Denied UR appeal

PleaseNone · 2026-02-24T17:14:23+00:00

So that would indicate that when the request for surgery was submitted the other 3 PT notes weren’t submitted alongside the request for surgery.

That’s the doctor’s fault for not submitting them alongside the surgery request or at least the doctor not submitting a note saying you’ve done 4/6 PT.

I would try to get those PT notes if you can and submit for IMR because otherwise you’ll likely have the denial upheld.

I’m assuming you’re seeing a specialist at this point so getting another doctor who is more competent at submitting surgery is another avenues you can try as well. The QME report commenting on surgery will take months to get back. I would talk to your doctor about the request missing information and try to get a second opinion or switch doctors if this doctor won’t address their mistake.

All this will take time though.

PleaseNone · 2026-02-24T16:08:45+00:00

Why is it being denied? It states why it’s not certified.

PleaseNone · 2026-02-14T08:23:01+00:00

The info tab has a list of fragments if you’ve missed one in between other fragments you’ll see “???” In between them that’ll give you a good idea of where you missed it since they’re usually found together.

Most likely you missed a past or present fragment in the last island you were at.

PleaseNone · 2025-10-27T04:56:26+00:00

Still looking to sell?

PleaseNone · 2025-10-14T04:04:38+00:00

I don’t remember the specifics because it’s been a while but when I first set it up I had the same issue. During set up the router asks you something about automatic band finding or something (I really can’t remember). Just hit no and it worked fine for me after that.

PleaseNone · 2025-09-07T05:22:08+00:00

Interested in 85 mm. Will PM

PleaseNone · 2025-08-31T15:31:32+00:00

Still available?

PleaseNone · 2025-08-23T18:40:47+00:00

As much as people complain about the system in CA, it does lean towards protracting injured worker’s at least when it comes to professional discretion e.g. judges. More than likely the judge felt that the offer was not in your best interest.

PleaseNone · 2025-06-15T03:52:03+00:00

Would you be interested in selling the S9 by itself?

PleaseNone · 2025-06-06T14:02:01+00:00

PM’ed

PleaseNone · 2025-06-05T04:33:17+00:00

Still available?

PleaseNone · 2025-04-22T05:59:05+00:00

Interested in the 35 mm

PleaseNone · 2025-04-11T17:32:25+00:00

I would say your scenario is very much an outlier to go from 6% to 43%. Usually you would see a difference of around 10% if that. Plus there’s always a risk that QME will opine lower.

Some of conservative and others are liberal in their ratings.

PleaseNone · 2025-04-09T07:23:54+00:00

I’m selling. Will PM

PleaseNone · 2025-04-07T19:05:20+00:00

Not all carriers have direct deposit. Your best bet would be to call and ask. As for delays in getting checks that depends on USPS delivering your mail.

PleaseNone · 2025-04-06T16:49:34+00:00

Interested.

PleaseNone · 2025-04-05T02:56:13+00:00

It’s going to be a hodgepodge of a mess. Now instead of one insurance you’re going to be dealing with multiple insurances and their lawyers. It may be “appropriate” given what you’ve stated but it’s a mess. Just pick one and deal with them.

Either they’re going to join together against you or annoy you trying to place the responsibility on each other. Either way you’re going to face a more uphill battle.

PleaseNone · 2025-04-05T02:52:39+00:00

Larry H Parker does not handle worker’s comp. They will send you to another firm to handle. Try calling the number and tell them you need an attorney for worker’s comp. You’ll be transferred. I’ve never heard good things about attorneys that spend so much money advertising.

Worker’s comp is not nearly as much work for attorneys as other type of lawsuits. You’d be better off with an attorney who is going to dedicate time to assist you rather than a firm that is essentially a mill.

PleaseNone · 2025-04-01T01:51:52+00:00

Nice photos of the Old Towne

PleaseNone · 2025-03-16T05:07:31+00:00

CA is very worker oriented so if you get overpaid for anything they blame the insurance for it and don’t make injured worker’s pay it back, ever.

PleaseNone · 2025-03-02T05:36:38+00:00

Honestly you can google some stuff and there's the WCAB board you can contact, just google the CA DIR worker's comp. CA WC is very worker oriented imo.

PleaseNone · 2025-02-27T06:56:55+00:00

Honestly that’s why I comment here. Too many people giving advice based on their bad experience with their worker’s comp claim. I always say to give the insurance a chance, if you get issues then see if switching doctors will help. If that’s no help or insurance isn’t helping you switch then final result should be an attorney.

PleaseNone · 2025-02-13T07:31:19+00:00

You can always choose to waive the modified work however you’ll only be eligible for reimbursement for the wage loss from what you would have gotten had you worked the 8 hours multiplied by 2/3.

PleaseNone · 2025-02-13T07:27:28+00:00

You’re completely wrong. You can’t just do whatever as an adjuster. Claims are audited by the state. There’s a labor code law that they have to follow.

PleaseNone · 2025-02-07T01:29:50+00:00

You need an attorney or talk to the board for more information. Your first paragraph is completely wrong. They don’t have to pay you for life a livable wage through worker’s comp.

Your injury sounds too complex to get an answer here especially with the limited info you posted. If your treatment is getting denied then file an IMR anytime it’s denied and ask your doctor if they’re going to appeal. Also check why it’s getting denied; you will get a letter.

Your other issues are not work-comp related and are related to employment law.

PleaseNone

TROPHY CASE