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Tn. WC not paying for pre surgery checkup

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  • Tn. WC not paying for pre surgery checkup

    I am on plavix to prevent blood clots forming due to a recent abnormal ekg.I am to have wrist surgery and have to be off plavix for a week before surgery. My question is "why is WC not going to pay for a check with the cardiologist to approve being off plavix before surgery?" Any help would be appreciated.I see the heart doc wednesday april 19th. Thanks

  • #2
    Umm...because it's not a work related injury or illness?
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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    • #3
      Maybe i should have mentioned that i am on WC for an injury to my hand which is why i have to have surgery

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      • #4
        And maybe I should mention that no one here works for your workers comp carrier, and the LLT crystal ball is out being recalibrated. So we don't have a clue why they aren't paying for it.

        So, when you asked the workers comp carrier why they weren't paying for the pre-surgery check, what did they say?
        The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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        • #5
          they told me that the checkup was not covered because that would have to be done before any surgery i would have because of the plavix.

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          • #6
            Then that's your reason. We don't have another one.

            If you disagree with it, your recourse is to appeal the decision.
            The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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            • #7
              You can appeal but in many states this would not be covered. It isn't unique to your work injury or surgery. Usually the blood work and pre-surgical tets that would be required of any person undoing a procedure are covered but not ones specific to unrelated medical conditions.
              I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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