Legal Question in Personal Injury in New York
Medicare and No-Fault problems
I recently had an L5-S1 disc decompression/fusion w/instrumentation(screws,plate rods) one year after an automobile accident with a commercial vehicle.The home care provider felt that I would benefit from a bath chair and a cane.I received the chair but not the cane.I was told by the provider that Medicare said that they are my Secondary payer since I was involved in a car accident.Allstate,the no fault provider,sent me to their doctors who all said that I had minor sprains/strains(boy were they wrong).I am looking down the road;if I am being denied for certain items now,I really need to get this situation under control.
My knees are beginning to buckle from all the added stress that is put on them(doctor says no bending,twisting,lifting heavy objects,etc.until I see him in 6 weeks).
Can I send a letter that asks Allstate to reconsider the denials on my claim,as I have been through extensive testing,MRI's,discograms,CT exams,epidural injections,etc.that state that there was a problem with my discs since the accident that got worse over time?(accident over a year ago).
Medicare keeps telling me that the Allstate claim is still open.
Allstate also sent me for an EUO in December and hasn't informed me of their findings.
4 Answers from Attorneys
Re: Medicare and No-Fault problems
Your attorney should be looking into this
Re: Medicare and No-Fault problems
The shprt answer is yes, you can ask for reconsideration but you should be represented by counsel if you are not currently. The sad truth is the insurance company will never take you seriously unless you are represented by a lawyer, your no-fault provider , especially, has a reputation for downplaying auto accident injuries.
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Re: Medicare and No-Fault problems
Do you have a lawyer? If not, you should get one asap, especially if liability is in your favor. You can bring an arbitration against Allstate or sue them. However, an adverse decision could affect your negligence case. Thus, you need to have a lawyer dealing with these issues. Our firm handles these cases all the time (on contigency) and we have 10 offices in NY. Feel free to contact me.
Re: Medicare and No-Fault problems
I'm not sure if you are the same person who has posted similar questions here before. If so, this appears to be a continuing problem which should be resolved. In any event, if you have an attorney representing you with respect to this automobile accident, that attorney should be involved in resolving the no-fault issues. An informal request for reconsideration can be made, however it is more likely that you will need to file for arbitration to compel Allstate to reverse its decision and provide you with benefits. These areas (automobile accidents, personal injuries and no-fault) are handled by my firm and I would be happy to discuss this further with you.
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