Sunday, January 1, 2017

Applied Underwriters Is Risking My Health, Denying Necessary Medical Treatments (Workers Compensation)

Warren Buffett THIS IS NOT RIGHT!
This past March 14th I was injured in a work related car accident.   I was working for KLS, returning from a run to the Penn Station in Newark.   The steering went out, and I crashed into the retaining wall  that divides the North/South lanes at least twice, the drivers side airbag deploying. The injuries suffered seem to be many and varied...disc issues in my spine, sciatica nerve issues, inflamed tendon and partial tear of my right Rotator Cuff.
Physical therapy exercises can help restore flexibility and strength to your shoulder after a rotator cuff injury. Sometimes it is possible to eliminate pain and restore function without surgery...this physical therapy has yet to be approved!
Through my attorney, was informed that Applied Underwriters (Letterhead also associates them with Applied Risk Services of New York, Inc/Continental Indemnity Company-PO Box 3804, Omaha Ne. 68103) would be handling my cases, making approval decisions on various and assorted medical requests made by my medical team.  I am just a lay person here, but it seems to me in my opinion that this company and some of their denials of medical treatment are at best egregious negligence that is being detrimental to my health, and speedy recovery from my accident.

Currently, my doctors are trying to get approval for a Cortisone shot into my back, physical therapy for my back/sciatica nerve issues suffered from the accident, and physical therapy for my right should/rotator cuff issues.  
Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. YET...Applied Underwriters are denying this medically requested treatment in my case.
The original requests for these treatments go back to June of this calendar year (2016).   Rather than approve these requests, Applied Underwriters back in June decided I should not have the requested fact, the doctor doing the IME (Independent Medical Examination) recommended that I should do the rotator cuff physical therapy, then have a new MRI to ascertain where we stood in the healing/recovery process.  Despite this finding by their own chosen medical profession, the requested treatments were denied on more than one occasion, some of denials on technical issues (wrong FAX number) that could have easily been resolved via a phone call to my medical team...New York Law on Worker's Compensation encourages Claims Adjusters and Doctors to work together to resolve issues.

When it was decided by Workers Compensation Board that the paperwork was submitted incorrectly, my team of doctors submitted new requests for the shot, and physical therapy.  Instead of approving the requests, Applied Underwriters decided they wanted a new IME which took place in early November of this year.  THEIR DOCTOR (emphasis added) said the requested medical treatments were necessary. Ignoring their own IME report, the claims adjuster has now again denied me necessary medical treatments.

All these wantonly negligent delays in my opinion have caused my medical issues to worsen, rather than improve.  As example, the doctor dealing with my rotator cuff issues has told me that the lack of physical therapy is now causing my shoulder to lock up...I believe the medical term is Frozen Shoulder.  This could have been avoided, in my opinion if my physical therapy had been approved clear back in June of this year by Applied Underwriters.   Now I am being told I may have to face surgery.  This chance of surgery is squarely on the shoulders, in my opinion, of Applied Underwriters, their delays, denials especially unwarranted when their own chosen medical specialists say the medical treatments requested are recommended.  The company's refusal of requested treatments is in my opinion MALPRACTICE.

Sadly, even though I have a competent attorney, seems my only choice is to accept these games being played with my health and well being.  Meanwhile, I live in daily pain, and that constant in my life now does have a detrimental effect on my emotional well being, and our elected officials need to write laws that would hold companies like Applied Underwriters legally libel if it is deemed their denial of medical requests negatively affects a claimants physical/emotional health.

If you have suffered through your own bad experiences with Workers Compensation case handled by this company, would love to hear about it in the comments section as I am considering litigation against the company.  Unnecessary pain CHANGES A PERSON!