Can an adjuster deny transportation if they previously provided it?

by Cindy
(Jax, FL)

I was injured on the job, and was sent to a doctor by the adjuster. At the beginning I had transportation, but now my vehicle is in need of repairs and can't be driven far. So the adjuster provided transportation.

The doctor sent me back to work and the adjuster closed my case. Then she re-opened it because the doctor spoke to a specialist who stated I should stay on light duty.

The adjuster reopened the case, but now won't provide transportation as she had before. The adjuster made appointments, even though I informed her weeks before the appointments I needed transportation. Now she told my doctor that my case is closed and I have no more visits because I didn't show for those appointments.

What can I do about this? Thank you.

Visitor Question:
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ANSWER for "Can an adjuster deny transportation if they previously provided it?":

Cindy (Jax, FL):

From the information you provide, it appears the claims adjuster was wrong in closing your claim. Workers' compensation payments are meant to cover a workers's medical, chiropractic, and even dental bills, out-of-pocket expenses, and about two-thirds of lost wages.

You made clear to the adjuster you did not have sufficient transportation to and from treatment. The adjuster apparently ignored your obvious need for such transportation. The costs of transportation to and from treatment, whether it be by taxi, bus, train, or other reasonable mode of transport, should be part of your compensation.

Contact the adjuster and tell her you want to speak with her supervisor. Make clear to the supervisor you previously advised her subordinate you had no means of transportation to and from treatment, and as a result you were unable to continue your required treatment.

Ask that your claim be reopened and that you be allowed to continue receiving the treatment you require. If, after making your case to the supervisor, she still won't agree to reopen your claim, then you will need to contact a workers' comp attorney.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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Comments for Can an adjuster deny transportation if they previously provided it?

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Denial of transportation
by: Jorge Guevara - CA

There are key points to close a file...

Is this injured worker represented by an attorney? Was there a report by the treating Dr. releasing this worker to return to work (MMI &/or P&S report)? Was the injured worker know about the doctors appointment made by the insurance, and totally missed it as no show?

It takes so little to close a file, and missing appointments is a main reason to cut benefits. I would ask for an explanation from the adjuster to explain their side and if an attorney is involved, then have him or her write a letter to the adjuster.

Have the adjuster make another doctors appointment and make sure the adjuster has the latest doctor's reports indicating any new medical status.

Jorge- CA
W/C Medical Reimbursement Specialist & Claims Examiner with total of 15 years of experience

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TYPE OF ACCIDENT
AUTO ACCIDENT
PERSONAL INJURY
WORKERS COMPENSATION
MEDICAL ERROR
YES! I WANT FAIR COMPENSATION