{"id":595,"date":"2014-06-24T07:34:00","date_gmt":"2014-06-24T07:34:00","guid":{"rendered":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/?p=595"},"modified":"2020-01-29T14:23:36","modified_gmt":"2020-01-29T14:23:36","slug":"what-to-do-about-delays-in-getting-medical-care","status":"publish","type":"post","link":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/2014\/06\/articles\/benefits\/medical-care\/what-to-do-about-delays-in-getting-medical-care\/","title":{"rendered":"What To Do About Delays In Getting Medical Care"},"content":{"rendered":"<p class=\"MsoNormal\"><span>&nbsp;<\/span><\/p>\n<p class=\"MsoNormal\"><b><span>1. First, know how long the adjuster has to approve or deny your doctor&#8217;s request.&nbsp;<\/span><\/b><\/p>\n<ul type=\"disc\">\n<li class=\"MsoNormal\"><span>Your      adjuster has 30 days to accept or deny your Nevada work comp claim.&nbsp; Expect only      emergency care and clinic visits in the interim.&nbsp;<\/span><\/li>\n<li class=\"MsoNormal\"><span>If your      doctor doesn&#8217;t think that diagnostic tests or treatment are necessary now,      your only option is to ask for a provider list of alternate doctors.      &nbsp;If you ask in writing within the first 90 days of your claim, the      adjuster must approve it.&nbsp; The next      doctor may agree that diagnostic tests &nbsp;<\/span><\/li>\n<li class=\"MsoNormal\"><span>Prior      authorization is required for MRI&#8217;s, more than 6 physical therapy visits,      surgery, neurological testing, or specialty consults.&nbsp;<\/span><\/li>\n<li class=\"MsoNormal\"><span>Nevada law      gives the adjuster 5 working days from receipt of the doctor&#8217;s request      form to approve or deny it. NRS 616C.157.&nbsp;<\/span><\/li>\n<li class=\"MsoNormal\"><span>Adjusters      routinely ignore the 5-day rule by scheduling a second opinion      consultation. &nbsp;Or, the adjuster may ask for a review by an outside      doctor hired to control claims costs, particularly if a low back surgery      is requested.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\"><b><span>2. Find out why there is a delay.<\/span><\/b><\/p>\n<ul type=\"disc\">\n<li class=\"MsoNormal\"><span>Don&#8217;t      assume it&rsquo;s the adjuster&#8217;s fault. &nbsp;Ask your doctor&#8217;s staff when they      faxed the authorization form. &nbsp;It      may not have been faxed for several days after you saw your doctor.&nbsp; Make sure they faxed an authorization      form.<\/span><\/li>\n<li class=\"MsoNormal\"><span>The      adjuster will also need the doctor&#8217;s dictated report if an expensive medical      procedure is requested.&nbsp; The adjuster may also ask the doctor answer      questions about preexisting conditions or what injuries were caused by      this accident. <\/span><\/li>\n<li class=\"MsoNormal\"><span>Politely      ask the adjuster whether she received the authorization form. &nbsp;If she      didn&#8217;t get it, confirm her fax number, and ask your doctor to re-fax it to      the correct number. &nbsp;If the adjuster claims she already returned the      form, ask her to please re-fax it.&nbsp;<b>Many delays are due to wrong      fax numbers, misplaced faxes, or the doctor&#8217;s failure to send the      necessary authorization form.<\/b><\/span><\/li>\n<li class=\"MsoNormal\"><span>Don&rsquo;t      resist any second surgical consultation the adjuster schedules. It will      just delay things further and could result in a suspension of your      benefits. &nbsp; However, if the adjuster wants multiple consults, she is      probably going to deny your doctor&#8217;s treatment request. &nbsp;Get legal      help soon. <\/span><\/li>\n<li class=\"MsoNormal\"><span>Using      abusive language or calling the adjuster daily will only result in      purposeful delayed action by the adjuster. &nbsp;&nbsp;<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\"><b><span>3. For denied or indefinite delays, you must&nbsp;write&nbsp;(or get help).<\/span><\/b><\/p>\n<ul type=\"disc\">\n<li class=\"MsoNormal\"><span>If      authorization is denied, don&#8217;t waste time arguing with the adjuster.      &nbsp;Quickly file a request for hearing, and get your doctor&#8217;s reports to      present your position to the hearing officer.&nbsp;<\/span><\/li>\n<li class=\"MsoNormal\"><span>For an      indefinite delay send a fax to the adjuster, stating that NRS 616C.157      allows your doctor to proceed as if the request was approved when there is      no response within 5 working days. &nbsp;When your doctor won&#8217;t proceed      without a signed authorization, file a request for hearing with the      Hearings Division. &nbsp;Attach a copy of your fax to the adjuster and a      copy of the request form your doctor sent.&nbsp;<\/span><\/li>\n<li class=\"MsoNormal\"><span>Secondly,      send DIR a complaint letter about the delay.&nbsp;<b>Copy the adjuster.<\/b>&nbsp;      &nbsp;Attach your supporting documents. &nbsp;DIR may not be helpful, but      the adjuster won&#8217;t want to take the risk of getting fined for a violation      of the law. &nbsp; The adjuster will now quickly authorize the request or      deny it, giving you the right to file an appeal. &nbsp;Promptly file any      appeals within the 70-day time limit.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin-left:.5in\"><span>&nbsp;<\/span><\/p>\n<p class=\"MsoNormal\"><span>&nbsp;<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; 1. First, know how long the adjuster has to approve or deny your doctor&#8217;s request.&nbsp; Your adjuster has 30 days to accept or deny your Nevada work comp claim.&nbsp; Expect only emergency care and clinic visits in the interim.&nbsp; If your doctor doesn&#8217;t think that diagnostic tests or treatment are necessary now, your only &hellip; <a href=\"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/2014\/06\/articles\/benefits\/medical-care\/what-to-do-about-delays-in-getting-medical-care\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">What To Do About Delays In Getting Medical Care<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[73],"tags":[172,280,306,321,333,342,408,505],"class_list":["post-595","post","type-post","status-publish","format-standard","hentry","category-medical-care","tag-compensation","tag-insurer","tag-loss","tag-medical-care","tag-motion","tag-nevada","tag-range","tag-workers"],"acf":[],"aioseo_notices":[],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts\/595","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/comments?post=595"}],"version-history":[{"count":4,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts\/595\/revisions"}],"predecessor-version":[{"id":1579,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts\/595\/revisions\/1579"}],"wp:attachment":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/media?parent=595"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/categories?post=595"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/tags?post=595"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}