As with most of us hear i think we mostly agree on the tactics GB uses to starve out a client. I refuse to be starved out and will fight them tooth and nail, win or lose. I won't go away and now i know they cars nothing about my well being or my family. Wrong move, nevr let me suspect you of doing harm to my family heres a tast of some of the lowdown dirty dealing of them and by chance this gets read by any GB adjuster i promise you i will be a force to be reckon with and I DON'T CARE HOW LONG IT TAKES I WILL GET WHATS OWED TO ME, BY ANY LEGAL MEANS NECESSARY. I just filed my second complaint with the state audit control and will continue with every denial and dirty trick they pull. I'm on to you and nothing makes me fight harder than my family. Now here the bulk text of my complaint, And if anyone want to class action them i'm down. I keep a record of all slaps to my face i can't wait to get in front of a judge and show him all my proof. Let me know what you think that can be helpful. Thanks My workman's comp diary October 6th 1. Date of injury was 3/14. The boxes we use for catering fell on me from about 4-5 ft off a shelf on my back while I was looking in another box bent over looking for chicken tins to restock the carver station. There is a video of the incident. There are several camera's throughout the store and where the accident happened there is a camera 2. My first payment was 10 days late. 14 days after my injury was sent without my apartment # and was sent back and received by the adjuster's office on the 9th of April and sent to me after a call from my attorney by the 11th. My payments were delayed again APR 28 until the 11th but was not issued until the 15th with me and my lawyer at the time making phone calls to the adjuster extra day were paid but once again delayed. The reason given is they (my employer) were looking for modified duty for me and haven't heard from my store manager. Now I'm not being paid and it has been 4 months as of October 6th of this year.
My claim was accepted and yet I still face numerous denials for treatments and have been off work since march 16th until the present with the worst example being that a upper GI was scheduled as a follow up for to a appointment that was scheduled by a nurse case manager Linda Krull, that worked for Coventry workers comp services, who scheduled the a appointment for me at Samson Clinic, Santa Barbara because she could not find one that accepted workman's comp closer. I went to the first visit with transportation was provided by the nurse case manager and authorized by the adjuster. While I was still was at the clinic everything to my knowledge was approved for the GI that was requested. The day before at 3:36 pm the transportation was not authorized, the nurse called me and the transportation as well. I had to postpone the appointment with no time to replace that ride as it was close to 4:00 pm. I would like to state that in my opinion this was done at the very last moment as I made the appointment for the transportation the same day of th first visit so ample time was given for the adjuster's denial, was done with malice and could harm my health. Another example my shoulder surgery was requested in June 2. As of October 6th still denied with physical therapy or not all conservative treatments were used. This is not true, by the time I even had a nurse case manager I had already had, physical therapy (5 out of 6 sessions) even before i had the first MRI and each time I complained of worsen pain in neck and burning in my shoulders. I had cortisone shot in both shoulders, which made things worse, I'm taking my medications with little to no relief and in June Dr. Price stated my shoulders would not improve without the surgery I need in both shoulders which each one takes 6 months of rehab thats a year at the least to just get my shoulders back to some type of functioning capacity. This is shoulders alone. I feel their lethargic way of handling my case has made things worse I have gone back to PT (I have had at least one trip to the Er and cannot finish after 4 visits as well chiropractic 4 visits as well.
4. My TTD payments have been cut off since May 17 which I was not notified by mail because mysteriously all the notices were sent to a address that has no association with my case ever. As well as the reason for this is that modified work was available for me since may 19th. Which not only did my Dr. Did not want me to return and wrote to this fact on may 29. Also another Dr also said I was temporarily totally disabled at least until 7/15. As of this date no payments are being made to me. And I cannot return to work with the injuries I have
5. The adjuster has also repeatedly denied my pain psychological consult with Dr. Errico to help me learn to deal with a non medication way to deal with the pain I suffer and because I have a previous condition. I think that is bias in every way. I was able to make it to work every day and was a manager in their store and was able to be a fully functioning person and now because I have a previous condition I'm denied treatments that could possibly help me and not even a part of my claim so I should be treated as any other injured worker. Once again I must state because of all this ongoing stress of pain and not be treated fairly in my opinion is taking a toll on my previous condition. I would like to know who did it benefit to send me back to pt again and it showed no signs of helping, made things worse. Not me and only slowed down any progress that could have got me back to work. The Mir's showed I have significant damage and my claim was accepted. 5. My first epidural was approved September 23 after at least 2 months of waiting for a approval.
6. Went to see Dr. Vayida on Oct 8 and he requested aquatic therapy for my back as well as adding ms con tin. I went to get the script filled and the was told that my card had expired (this with the fact I was not sent a current one and me still having a open w/c comp case) and told pharmacist they would try to get it extended all that with me being without my medication possible until Mon and not sure if they can do it period I would take this as a denial.
7. Also as of the 8th of October no word on my shoulder surgery. My appointment with Dr. Price was on the 29th of September and the nurse case manager did speak with dr. Price. This would be the 3rd request if not more made for this surgery as I remain in this pain. I would like to file a complaint against the insurance adjuster. My Dr has told me that I will not get better without this surgery on June 2. All that the adjuster would agree to is my back to physical therapy again after the first round hurt me and made thing worse.
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