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denisemariepaulene

Service dog workers compensation

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Had two serious accidents as covered and provided under Fl WC l,aw.  Fist was in Oct 1984.  Neurosurgery required.  Chronic pain continues. Did not settle medical benefits and are open today, per the State Financial Services and the e/c for the employer who is self insured.  See Neuropsychiatrist and pain management MD each month and med RX covered. Did not need a service dog. Went back to work for 5 years before attending law school.

 

Attended and graduated cum laude from law school in 1992.  2000 admitted to practice law before Supreme Court of US. Practiced law until March 2000, when large truck hit my car and totaled it and nearly me.  My auto and workers compensation covered the medical and other related  expenses. Per my neuropsychiatrist RX service dog and one became availkable without need to file claim Workers comp e/c in Florida responsible for medical expenses as I was returning from neurologist for check up of second surgery needed in neck from Oct 1984 wc accjdent and the e/c of 1984 paid medical and continues to pay medical benefits.

 

I am not the oldest medical  case in workers comp in Florida.

 

It is now Jan 2018.  My service dog died 6y months ago.  Seeking replkavement per pain management MD and psychitrist RX and medical necessity RX.

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54 minutes ago, denisemariepaulene said:

 

 

My service dog died 6y months ago.  Seeking replkavement per pain management MD and psychitrist RX and medical necessity RX.

 

You had a lengthy discussion on this topic in Sept/Oct with no resolution.

 

https://boards.answers.findlaw.com/topic/240375-service-dog-workers-comp/#comment-611079

 

If you still want to know if WC will pay for a replacement service dog the best and only place to ask is of the WC carrier.

 

If the claims person says no, then you either accept it or you hire a WC lawyer and litigate the issue.

 

 

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Thank you for your response to my inquiry.  I am in the South, and there is a saying that I'd liked to share with you regarding the discussion and personal legal opinions that responded to my inquiry last fall:

"THAT DOG WON'T HUNT." 

The last thing, and least wise thing,  in our legal world, would be fo me to ask the carrier for a succession service dog to learn if one would be provided.  Then try to find a wc attorney to file a petition for same.

 

1.  No WC attorney will take the case unless I agree to a settlement of my medical benefits.  (Not enough $ for the attorney to take the case otherwise.)

 

2.  I have permanent serious injuries and would be an absolute fool to settle my medical benefits for life.  You understand also the complications of the Medicare set-asides involved.

 

3.  While an old friend that still practices WC has decided to try to take on the case, it is by sheer friendship and having practiced in the WC trenches years ago with me that he is stoked enough by how a number of my physicians' medical necessity requests for other needed care I have had for years are being denied.  He and I understand the game being played; the carrier is trying to wear me down and force me into a corner in order to get me to agree to a settlement of my medical benefits.  They tried it with our clients, and we fought hard to prevent it.

 

4.  There is another Southern saying to be shared:  "One can ignore the discussion of a long winded man; but when a Southern woman isn't talking, pay attention.  She is hiding the shotgun behind her back."    The shotgun isn't loaded with all the specific shot needed yet and I am trying to secure that it does.

 

5.  When I can have enough info of the details, and have prepared the three specialists caring for me for the last 30 years on how exactly their Medical Necessity Requests must be written as opposed to the typical medical care Medical Necessity Requests are drafted, and the specifically needed requirements to acquire a proper functioning breed and trained service dog in my geographic location, I will fill that gun with the all the shot my attorney to prepare the petition.  He will know when to fire it before the carrier even knows the petition absolutely meets every and all the necessary requirements.  That petition for the service dog is much more complicated and detailed than any my friend or I have ever seen, much less drafted. 

 

6.  Then I am in the position to hire my attorney and hand him the shotgun and let him do what he knows best to do.  Never met a better WC attorney, and he is successful, respectful, thorough, and respected, not hated, by any opposing WC attorney or WC judge in our jurisdiction.  I am very glad I let him win a poker most of the time.

 

7. Cases are beginning to be reported in the positive by some of your more understanding members that meet the criteria of current WC law and service dogs and my appreciation to them is great.  THEY GET IT!

 

The response last fall was mostly discussion, and no one felt the care of the service dog would be provided even if the service dog was. I have not just been sitting around.  My disabilities eventually cost me my livelihood and much more.

 

From the numerous calls, letters and discussions with doctors and vets, none have ever had a carrier just politely agree to a service dog, and as importantly, critical specifications must be included to acquire the proper dog, training and location of same.  The physicians medical necessity documents need to be very specific and documentation of the nexus between the injury and the unavailability of a lesser expensive medical provision  There are other issues  even if the carrier agrees, which I need to find as many answers as possible, so if a petition is filed, certain very important conditions are also requested such as  who has the freedom or the responsibility for locating a  proper trainer, the breed of dog, the location of the training, the number of years requested for healthcare of the dog.  Appears a private trainer near me needs to be found and requested, why the specific breed, size, pedigree documentation and healthcare of the dog must be requested and agreed to by the carrier. If I ask the carrier for all these stipulations, greatly doubt it will just agree.  And as already mentioned NO ATTORNEY would take the case unless I would also settle my medical benefits.

 

Now, if the attorney(s) who sent me this smug message can prove that he/she even knew or could meet the standards and all the details to be explored properly, and would take my case or find a  WC attorney to do so and would not again tell me to handle my own case (in spite of injuries (including brain  injury), let me know.  You would be one hell of an attorney.

 

I rather believe, even if I did not have my challenges,  in Lincoln's quote about an attorney who represents himself has a fool for a client. Please be more introspect and kind to anyone seeking advise or caselaw on this forum.

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On 1/4/2018 at 5:28 PM, denisemariepaulene said:
On 1/4/2018 at 6:25 PM, adjusterjack said:

 

You had a lengthy discussion on this topic in Sept/Oct with no resolution.

 

https://boards.answers.findlaw.com/topic/240375-service-dog-workers-comp/#comment-611079

 

If you still want to know if WC will pay for a replacement service dog the best and only place to ask is of the WC carrier.

 

If the claims person says no, then you either accept it or you hire a WC lawyer and litigate the issue.

 

 

Had two serious accidents as covered and provided under Fl WC l,aw.  Fist was in Oct 1984.  Neurosurgery required.  Chronic pain continues. Did not settle medical benefits and are open today, per the State Financial Services and the e/c for the employer who is self insured.  See Neuropsychiatrist and pain management MD each month and med RX covered. Did not need a service dog. Went back to work for 5 years before attending law school.

 

Attended and graduated cum laude from law school in 1992.  2000 admitted to practice law before Supreme Court of US. Practiced law until March 2000, when large truck hit my car and totaled it and nearly me.  My auto and workers compensation covered the medical and other related  expenses. Per my neuropsychiatrist RX service dog and one became availkable without need to file claim Workers comp e/c in Florida responsible for medical expenses as I was returning from neurologist for check up of second surgery needed in neck from Oct 1984 wc accjdent and the e/c of 1984 paid medical and continues to pay medical benefits.

 

I am not the oldest medical  case in workers comp in Florida.

 

It is now Jan 2018.  My service dog died 6y months ago.  Seeking replkavement per pain management MD and psychitrist RX and medical necessity RX.  Cannot find any FL case law on WC e/c providing service dog;  may be case of first impression here. Anyone deal with this issue or aware of any caselaw regarding same?

14

 

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On 1/4/2018 at 5:55 PM, ElleMD said:

Do you have a question?  YES does anyone have any information oir caselaw regarding WC and e/c responsibility to provide as a medical necessity a service dog if medical benefits have not been settled.  Appears may be case of first impression in FL and no attoreny wants the case as does not have enough "skin" for fees .  And why do you still have adjusterjack even on this forum, as his smug, nasty report/reply obviously shows he has no clue as to what is involved in matter.  I have submitted a reply to explain at length why he would never make it as an attirney in Florida, much less in workers comp.

Yes, does anyone have any info or case law regarding e/c responsibility to provide a medical necessity service dog if medicalbenefits are not settled and two dates of serious accidents are involved.  May be a case of first impression in Florida, and no attorney will accept case as there is not enough "skin" in it for attorneys fees unless medical benefits are also settled at same time?  And believe AdjusterJack needs to ":ADJUST HIS ATTITUDE".  His lack of knowledge indicates he should remain an adjuster as he would not make it as an attorney in Florida much less in practice of WC.  His response to me is a reason why I always had to try to convince that niot all adjusters were the "enemy."

17

Does anyone have any information or caselaw regarding WC and e/c responsibility as a medical necessity a service dog if medical  benefits have not been settled.  Appears may be a case of first impression in Florida.  No workers comp attorney will accept the case as not enough "skin" in it for attorney fees.

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On 1/4/2018 at 6:25 PM, adjusterjack said:

 

You had a lengthy discussion on this topic in Sept/Oct with no resolution.

 

https://boards.answers.findlaw.com/topic/240375-service-dog-workers-comp/#comment-611079

 

If you still want to know if WC will pay for a replacement service dog the best and only place to ask is of the WC carrier.

 

If the claims person says no, then you either accept it or you hire a WC lawyer and litigate the issue.

 

 

 

On 1/4/2018 at 6:25 PM, adjusterjack said:

 

You had a lengthy discussion on this topic in Sept/Oct with no resolution.

 

https://boards.answers.findlaw.com/topic/240375-service-dog-workers-comp/#comment-611079

 

If you still want to know if WC will pay for a replacement service dog the best and only place to ask is of the WC carrier.

 

If the claims person says no, then you either accept it or you hire a WC lawyer and litigate the issue.

 

 

 

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You have added nothing new to your scenario. Even if there was a case where a service dog had been approved in the past, or even denied in the past, YOUR case is still different. If you are an attorney, you should know that. If you can't get an attorney to take the case, that should tell you something. MSAs are a pain in the neck (though you don't have to do anything so it really shouldn't matter to you), but so is having to go back to the carrier for treatment approvals. Maybe, consider listening to those attorneys who tell you to settle. It is your right not to, but I can't fathom why you would go to multiple attorneys for advice and then disregard that advice.

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Attorneys are not encouraging me to settle.  They just don't want to just handle the service dog issues as not enough money in it for them.  If I settled my benefits, there is a significant fee.  Thank you for your response. Bottom line is I may need an assisted living arrangement as I age with the injuries. The e/c knows that and it could be financially responsible.

Over 10 years ago several financial firms ran the numbers of medical needs, costs, and lifespan; all calculated value over 7 figures and were presented when my attorney had to offer settlement figures. E/C actually took those documents and contacted the firms...only.offered $100,000 which they could not offer any justification to the rather surprised arbitrator. Obviously, there was no settlement, went to court and e/c  ordered to continue benefits.  SSD determined I was totally disabled  without  filing a reconsideration when I was 50. 

My case doesn't

fall under any managed care restrictions or process, and the e/c is delaying and/or not authorizing the pain management epidurals, nightmare medication, and other benefits now.  etc.  I am having to pay over $2000 for the epidurals as self pay, when comp only pays $800-900. The attorney handling this wants to make certain the petition includes every benefit being denied.  I'm trying to help him as much as I can when he asks.  Am trying not to take advantage of a personal and legal friendship. He is trying to determine who gets to decide all the matters related to the service dog if the e/c is willing to negotiate the entire petition without settling my medical benefits. That is an important matter.  Do not want to be matched with  a dog that does not bond or not trained with me involved.  Wish it to be a local trainer  rather than away at a camp  and I have only 2-3 weeks at the end of training to stay there to have the dog bond and work with me. Have dealt with my permanent injuries for over 30 years.  I simply will not be able to afford the retail self pay cost of my healthcare that is covered by WC.

 

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Still doesn't change anything. If you can't find an attorney to take the case, then that should tell you something about your odds. If you are/were an attorney, you know how they get paid in WC claims; so that isn't a reason they are turning you down, no matter what they tell you.

 

It is clear you do not understand how MSAs work in a WC settlement, but that is something that is much too complex to cover on a message board.

 

At the end of the day, your options are exactly the same as they were 20 posts ago; either file to litigate the dog through the WC system, or don't. If you can't find an attorney to take the claim, you will have to handle it pro se.

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Well, ElleMD, thank you for your condescending reply and as you seem to think you have all the answers in this situation, and they are always the same, please just leave me alone.  You apparently have more time on your hands than I do.  Supportive comments might show a different side of you.  Amazing how one gentleman was able to respond privately to me in 30 minutes with the case law and how to go about this in a productive way.  He mentioned how he monitors this forum and several others and remarked upon the egos and disrespect that you and a few others have in this venue and is considering flagging you.

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Free advice is worth what you pay for it. You have posted for months asking the same exact questions that have the same exact answers. Those answers are not going to change. I don't know who you spoke with but I have conversed with and know the moderators and there is no issue. If you don't like the answers, you re free to ignore them. Vaguely veiled threats are not going to encourage others who might have been inclined to help you to do so. If anything posted was inaccurate, by all means post your links to correct information.

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31 minutes ago, denisemariepaulene said:

Amazing how one gentleman was able to respond privately to me in 30 minutes with the case law and how to go about this in a productive way.

 

I have to wonder about the ethics of anyone who would respond privately and provide the results of legal research and (apparently) legal advice.  Query whether this person is an attorney admitted in your state (or an attorney at all).  You're obviously free to do as you please with whatever information you received, but that sort of thing is a great way for an attorney to get sued for legal malpractice or disbarred or both.

 

 

33 minutes ago, denisemariepaulene said:

He mentioned how he monitors this forum and several others and remarked upon the egos and disrespect that you and a few others have in this venue and is considering flagging you.

 

Everyone's got an opinion.  If this unknown coward has an opinion to express, he or she is certainly free to express it by actually posting on the boards.  As someone who has posted on these and other boards for more that 15 years, I can assure you that there will be no adverse consequences for the sorts of responses that "ElleMD" has posted here.  As noted, if you don't like the responses you get here, you're free to go elsewhere for free legal information.

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As a new person to this post. I can understand the frustration your going through as im disabled vet trying to get my 1st service dog that my mental health provider has given to me. Its Hoops and jumps to get it started. But from the NE I know some who also was disabled by accident, insurance company was giving him the run. Around as he tried doing it the way he thought he should  but then he realized that if the Dr submitted the order for the dog then insurance would receive orders from the dr and have tk process them. But they can give a client the run around. I dont know if it's the same where you are but that's what j would do get the dog deal with the insurance after the fact its alot harder for them to take something away then the they give approval to get.  NOW all I have to say is it seemed like you were giving a very detailed account of your situation and yes the reply was sarcastic and repetitive saying same thing over and over and then gives you a spiel about same question over and over which you should do thinking that may be someone else would answer not the same guy repeating the same answer. Like you said when answering it's his question feel free to ignore it especially if you already gave an answer. He is trying to get help while going through something and def doesnt need your crap that had absolutely no impact on his situation and hell wasnt even advise you asked him questions about not listening to lawyers he's asked. To me in the army your what we call a **** house lawyer someone who had to act like they had everything figured out and nothing they said or did or was wrong. Anf those meat heads were the ones out on the front lines running their mouths still not realizing what got them where they were.   If your not helping or being constructive to people asking for help why the hell would you open your mouth and show how ignorant you truly are by trying to belittle the poster and somehow make yourself feel or look better somehow but u never do you prove how incompetent you are.  Please something's can push people over the edge even something as small as that back and forth earlier there no reason for that on website that is ment for people to help each other not try to act like they better then everyone. If some one asks for help and you cant either keep it shut or maybe rec something or someone that can help. 

 

That's all good luck let me know how you make out with the S.DOG when u get it squared away..

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