Legal Question in Health Care Law in Florida

Possible Malpractice in refractory seizure disoreder

Let me start by qualifying this... i also have progressive relapsing MS ( one of the 5 % with MS that do) but have also had a neuro psych exam eval for grad school- baseline in 1998). Two and ahlaf years ago i had multiple grand mal seizures that occured out of the blue and quickly generalized into a stic episode ( witnessed), i went to a GP, saw a neuro, gentleman saw me for a total of 3 minutes and was rude, never inquires about my seizure episodes or anything related to them, even though i was having repetive seizure at about the rate of 150 or 200 a day, i asked immediated for another refferal from my insurance company to a specilaist in seizure activity, it was denied.. said see someone in network ( HMO) they didn't have one.. I have over the course of 2 years had five seperate referal to epileptologists. all have been refused, denied rejected, I have been placed on ever drug made that is an AED with no response, and the nero they finally did send me to was a paim specialist who knew nothing about seizures and almost killed me while trying to help me. I finally, called in a bunch iof favors, called the agency for health care administration, the HMO Compliance office in Tallahasse, the states attorney. HELP!


Asked on 3/01/07, 11:48 pm

1 Answer from Attorneys
Alan Wagner Wagner, McLaughlin & Whittemore P.A.

Re: Possible Malpractice in refractory seizure disoreder

The wonderful world of managed healthcare. Your ability to appeal is usually governed by the terms of the insurance policy. This is particularly the case if you have employer provided coverage governed by a federal law called ERISA your options are usually much more restricted and the laws are stacked in favor of the insurance company (thanks to the federal government).

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Answered on 3/16/07, 10:49 pm


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