Reasons Why You Are Not Getting Money

1. The insurance company/employer is investigating your claim. They have 90 days to accept or deny the claim. It is not possible to get a hearing at the Workers’ Compensation Appeals Board (WCAB) during this time.
2. Failure to attend medical appointments can result in your benefits being cut off or delayed. If you can’t show up please notify doctor and reschedule.
3. Failure to perform modified/alternate work that the MPN doctor says you can perform and that the employer is offering will result in your not getting workers’ compensation benefits. The bitter truth is that you will either have to work in pain until we can obtain a medical opinion and a conference date at the Board or not get any money. This process can take two to five months.
4. If your injury is denied, an Agreed Medical Evaluation (AME) or a Panel Qualified Medical Evaluation are required to determine the issue of compensability of the claim. Neither party can obtain their own medical opinion. This can cause significant delays. See Section XX for more information on AME’s and QME’s.
5. Delays occur in the processing of mail at the post office. Such delays can cause a check to be one to five days late. This occurs during the holiday season and tax time when the post office handles a higher than usual volume of mail. Also please take in consideration the weekend and holidays in which the post office is closed. If your check does not arrive five days after the expected time, please call our office. At that time please call and we can report the check as lost and/or place a stop payment. (If you do receive your check and we do place a stop payment, you cannot cash it, and you will have to return the check in order to receive a new one.)

When calling about late benefit payments, we must have the following information:

The type of benefit payment: Temporary Disability, Permanent Disability, Medical Mileage, Medical Expense Reimbursement.

If you are calling regarding a late payment of medical mileage or medical expense reimbursement, we will need the date of the reimbursement request. If 70 days have not passed since the reimbursement request, the payment is not late. The insurance company has 60 days to make these payments.