[Maria]

Is this a situation where one is injured at work (no matter what dept you work in or job title) and one files the injury as work related intially or doesn't?

If originally filed as Work Related injury and one has private insurance so in essence if one is seen as a non industrial accident/injury would this not make it more difficult have the WC carrier approve/pay on something that was seen as non industrial or does it just not matter because one filed as a WC injury originally but chooses to utilize private insurance and the insurances can battle it all out in the aftermath?

In between the time I had my first surgery and 2nd and even after 2nd surgery I was attended by my employer's insurance. Only when I went for MRIs, Pain Management and later more surgery did I utilize the WC insurance. Now since 2000 I've utilized my WC insurance but it's getting increasingly difficult to get ESIs authorized even 3 x/year which was the norm for me and helped greatly.

I've thought about using private insurance but then again there's that thing about *is this a work related injury*. If I say yes then I'm told it has to be dealt with by my WC carrier and authorization has to be obtained first. Sometimes I will be seen with private insurance saying my something else hurts and I know it's related to my low back prob but I want to be seen w/o all the hassle.

I do have to wonder that if I'm seen as a non industrial patient for my low back and get an ESI ordered/done then would the WC insuranc *have to pay* just because I have future medical on my low back. The adjustors have always told me that if I utilize another insurance for my spine problem and it's not authorized by WC they do not have to pay.

The WC firm that took care of my case advised me that the private insurance didn't have to pay for non authorized care related to my work related injury. I have tried consulting with other WC attorneys and I've had a range of advice such as take the money and run (what's offered in closing out future med) and that the legislation is so vague right now that it's hard to tell what will happen...

Allan hooked me up with someone that answered a question for me really easily and freely. The guy was great. Of course I didn't ask him *that question* as I had a situation at that time that was hanging over me WC wise.

If you can use your PPO/private insurance and get your needs taken care of, do so esp. if WC will pay anyway if the other insurance doesn't or if you've just decided to go the non WC route.