain and my left sciatic nerve is giving me problems. I went to physical therapy but workers comp only approved 12 visits. I have a list of restrictions. Workers compensation won't approve my 2nd opinion on my back and won't approve any more therapy and they just started pay me but they are under paying me. On January 13th, I would have been off work for 3 months. I have an 11 month old child and due to non payment from workers comp I lost my apartment and my lights and water got cut off. I had to pull my child out of daycare. My job wont let my come back unless I am free from restrictions and free from doctors care. If I do a settlement case with my job and workers comp how much do you think I'll get? Because I am so far in debt and now I have to go to court over the apartment I just lost. and yes i do have a lawyer but it seems as if he cant do anything either. workers comp wont communicate with him or email back they wont correct my amount or back pay me so I'm like what do I have a lawyer for again?

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Law Office of Ronald Arthur Lowry
Law Office of Ronald Arthur Lowry | Ronald Arthur Lowry
This is classic employer/insurer abusive behavior. Your lawyer should be fighting this. If he/she won't or doesn't know how to fight it, maybe you need a different lawyer. Many lawyers do not know how to handle a Workers Compensation case but won't admit it. You need to talk to your lawyer and try to get this issue addressed. If you are still not satisfied you have the right to fire the first lawyer and hire another.
Answer Applies to: Georgia
Replied: 1/6/2012
Law Office of Jared Altman
Law Office of Jared Altman | Jared Altman
I really can't comment. You have a lawyer. If you are dissatisfied with your attorney then hire a new one.
Answer Applies to: New York
Replied: 1/5/2012
R. D. Kelly Law Firm, P.L.L.C.
R. D. Kelly Law Firm, P.L.L.C. | Robert Kelly
You should continue to communicate with your lawyer. Sometimes dealing with an administrative agency or other organization can seem nearly futile, but the end results are usually better when you have an attorney on your side.
Answer Applies to: Washington
Replied: 1/5/2012
David F. Stoddard
David F. Stoddard | David F. Stoddard
I cannot give you advice as you are represented by an attorney. I can give you general information regarding workers compensation law. When you are hurt, you are entitled to temporary benefits , including payment for medical treatment and payment of 2/3 of your average weekly wage (comp rate) while you are out of work because of restrictions placed on you by the doctor. You do not say whether your under payment is because they have assigned too low a comp rate, or because they have not paid you for all of the weeks you have been out. If you are being denied temporary benefits, you can request a hearing and ask the worker's compensation commission to order that they pay the correct comp rate, or pay you for all of the weeks you have been out. If you are denied medical treatment, then you can request a hearing to ask the commission to order medical treatment. Refusing to authorize a second opinion would probably not be considered a denial of treatment. If you do not like the opinion of the doctor they choose, your only option may be to pay for a second opinion yourself (if you have health insurance, you could probably put it on your health insurance). Normally, if there is an issue of underpayment of temporary benefits, or denial of medical treatment, it is best to try to work it out with the adjuster before asking for a hearing. You should discuss these issues with the attorney, and listen to what the attorney says. It is possible, for example, that they have paid the correct benefits, but t heat the just took too long to pay. It may be that the adjuster is looking into the issue. Surprisingly, it is difficult to get the issues you describe straightened out in three months.
Answer Applies to: South Carolina
Replied: 1/5/2012
The Law Firm of Shawn M. Murray
The Law Firm of Shawn M. Murray | Shawn M. Murray
You have a lawyer to file a lawsuit on your behalf and seek penalties and attorney's fees, in addition to the benefits you are entitled to, if the matter can't be settled before it goes to trial. No lawyer can force the insurance carrier to increase the amount of your checks or pay for medical treatment that they refuse to pay for, until and unless he/she wins at trial and the judge orders the insurer to do so.
Answer Applies to: Louisiana
Replied: 1/5/2012
Ford, Howard & Cornett, P.C. | Bradley Cornett
If you are already represented by an attorney (as indicated in your question), then you need to confer with your attorney and express your concerns. If you are dissatisfied with your lawyer, then there are many attorneys that handle work comp matters with whom may may wish to consult.
Answer Applies to: Alabama
Replied: 1/5/2012
RECHTMAN & SPEVAK | DAVID RECHTMAN
If the workers compensation insurance company will not communicate with your lawyer, the lawyer may still request a ruling from the State Board of Workers Compensation. A judge has the power to correct your compensation weekly rate. A judge has the power to order payment of back compensation benefits. A judge does not have to depend on communication from the workers compensation insurance company in order to do the right thing in your case. But it is your attorneys job to properly bring these matters to the attention of the State Board of Workers Compensation and their judges. You do have the right to change your representative if you believe you are not being properly represented.
Answer Applies to: Georgia
Replied: 1/5/2012
Law Offices of Minh C. Wai, P.C.
Law Offices of Minh C. Wai, P.C. | Minh C. Wai
If you are dissatisfied with the work your lawyer is performing on your behalf, you should seek the advice of new counsel. However, some things are out of the lawyer's control. Settlements and benefits in worker's compensation cases are set by law, so there is often very little that can be done to change the outcome. A good lawyer may be able to help you argue a higher disability rating which would get you a higher settlement. Also the calculations of your weekly pay may be incorrect and your lawyer may be able to recalculate the proper pay for you. However, you must realize that worker's compensation laws were a compromise between employers and employees. You are not going to get the full benefit as if you had never been injured. But you will get something to help and you get your reasonable and necessary medical treatment paid for which is better than the situation prior to the enactment of these laws.
Answer Applies to: Indiana
Replied: 1/5/2012
Bernard Huff, Attorney/Mediator
Bernard Huff, Attorney/Mediator | Bernard Huff
Your attorney and/or you should contact your State's worker's Compensation Agency for possible assistance.
Answer Applies to: Indiana
Replied: 1/4/2012
Lapin Law Offices
Lapin Law Offices | Jeffrey Lapin
Generally, as to your actual question ("What can I do if worker's compensation won't communicate with my attorney?") if a workers' compensation insurance company will not communicate with an attorney, the attorney can file suit against the employer (you sue the employer, not the insurance company). The insurance company will then hire an attorney to defend the lawsuit. Your attorney can than communicate with the employer's attorney. Once suit is filed your attorney can get a lot of the information he/she needs for your case. if there is still a dispute about some aspect of your case, then ultimately the case will go to trial and a judge will decide what you are entitled to. With regard to the question posed in the "Question Detail" asking "how do you think I'll get" I cannot answer your questions without a lot more information. I would need to review your medical records and determine what your medical providers (doctors) have said about your injuries. In addition, I would need to know your wage history and what monies, if any, the workers compensation insurance company has paid. I would also want to know the basis, if any, of the denial of some of the items you list. This response is based on the limited information provided, makes certain assumptions, and assumes that all events took place in Nebraska. In addition, this response is not a substitute for professional legal advice and does not create an attorney-client relationship, nor is it a solicitation to offer legal advice. If you ignore this warning and convey confidential information in a private message or comment, there is no duty to keep that information confidential or forego representation adverse to your interests. You should seek the advice of a licensed attorney in the appropriate jurisdiction before taking any action that may affect your rights. If you believe you have a claim against someone, you should consult an attorney immediately, otherwise there is a risk that the time allotted to bring your claim may expire.
Answer Applies to: Nebraska
Replied: 1/4/2012
    Joel H. Schwartz, P.C.
    Joel H. Schwartz, P.C. | Steven A. Schwartz
    Your attorney should have communication with your worker's compensation insurer, and I find it puzzling that the insurer will not communicate. If you feel you are not being paid the correct amount of worker's compensation benefits, your attorney should be filing a claim for you at the industrial accident board in an effort to correct this situation. Unfortunately, it is impossible to comment on the potential value of any lump sum settlement you may be entitled to, as I would have to see your medical records to assess your medical condition, and would need to know your correct average weekly wage. Unlike a car accident where you are paid for "pain and suffering," your worker's compensation settlement is based in large part on your wage.
    Answer Applies to: Massachusetts
    Replied: 1/4/2012
    Paul Whitfield and Associates P.A.
    Paul Whitfield and Associates P.A. | Paul L. Whitfield
    First. Know that you are [paid 2/3s of your average weekly wages up to a cap. You are never paid "in full" Secondly, if you are really injured and the comp dr does not agree, ask the NCIndustrial Commission to permit you to get a second opinion. Or get one on your own and try to convince folks you are hurt.. your lawyer probably knows all this. Comp is a political thing. I was never designed to pay you in full and minister to all your perceived problems. It was designed to get you some medical care and keep you from starving, it has nothing to do with fault.
    Answer Applies to: North Carolina
    Replied: 1/4/2012
    Kelaher Law Offices, P.A.
    Kelaher Law Offices, P.A. | James P Kelaher
    Your lawyer should call the matter up for hearing before the judge for industrial claims.
    Answer Applies to: Florida
    Replied: 1/4/2012
    Andrew T. Velonis, P.C.
    Andrew T. Velonis, P.C. | Andrew Velonis
    Your question looks very familiar, so my answer will as well: You are entitled to have all of your medical costs covered as well as your lost wages at an amount of 66% of the average of your wages for the 52 weeks immediately preceeding the accident. As for the 2nd opinion, they can take the position that it is not medically necessary. As to therapy and underpayment, you can take an appeal. As to a schedule award, your doctor has to assign a percentage of permanant loss of use of the body part injured, the comp carrier can hire its own doctor to dispute that opinion and the board applies a formula determining the number of weeks you are entitled to on a lump-sum basis. Worker's Comp is under no obligation to communucate with your lawyer. What are they going to say, anyway? "We are paying this claimant the amount that we think is appropriate. We will not pay for a second opinion. No further physical therapy is necessary." Well, you already know all that. Your lawyer needs to take an appeal and/or have the comp board schedule a hearing. The carrier has made its decision and is not about to listen to anyone outside the company who wants them to change that decision. That is why the comp board exists, to force the carriers to pay the benefits they are supposed to pay.
    Answer Applies to: New York
    Replied: 1/4/2012
    Lombardi Law Firm
    Lombardi Law Firm | Steve Lombardi
    Your lawyer simply has to file the claim with the Industrial Commission.
    Answer Applies to: Iowa
    Replied: 1/4/2012
    Counard & Heilmann Law Office | Michael Heilmann
    You need to file a PIP application with your own auto insurance company and let them sue your worker's compensation carrier. We do this all the time when Worker's comp will not pay. Good Luck.
    Answer Applies to: Michigan
    Replied: 1/4/2012
    Neighborhood Law Office, P.C.
    Neighborhood Law Office, P.C. | Jim Underhill
    I have no idea where the break down here is, but there is clearly either a communication or representation problem. First, any attorney how understands and regularly practices Workman's Compensation law will know how to talk to the bureaucracy and get answers. If your attorney tells you that he can't get an answer, you have an attorney that is probably not experienced in this area - or does not want your case and is telling you a fib instead of just saying that he/she doesn't want to represent you. Second, most competent and scrupulous attorneys who practice workman's compensation DO NOT charge a fee up front. They are paid a portion of the award when and if you receive it. If you have a different deal with an attorney, go get a second opinion immediately. The yellow pages has many listings under Workman's Compensation. Next, your employer is quite likely violating the law if they tell you they cannot put you on light duty because of an injury, especially one covered by Workman's Compensation Insurance. Again, you need a competent attorney, and you need to consult right away. You need to file an application for unemployment right now. Tell them in the application that the employer has laid you off. You also need to visit the County welfare office where your apartment was. They can get you temporary lodging, food stamps, etc. You need to go there in person and start the process, and then keep on them. They will want a permanent address - see if you can use a friend or attorney's address to receive mail. Your best bet is to find a good lawyer who provides advice on these kind of issues on a regular basis and review your specific facts; the lawyer will be able to give you an analysis of the law and your options.
    Answer Applies to: Colorado
    Replied: 1/4/2012
    The Margolis Firm
    The Margolis Firm | Charles J. Candiano
    You desperately need a WC attorney who knows what they are doing. The day you hired an attorney, he/she could have filed a Motion for Immediate Hearing so all outstanding issues can be resolved. The fact that your attorney did NOT explain this is, itself a big red flag. The attorney NEVER needs to beg the WC insurance to speak with them unless WC is doing everything it is supposed to do. "WC won't talk to my attorney" means your attorney does not want to put forth the effort to aggressively prosecute your case or does not have the expertise to do so.. Talk to your attorney about this. If you do not get satisfactory answers, seek new counsel before your attorney tries to settle your case, making it impossible for you to hire a new lawyer. There is no such thing as "WC won't authorize my care." What happens is that WC has sent your matter for UR (utilization review). Your Governor signed a law that says the insurance company can seek the opinion of a doctor in California or Texas, who has never seen you to render an "opinion" that "most people with your injury "generally" need no more than "X" number of treatments." It has nothing to do with what care you receive or when you receive it unless your attorney doesn't know enough to have your treating orthopaedic doctor write an order for more treatment with an explanation as to why you need more treatment. It is also possible that you have an action against the bus manufacturer for defective stairs or against the school corporation for defective maintenance. Ask you attorney to explain.
    Answer Applies to: Illinois
    Replied: 1/4/2012
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