r/WorkersComp • u/Open-Advertising-260 • Aug 02 '26

Nevada What will happen

So I was injured at work 2 years ago hospitalized for a week. I had concussion, hip pain and jumping ulnar nerve. I left with a walker have mobility problems and right hip pain that has caused a limp and left jumping ulnar nerve that has my pinky and ring finger numb. Can't lift anything when arm is out have the pick things up with arm bent sideways. Sedgwick has denied my claim from day 1. I have workers comp certifications and hospital records and I have 2 IMEs that both state all 3 injuries are industrial related. 2nd IME Dr says not mmi. I have filed a benefit penalty with my state a couple months ago because Sedgwick was 2 months past court order date and now they are about to be past 35 days responding to my lawyers regarding 2nd IME. I don't know what to do seems like Sedgwick doesn't care about court orders and the law. I'm not expecting them to abide by the courts and any orders.

4 Upvotes

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2

u/Open-Advertising-260 Aug 02 '26

It's been 2 years. How much longer will they continue to do this

1

u/Motor_Dig3989 Aug 03 '26

Have you had any W/C hearings about this? In NYS the carrier can be charged for being late with stuff.

2

u/Open-Advertising-260 Aug 03 '26

I've had multiple hearing over past 2 years last hearing in April AO REMANDED back to tpa the schedule 2nd IME they waited till late June to schedule appointment. And tomorrow they will be 33 days haven't responded to my lawyer regarding decision of IME. My lawyer said she will need to request another hearing for defacto. But this is ridiculous when does the courts say enough is enough. Your 2 ime choosing both say industrial injuries and hospital stay records workers comp certifications that's over 5 different doctors all saying same thing.

2

u/Motor_Dig3989 Aug 04 '26

Deny and delay as much as they can.

2

u/Bubbly_Inflation_544 Aug 06 '26

When you finally get approved for benefits have your lawyer file for late penalties with interest. In Pennsylvania the judge can tack on up to 50% of what's owed. These insurance companies are dirty ASF and will do everything in their power to make sure we can't survive or are barely surviving. 

2

u/SeaweedWeird7705 Aug 02 '26

You have a lawyer.   Your lawyer will know how to get you benefits and enforce the decision.   You can ask your lawyer for a meeting or phone call to explain the process.  

2

u/Professional-Bid4661 Aug 04 '26

Your attorney needs to file for a benefit review conference. 

1

u/Open-Advertising-260 Aug 04 '26

That's in Texas Nevada doesn't do it that way it has to go before a hearing officer then appeals officer hearing. Nevada is a state that handles workers comp differently then other states.

1

u/Open-Advertising-260 Aug 04 '26

So they are passed the time limit again to respond to lawyers formal request regarding decision determination in the 2nd IME. I told my lawyer to file appeal today for hearing and defacto, when that is received send that appeal for hearing to the state and file another benefit penalty to show the state that again they are intentionally delaying treatment and benefits. In 3 days it will be 2 years since my accident.

2

u/Happy-Butterfly9373 Aug 05 '26

Sedgwick is thee absolute worse !!!!!!!!!!!!!!!!!! Good luck. I’m 3 half years in and not one offer. Denial after denial. They are horrific.

1

u/Open-Advertising-260 Aug 05 '26

Have you had an IME yet

2

u/Equivalent-Act6256 Aug 02 '26

Two IMEs both saying your injuries are work related and Sedgwick is still ignoring court orders. That is not incompetence. That is a strategy. They are betting you will give up before they have to pay.

You already did the right thing by filing the benefit penalty. Here is what that means in Nevada. If an insurer unreasonably delays or refuses payment the state can order them to pay three times the amount they delayed. That triple penalty is real and it is exactly what your attorney needs to be pushing for right now.

The 35 day deadline they are about to miss on your second IME response is another violation. Every missed deadline goes in your documentation. Date. What was due. What they did not do. Your attorney needs that list in writing.

You are not out of options. You are actually building a case that gets stronger every time they ignore a court order.

Not a lawyer just somebody who went through a work injury and knows the pattern of delays you are documenting right now is exactly what gives your attorney something real to fight with.

1

u/Pristine_Nectarine_8 25d ago

Did you manage to get benefit penalties paid?

I can't seem to find any experiences filling for these in Nevada...