Don’t confuse medical claims with your overall claim

UnknownWhy should the system change? just because it is confusing is no reason surely?

the other day we received a phone call from an injured workers which went so much like a script it got me wondering how we ended up in this place.

 

 

Caller: I’ve just received a section 74 notice. what should I do?

IWSN: Do you have a lawyer?

Caller: Yes, I can’t get through to them so I decided to ring you.

IWSN: That’s fine, it wasn’t why I asked, with a section 74 notice we usually advice you to go straight to the lawyers and get them to lodge at the Workers Compensation Commission. what did the letter actually say?

-won’t repeat the callers words but is usually runs along the lines of my [insert medical specialist here] says I need [insert medical intervention here] and the insurer [insert untrained insurance clerk here] didn’t believe [medical specialist] and sent me to [insert medico-legal dr here] who said [insert standard denial of medical science here]- and then I got the letter.-

IWSN: OK so you are still receiving weekly income replacement?

Caller: Yes

IIWSN: It didn’t come as part of a Work Capacity Decision? ( I hate it when they do that)

Caller: No.

IWSN: Then it’s just a denial of medical care. The advice is the same though you need to go to the Workers Compensation Commission. Don’t bother talking to the insurer for a review of their decision, they never change their minds [we have the stats on this].

Caller: but how long will this take?

IWSN: How long has it been now?

Caller: one/two/ [weve had six months believe it or not] so far.

IWSN: well it could take up to that again to get it sorted but once your lawyer has lodged their papers the Workers Compensation Commission is relatively quick at one to two months.

Caller: So go see the lawyer again?

IWSN: Yes. .


Why does access to medical care have to involve such a lengthy process?

Why does it have to involve another claim? with the same dam stupid rules for approval and legal action as the original claim?

Why is this government so utterly bereft of sensibility that they would make injured and ill people go through this using an industry who’s whole purpose is to prevent the spending of money?

I don’t know but this is the way it is until those with a sense of morality actually do something about it.

Until then the takeaway here is simple.

If you get a section 74 notice:

  1. Read it properly,
  2. Find out if it is against your original claim (i.e if it will stop your weekly income replacement)
  3. Find out if it is against any recent medical claims you have made.

 

Basically:

If it is not attached to a Work Capacity Decision- go straight to the lawyers.