Why You Can’t Get your Prescription Filled.
Easily one of the most common and frustrating experiences for a workers’ compensation claimant is when their physician prescribes a needed medication only to have the pharmacy frown and tell the claimant that the prescription is not authorized. This article will discuss the process, why this happens, and help you understand what is going on. […]
The “Independent” Medical Exam (IME) – Anything But!
When claims are not moving fast enough for the adjuster, or the adjuster disagrees with your treating doctor’s opinions, the adjuster may send you to what is referred to in work comp as an “independent medical examination” or “IME.” The adjuster can make it sound helpful, “this doctor is a specialist” or “this doctor understands […]
How to Talk to Your Work Comp Adjuster (and How NOT to)
Your adjuster must reside in Montana Many insurance companies write coverage in Montana but that doesn’t mean those companies have offices here. In some states, it is permissible for an adjuster to handle claims from anywhere in the country. That is not true for Montana. Any insurance company handling workers’ compensation claims in Montana but […]
The Myth of the Montana Utilization and Treatment Guidelines
Adjusters and nurse case managers frequently rely upon The Montana Utilization and Treatment Guidelines. More troubling is that the adjusters and nurse case managers, use the Guidelines to prevent a medical provider from pursuing treatment options. The adjuster will try to manage your medical treatment using the Montana Utilization and Treatment Guidelines. During your healing […]
Just Don’t!: Social Media and Your Montana Work Comp Claim
Let’s be clear…I don’t think any injured worker has ever won his or her case in court by posting on Facebook. Okay, let me be extra clear on this point: what you say on Facebook will definitely help you LOSE your case. You can see that from the cases in the Worker’s Compensation Court. In one case, […]
The Worker Comp Adjuster’s Initial Investigation and Your Right to Medical Privacy
When you file a work comp claim, the claim is assigned to a workers’ compensation adjuster for your employer’s insurance company. That adjuster is responsible for reviewing the facts of your claim and applying the rules of the Montana Workers’ Compensation Act to your claim to determine if you qualify to receive workers’ compensation benefits. […]
How to Challenge a Work Comp Claim Denial
Work comp insurers are eager to deny your claim! According to the Montana Department of Labor and Industry, 38% of claims were DENIED during the fiscal year 2017. This article is the first of five that discuss how you handle a denied claim if you are a claimant. Think of it this way. If an […]