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my insurance won't cover me if my workmans comp ends? please help

in painiin pain Posts: 11
edited 06/11/2012 - 8:35 AM in Health Insurance Issues
This is sort of a follow up to a previous post, concerning a back injury and workmans comp neglecting to cover. Well I am under the assumption that if the workmans comp case was closed, and they have not treated me in full, and I would have to continue treatment with my own insurance that they won't cover my claims? How Will i resume or manage my injury if my own insurance won't? Should I get a lawyer in this case, seems like the thing to do. Because the back issues are never really going to be eliminated, only managed. So can the insurance company really do this to me. Also what if I would change jobs,would i be covered under there plan? thanks for reading, just feel like my hands are tied.


  • Probably an attorney's advice is best-most offer free initial consultations. I have been told in my state that if work comp sends a letter saying, "non covered" or "not work related" that you can give to you private health insurance and they will pay. But again, I would see an attorney, so many rules, so complicated!!!
  • If you leave your job and your current insurance company and go to another job, their insurance will consider your injury a "pre-existing condition" and it will not be covered. Good luck

  • You should be able to use your private carrier for medical care. You have a letter from work comp stating they are denying you coverage. So if you go for treatment you will need this letter with you, to provide the doctors that work comp is refusing coverage. Insurance companies won't do riders on a policy, for a injury that is work related. The reason is for exactly what is happening to you. In a event work comp is not covering the injury they will need to pay the claim out. However you insurance company has the right to seek all the money back they have paid out.

    I would get a lawyer to help. The attorney can appeal the commission in your state to make work comp cover the injury. Work comp is considered a personal injury so most attorneys will take the case without you paying up front. They will recoup their money from any settlement money. In most states it is a set percentage, by law, as to what a attorney can charge as a percentage of the award.

    Keep in mind that laws for work comp differ by state so we all are under different laws. In most states you can go to the state web site and follow the appeal process against work comp, if you don't want to hire a attorney. But please look up your state's web site and become familiar with the laws in your state. A quick google will lead to the site. Good luck and keep us posted.
  • I went throght the same thing.
    The ball did not start to roll until I obtain a lawyer.
    Go and talk to one ASAP!
  • First of all thank you to everyone who has responded to my post. To fill you in Workmans comp says that she has dddisease and arthritis and it is not a work related injury. Is this enough info to tell my private insurance, so that she can get help. i am afraid she will lose her job because she cannot seek treatment for this.
  • I would assume that if the back was injured at work they would be required to take care of the dr visits and treatments for that injury. the actual injury only made matters worse right? so maybe get a lawyer and see what he has to say. Im sure they are just looking for a way out as they do with most everyone.
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