Not resolved

Mother and Son Carbon Monoxide Poisoning Ak 2013.

State Farm is the Corporate Giant which holds the Workers Comp claim. The Family extremely abused and abandoned by this company to say the very minimum.

Brain damaged mother and 12 year old Son abandoned by all. The game that State Farm has played is unbelievable yet oh so factually true. Very well documented truth filled story of corporate power abuse which translates to severe fraud. Would love to share with the world of truly injured workers, media and/or anyone which still stands up for truth and people wronged by Corporate conglomerates !

The story beginning can easily be googled by any, but the Long journey in between and to current can not. Do Not Expect righteous or professional treatment from State Farm unless you are the corporate end user!!

Product or Service Mentioned: State Farm Insurance Claim.

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Bentonville, Arkansas, United States #958778

IME Crookedness is Not a Secret in Comp and Corporate Insurance Giants such as State Farm.


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Share: Avoid Workers' Compensation Doctors' Conflicts of Interest by Judge Anthony P. Calisi (ret.) Navigating the workers' compensation medical process can add even more discomfort to a painful work injury.

Each state has its own rules and regulations regarding workers' comp claims, but one rule is common to all: Injured workers seeking benefits must be evaluated and diagnosed by workers' compensation doctors hired by the employer's insurance company. If you are injured on the job and making a workers' comp claim , you must be medically evaluated and treated by doctors who are approved by your employer's insurance company. Virtually all state regulations permit you to be treated by your own doctor, but your claim is highly dependent on the medical opinion of the doctor(s) you choose from the insurance company's approved list. Doctor Competence Doctors have various reasons for deciding to work for an insurance company, but like most people in the workforce, their goal is a paycheck.

Whether they are seeking to augment their private practices or are retired and need additional income, most are financially motivated. Doctors with certifications in surgery, orthopedics, or other specialties aren't often found performing medical evaluations for workers' comp insurance companies. Depending on his situation, a doctor may count on the continuing income from workers' comp referrals. If he disagrees too frequently with an insurance adjuster, the doctor may find himself off the approved list of doctors.

Some doctors primarily handling workers' comp claims are often considered "fringe" doctors. Many don't keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. Some are general practitioners with limited or no previous experience in orthopedic medicine. The majority of workers' comp claims involve torn cartilage, herniated disks, stretched muscles and tendons, and other soft tissue injuries .

Back injuries are especially difficult to diagnose. Often determining the root cause of a patient's back pain requires MRIs, CT Scans, and other expensive diagnostic tools. Workers' compensation doctors know insurance companies don't like spending money on diagnostics. They are expensive and complicate the entire claim.

The doctor may not tell you he would recommend those diagnostic or therapeutic services. Then he won't have to deal with your frustration or become embroiled in a controversy with the insurance company. As a result, a good number of insurance company approved doctors are more likely to treat injuries with pain medication. Pills are much less expensive than an MRI.

Too often doctors don't believe patients' accounts of their pain and discomfort. To remain on the list for workers' comp referrals, some doctors may classify patients as malingerers, rather than diagnosing real pain issues. That's why second opinions are so valuable. Independent Medical Examinations Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME): The insurance company disagrees with their doctors or with your private doctor.

The claim is moving too slowly and/or costs are rising too quickly. (Workers' comp insurance adjusters want to close claims as quickly and cheaply as possible.) Evidence is needed to resolve a controversy about the patients' condition and right to benefits, to deny the claim, or to extremely limit the amount and type of treatment the injured worker receives. There is no such thing as a true IME. Doctors hired to perform IMEs are usually paid by the same workers' comp insurance company handling your claim.

In most cases, the adjuster working your claim chooses the doctor you will be required to see. If requested by the insurance company, you must submit to an IME. Your refusal may allow the adjuster to deny your claim. The role of the workers' compensation doctor performing the IME is not to treat you.

Her job is to study all the medical notes and documents related to your claim, discuss your injury, and examine you. The examinations are traditionally very short, some lasting less than ten minutes. Most doctors who perform IMEs have little incentive to take the necessary time to study all the medical documentation related to your claim. Fees are based on the number of patients, not on the time spent on each case.

Therefore, the more patients the doctor sees, the more money she is paid by the insurance company. The Role of the Nurse Case Manager Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. You may have a nurse case manager assigned to help you with your claim. The nurse may present herself as your advocate who is acting in your best interests.

Although most nurses are honest and hard-working, do not forget that she is employed by the insurance company. She may ask to be in the room when the doctor is examining or treating you. You must understand that nurse case managers are bound to share their findings and impressions of you with the insurance company. Therefore, anything you say can be used against you.

In most states you can refuse to have the nurse in the examination room with you while you are seeing the doctor. In addition, you don't have to speak with the nurse. Remember, it's you against the insurance company, and the nurse case manager is just another of their employees. Doctors with Financial Interest in Health Care Facilities Another potential conflict of interest arises when doctors own or have financial connections in the health care facilities they are referring you to for diagnostic exams.

Because of their financial interests, doctors may order unnecessary or questionable tests hoping the insurance company will pay for them. Should the insurance company deem those tests medically unnecessary, you may be personally responsible for the costs of the tests or other extended treatment. There are doctors who order tests because they truly believe it's in your medical best interest to do so. These doctors put your health needs first without concern for who will later be responsible for paying.

That may be the right thing to do, but when the insurance company later refuses to pay, you may have to bear the costs. Most workers' compensation doctors will seek approval for diagnostic tests (and extended treatment) from the insurance company before scheduling them. Even so, it's a good idea to ask the doctor if the insurance has agreed to pay before submitting to any diagnostic tests. Doctor Prescribed and Sold Medications In some states, doctors can both prescribe and sell medications to their patients.

A substantial number of workers' comp insurance companies do not interfere when their approved doctors sell prescribed medications to patients at highly inflated prices. According to a New York Times investigation , doctors can make tens of thousands of dollars each year selling medications to patients at a price as high as 10 times what they would pay at a local pharmacy for the same prescription. The newspaper cited an example of a doctor who sold thousands of Zantac pills for $3.25 each when a local pharmacy sold the same medication for $0.35. Workers' comp insurance companies reimburse the cost for medication they determine medically necessary, but refuse to pay if they find it unnecessary.

Keep that in mind if a doctor writes you a prescription, then offers to fill it at the office. You could avoid a much higher out-of-pocket cost by driving down the road to your local pharmacy. Second Opinions You should seek a second opinion if you feel the workers' compensation doctor you chose isn't addressing your medical issues. Most workers' comp insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list.

While second opinions may seem helpful, the other doctors rendering those opinions are under the same conflict of interest as the primary one. After a specified time, usually 30 days or more after filing your claim, you'll be permitted to have an evaluation and treatment from a physician you choose, whether on the approved list or not. Getting a second (and sometimes third) medical opinion can help support your claim. A second opinion isn't always necessary.

If you believe the primary doctor is addressing your medical issues and supports your claim, seeking additional medical opinions may be risky. You're taking a chance that another medical opinion may not be as favorable, and a non-supportive opinion could damage your claim. Print Friendly and PDF Ask a Workers Compensation Doctor Question Unfortunately, we can only accept questions from the U.S.A. and we can't guarantee a response.

Please proofread your submission, and DON'T WRITE IN ALL CAPS! Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter.

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Springdale, Arkansas, United States #956821

State Farm sucks!!

Orlando, Florida, United States #956220

See my point? Where in ANY of this was a flood accident mentioned?

Do your research before commenting idiotic and irrelevant ramblings as you say. The family listed here are victims of a faulty boiler at a place of employment that has caused carbon monoxide poisoning and irreversible damage that has forever changed their lives! What could be posted is posted and whatever else you want to find out research it and use the tools you were given like I've done with this whole case! You hear something on the news or the storyline on the radio of some news clipping that catches your eye, you research it more in detail dont you?


So why not do it with this? If you're too lazy or not concerned with it move on and issue solved with your complaint :)

Bentonville, Arkansas, United States #956192

Soon. As sole caretaker, time is very limited. But I feel for the family with the King bed left as I may know their pain as we did not even get to keep that.

Bentonville, Arkansas, United States #955699

I am not sure where last post came from? However it was very true in many ways.

Thank You HonestT89.

I have hundreds of videos and legal recordings as well as proving documents that the flood gates of knowledge will release soon.. I/we truly will post only truths and helpful wealth of knowledge proving IME exams as unjust/etc. And proving that the Workers Comp system in conjunction with the Corporate Giants (Insurance Companies) or vice versa is an extremely dysfunctional system saying the least. 40 billion in profits State Farm and able to start financial institutions??

Where does all that money come from? Premiums ,and medical not paid for legitimate injured etc. Maybe?! Theft of Dignity is a great article done on the comp system!

Excellent truth filled article. Research to find.

If they blocked it ?

I think I can provide a link or copy to the interested. Many want the details however the timing and location areas are of Utmost importance .

to monoxide2 Omaha, Nebraska, United States #956126

The whole point of this web site is to put your story out here, not try to get others to go check this site, that site whAtevr...i am saying as a random person coming across this, it makes no sense and i am not going to go to otter web sites...tell the story here, and tell how it started, what happened and what was the end result,then if you want to add 'proof' to your story, then add the sites maybe at the end. You dont come on here,not giving details, and expect others just to randomly going to other sites just to figure out what is the story and what happened, when that is what this page is for..just saying..sounds like you are making stuff up otherwise.

With this said, i do know of a house that burnt down in my towN about 15yrs ago and state farm screwed them, and the had a large sign the size of a king sized bed oN a busy road for years while they tried to rebuild.

then another was in the country and the back porch had lots of water randomly on their back porch, and state farm would not cover them siting they didnt have flood insurance which it wasnt in a flood zone it had nevr flooded before, and it was from heavy rain with no streams,lakes or anything around this house.

the more recently, my 90 year old neighbor has them, and had an issue with his roof, and it took them 6 months to come fix it. They redid his whole roof in 1 day, while it was fastly done and they cleaned up well, not even 3 weeks later about 4 feet chunk of his dining room ceiling fell all over the room froM a leak where state farms roofers didnt cap it right and caused It to leak ,and cause the celing to collaspe.

So see, you can explain your story and experience here where people looking up a company can read through the info here because more then likely people that come here will not go to otherwebsites to figure out what your experience is...thats all i was saying.

to gtytvuuhkbjgctg 5y4t76ffyt #956181

I have no idea what your neighbor dealt with causing a sign in their yard. I would like to clear something up as far as flood is concerned.

No homeowners policy covers flood. Flood is defined as sudden and accidental rise of water and flow of outside water including rain. Basically, it makes absolutely no difference if a home is in a flood zone or not to determine the need of flood insurance. The purpose of a flood zone is to determine the risk level of a flood and the insurance premiums associated with that risk.

No flood zone, low risk, but is could still happen. Heavy, continuous rains seeping in walls and roofs is also considered flood. Again, not covered by homeowners insurance and again, a flood zone doesn't determine where or who will be affected by heavy rains. In other words, it's up to each of us to decide if we want to take the risk by not protecting ourselves against floods or heavy rains.

Third, your info about the roof customer doesn't give enough detail to determine the reason for the six month delay, but whomever the customer chooses to do their repairs is totally up to them.

Insurance companies can recommend someone, but it's up to the customer to do their research and make the final decision. If the company that is recommended is part of an insurance program, the completed work will be guaranteed by the insurance company.

Orlando, Florida, United States #955692

Funny how this is supposed nonsense rambling yet you were given the proper info to search and read the whole story. This great thing called Google or any other search engine that has been invented will aid you in this...if you're not too lazy to use it!

There are news articles, News tappings of this family which were aired , there is a YouTube video, and so much more!!! Take the time to read and research as you would any other thing you would want to find out Via internet! They have been through pure *** and then some and denied so much due to an terrible accident beyond their control yet if it was something to aid a wounded animal or someone over seas it would be jumped all over. Pathetic much?

I think so!

I know all sides to this story and have been involved since day 1 and I can honestly say I'm sickened at how a family can be treated the way this family has and is still continuing to be treated and the big corporate personals , lawyers, and doctors for the corporation that is guilty can actually lay their heads down at night and sleep peacefully because this could have easily been someone in their freaking family! My point is do YOUR research before lashing out with idiotic comments because only so much can be posted here and what has been is sure as heck not nonsense rambling!!

to HonestT89 #956131

Um, if the whole story is too long At least post the gist of the story. People are not going to go to youtube, or other sites to try and figure out what 1 person is trying to post about here. .post the whole story or make some sense out of wonder you are getting nowhere with them if this is how you come across

Bentonville, Arkansas, United States #955685

The story is much too detailed and too long to write all. This is a post to support those who have been denied proper medical care due to a broken insurance and workers comp system.

Warning of State Farm practices through comp system. I only wish Sir or Ma'am that it was just rambling as this family has been denied medical care for nearly a year after hyperbaric that was even later controverted by the system even though sent their by physicians for hopes of physical repair.

We will share full details of tragedy if it is professionals that can provide restorative medical care or to support those lost in same broken system. Again the post was to review insurance and comp practices that many do not know they are headed for if truly injured at work.

Sincerely Thank You

Kokomo, Indiana, United States #955674

Um, we have no clue as to whats going on...why dont you start by starting the storyvat the beginning withvdetails that make sense. This post just seems like a bunch of rambling nonsense

Bentonville, Arkansas, United States #955654

12 year old is now 13. He was at the work place on Christmas break volunteering as he did often. He is not part of the comp claim.


Doesn't make sense ... 12 year old in a workmans comp claim? Why don't you give full info now.

Bentonville, Arkansas, United States #955634

Full details and documentation available. Much more to come in near future. Comments welcome as well as questions from appropriate persons and or injured workers facing and living the same tragedy of insurance neglegence ,by State Farm or other insurance Giants.

to Monoxide2 Kokomo, Indiana, United States #955679

Thats the thing, by you not posting the whole story behind what you are trying to say, how will anyone be able to understand what is going on?? You know because you lived it, but if your someone like us who has no clue, reading these postings are garbled nonsense unless you post the full story to make sense

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