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my wife was injured at work a few years ago,part of her settlement

 

Customer Question

my wife was injured at work a few years ago,part of her settlement was life time medical on her back,now she needs her annual shot in her back but cant get approval through workmenscomp . She has been going through this for 4 months, she went to apply for ssi,they denied her because I am disabled and get too much income,what are her rights and does she still have lifetime medical? Can she get some kind of assistance through the Gov. until we can get the answers to the legal side. She was also denied medicaid. Please give a answer know, she is in a lot of pain, dont know what to do. Thank you all for listening.

HURTING BAKERS.

 

Optional Information:
State/Country relating to question: Tennessee

Already Tried:
By contacting her lawyer at the time,and her old insurance co. at the time but get now answers form either so far and thats been 4 months.

Submitted: 305 days and 15 hours ago.
Category: Consumer Protection Law
Value: $59
Status: CLOSED

Accepted Answer

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Expert:  VAMD, Esq. replied 305 days and 14 hours ago.

Hello and thank you for allowing me the opportunity to assist you.

If your wife has a settlement agreement that states that she has lifetime medical care for her back, then she certainly has the right to enforce that settlement agreement, since a settlement agreement is basically a contract. In exchange for giving up the right to sue, your wife agreed to accept an offer that included the medical care. Accordingly, your wife could sue to enforce the settlement agreement to get the shot. My suggestion is for her to speak to a local attorney who has experience in worker's comp claims. I'm surprised that her lawyer who worked on the settlement didn't help. But it may be time to move on and find a lawyer who will help. She should call around to various attorneys in the area and set up a consultation (most will give a free initial consultation).

As for the pain, I'm sorry to say that if she doesn't qualify for Medicare or SSI, then government assistance is unlikely. However, if the pain is unbearable, then she may consider visiting the ER. Federal law requires that an ER takes any patient who has an emergency regardless of the ability to pay. So, it's possible that if the pain is unbearable, then the ER may give her the shot she needs (or something else helpful), and then bill her after the fact. She would likely owe the ER, but it may be possible to get that bill paid for if it is determined that the settlement agreement was breached.

If you would like any additional information or need clarification, please do not hesitate to ask!

Also, I strive to be as helpful as possible so that you are satisfied and will give me positive feedback. Accordingly, please remember to only rate my answer when you are 100% satisfied. IF you feel the need to click either "I expected more" or "Helped a little" (which are considered negative ratings on this website), please stop and instead of rating me, reply via the REPLY or CONTINUE CONVERSATION button with the issue that you have. I will be happy to continue our discussion and do everything that I can to provide you with the service that you seek.

Thank you.

Expert TypeAttorney
Category: Consumer Protection Law
Pos. Feedback: 96.4 %
Accepts: 502
Answered: 6/27/2012

Experience: Licensed to Practice Law

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