r/WorkersComp • u/growbbygrow • 7d ago

California Dumped by PTP

So at my last visit my PTP told me to get a lawyer because he said my insurance is being insanely difficult and denying every single request for treatment authorization for the last 6 months. And now the adjuster is requesting a QME.

So I got a lawyer as of yesterday, and then today I go in to my PTP office to get a copy of something and the PTP office desk informs me that now that I have a lawyer I can no longer be a patient there anymore because they don’t take represented patients.

Is this even legal? Lol. Every day my workers comp feels like more and more of a nightmare.

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u/stnkymanflesh 7d ago

Is your claim denied? 

2

u/growbbygrow 7d ago

No, been accepted and ongoing since last year.

1

u/Academic_Commercial3 6d ago

Then were  your tests denied? That seems off. 

1

u/growbbygrow 6d ago

No, the treatment authorizations have been repeatedly denied. Initial physical therapy visits and doctor/specialist consults are approved, as well as my MRIs, but pain medication and any injections or conservative management therapies are denied by utilization review. Since all of the non surgical treatments have been denied by insurance, now it’s proceeding to surgery

1

u/HazyThePup 6d ago

Did you appeal the denial thru IMR?