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IF A MEDICAL DR. WITH SPECIALIST CERTIFACTIONS TO SUCH ...

Sent to Legal Experts September 28 2007 at 6:50 AM
   

IF A MEDICAL DR. WITH SPECIALIST CERTIFACTIONS TO SUCH MAKES A DIAGNOSIS...AND THE INS CARRIER PAYS AT THE START OF CLAIM...DOES THE CLIENT HAVE TO HAVE AN IME WITH A DR THAT JUST DOES GENERAL PRACTICE IN THAT FIELD?...IS THE FACT THAT IF A SPECIALIST MAKES A DIAGNOSIS WITH CORRESPONDING TESTS, NOTES ETC, IS THGE PREVAILING DIAGNOSIS TO BE REPROVING AND REPROVING..WHEN AN IME DR (OF LESSER STATURE DISAGRESS..NOT EVEN REFERRING TO DIAGNOSIS BUT RATHER GENERAL CONDITION..DO I HAVE TO CONTIOUSLY PROVE MY DIAGNOSIS..OR IF A DR OF EQUAL STATUS CAN'T BE FOUND...WHAT PREVAILS

 

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FORT LEE, New Jersey

Already Tried:
DEPT OF INSURANCE

Customer (name blocked for privacy)
Status:  Closed   Value: $15
Info Request
September 28 2007 at 7:09 AM (18 minutes and 54 seconds later)
         

Dear Customer (name blocked for privacy),

I need a bit more information please.

If you turn off the caps, and use regular text it will be easier to read and understand. Also, I need the following clarifying points.

1. What are you referring to when you use the intials IME.

2. Please tell me your specific situation>



YOUR PAYMENT AND BONUS IF ANY MAY BE TAX DEDUCTIBLE

Edward M. Johnson
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Ed Johnson -- International HR Consultant -- 99% Positive Feedback on 3293 Legal Accepts
GPHR cer BS, U.S.C. Pueblo; Immigration Law by Am. Mngmnt Association & USCIS Bus. Liaison ofc 1999
Reply
September 28 2007 at 7:38 AM (28 minutes and 28 seconds later)
         
I was in a car accident...fracture my skull, broke right eye scoket and entire right side of face.

this resulted in partial epileptic seizures. also re-opened the incisions from 2 ear operations. the operations were to cease additional loss of hearing...and to help with visual and audio processing. i had a vestibular disorder (perilymphic fistulas)...this had been corrected. I had been able (prior to accident)
to return to the work force and had a relatively high paying job.

Am no longer able to work. Due to a recurrence of the ear and neuro problems, I had a fall and seizure which left me with fractured vertabrae and am now wheelchair bound.

In an effort to have the operation again, to repaire damage from accident in car, Insurance company had me for an Independent Medical Exam..with one of their doctors.

However, where my doctors are associated with well known hospitals and highly thought of Neuro Ear and Eye specialists WHO HAVE REPEATLY submitted notes and extensive sophistcated tests results...they sent me to a general Ear Nose & throat doctor that removes tonsild and does Nose jobs. who sated no further tratment was necessary...However when I went for an eye IME, in Manalapna Nj (3 hours round trip) there dr immediately said..why are u here?..I told insurance company...your doctor's words are gold..ACCEPT them.

Do ins co allows me to see Eye specialist...but refuses me the operations and the ability to have the vestibular (ear part) monitior. It is getting worse.

Aren't I entitled to see a doctor of equal stature? Or must I accept..a general doctor diagnosis over a specislist's

Does my dr. diagnosis prevail? Do I have to keep proving my illnesses?..isn;t a law that states they have to contradict with a equalate docor
Customer (name blocked for privacy)
Reply
September 28 2007 at 8:26 AM (48 minutes and 43 seconds later)
         
i haven't received an answer to my question...so

1. why are you depositeing my money twice?

and
2. when will i get an answer?
Customer (name blocked for privacy)
Answer
September 28 2007 at 12:29 PM (4 hours and 2 minutes and 23 seconds later)
         
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Ed Johnson -- International HR Consultant -- 99% Positive Feedback on 3293 Legal Accepts
GPHR cer BS, U.S.C. Pueblo; Immigration Law by Am. Mngmnt Association & USCIS Bus. Liaison ofc 1999
Reply
September 28 2007 at 12:51 PM (22 minutes and 33 seconds later)
         
I SENT EVERYTHING U ASKED FOR 6 HOURS AGO!!!!

IRIS SHAPIRO
WHO WRITES IN CAPS BECAUSE IT IS EASIER FOR ME

bUT answer you in lower case as you requested!!!!!!

Sir

This is not acceptable. I knew the answer you are giving me. I wanted a definite answer. Yes, I know I can file an appeal...however wanted to know if there was an existing precedent, stature, law, etc that regulates. When a doctor is not of the same level as a specialist, and ins co cant find one..who prevails...I explained what happened with another doctor in same case.

Also is it necessary for me to have to prove my medical problems over & over if substansating paperwork has been filed...and what constitues
maximum improvement?..if i have gotten to a place which I can function...how do I continue to stay at that level???   with rapidly failing medical conditions, I wanted to know how to avoid a hearing and arbitration..

Obviously, your service can't help. I only was willing to pay for help. Not repeating info from the site where I got your #

Iris


i have read the answer...did you read the question?...did I ask if I can ask for a third option NO! did I ask if I can file an appeal...NO!

so, I think this service

a.   doesn't read questions
b. wont admit they are stumped
c. will do anything to get money

not to be insulting...but almost 7 hours for this?
Customer (name blocked for privacy)
Reply
September 28 2007 at 1:12 PM (20 minutes and 54 seconds later)
         
IS ABOVE ACCEPTABLE TO GET AN ANSWER???????????
Customer (name blocked for privacy)
Reply
September 28 2007 at 3:51 PM (2 hours and 39 minutes and 24 seconds later)
         
Er, should we consider this a lost cause?..After 9 hours. I know nothing more than when I started.

I don't think you should say, on the Insurance page, you can help, you can't. I knew about
filing appeals and arbitration...its right there. So, what have I gained?..A sore backside, pain in my spine, and a headache. Please just let's confirm you are at a loss to help..Ok

Please answer this

Iris Shapiro..really upset
Customer (name blocked for privacy)
Answer
September 28 2007 at 5:44 PM (1 hour and 52 minutes and 2 seconds later)
         
THIS ANSWER IS LOCKED!
You can view this answer by clicking here to Register or Login and paying $3.
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Ed Johnson -- International HR Consultant -- 99% Positive Feedback on 3293 Legal Accepts
GPHR cer BS, U.S.C. Pueblo; Immigration Law by Am. Mngmnt Association & USCIS Bus. Liaison ofc 1999
Reply
September 28 2007 at 7:03 PM (1 hour and 19 minutes and 39 seconds later)
         
Excuse.........me, unintelligible......have you read your answer? For someone with your credentials.   One would assume you would know how to spell!!! And for all your so-called achievements, Iam not impressed. You see before the damage to my brain..I acted as a pro-se before the Us Court of Appeals for the Eastern District in Ny and won.

And there are precedents...which you should know.
In fact, when I mentioned having to go to South Jersey, you should have responded that I am not required to go outside my county unless I consent/

It looks like I will have to do this byself..And as for your sitting in front of a computer as you have a list of clients. well then don;t tell me to sit here and wait. You are arrogant, self-impressed and a condesending i***t.

Please cancel any request for help, as I see none will be forth coming. Had hoped tp avoid a trip to the law library at Columbia..but I guess that's the only way to get my answer..or even a FREE consultation with a LAWYER!!!!

Iris Shapiro
Customer (name blocked for privacy)
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