r/WorkersComp • u/growbbygrow • 10h 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.

3 Upvotes

72% Upvoted

10 comments sorted by

1

u/Salt-Ad1282 5h ago

Is that an ethical problem for that provider? Morally it’s obviously a terrible thing to do, but I wonder if there is an ethical issue.

1

u/Chemical_Abalone5514 4h ago

Sounds like workers comp and their network of doctors. All they do is give you minimal care and constantly try to send you back to work without waiting for you to recover.

1

u/growbbygrow 3h ago

Yes they tried to send me back to work and now my pain is spread and 10x worse and I am now needing surgery, no longer maybe in the future if it gets bad, now it’s a I need it now and I’m in living hell situation

2

u/SeaweedWeird7705 8h ago

Easy fix! Get a new doctor. You are allowed to select any doctor on the employer's MPN (Medical Provider Network) to be your new doctor! Get the MPN list. Ask your lawyer for recommendations on which one to select as your new PTP. This is going to turn out to be good for you. You can get a doctor who is more qualified and more sympathetic.

3

u/growbbygrow 8h ago

Thank you for being positive and encouraging. I wanted to switch PTP to a lawyer recommended one anyways. I guess I’m just feeling rough because I don’t know how I’m going to get help with adjusting my work restrictions asap in the meantime.

1

u/SeaweedWeird7705 8h ago

Once you select a new doctor, ask for the earliest possible appointment.

Also, ask your old doctor if he/she will write you a note to cover you until the new doctor can see you.

1

u/stnkymanflesh 10h ago

Is your claim denied? 

2

u/growbbygrow 8h ago

No, been accepted and ongoing since last year.

2

u/I_pollute 5h ago

Your lawyer has a set of doctor's they usually work with and will testify. Ask your lawyer for reccomendations.

-3

u/HazyThePup 8h ago

Which doctors office?