What to do if workers comp has stopped paying for 24-hour nursing care?

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What to do if workers comp has stopped paying for 24-hour nursing care?

I am under contract with my workers comp such that they send me a check so that I can have 24-hour care. I am a C 3-4 quad. This arrangement was set up through their attorney and the one that I had at the time. Can I force them to pay up?

Asked on October 19, 2010 under Insurance Law, Illinois

Answers:

Mike Harvath / Harvath Law

Answered 13 years ago | Contributor

     Hi.  I am an Illinois injury attorney that focuses my practice primarily on work injury and personal injury claims.

     In order to determine what the necessary procedure would be to force the insurance company to continue making payments, it would be necessary to know what type of agreement you have.  Is the agreement an award of workers' compensation benefits that was ordered by the Division of Workers' Compensation?  Did you receive a lump sum of money as well for the permanency of your injuries, or just the weekly checks (which are currently not being paid)?  Also, did you end the representation with your attorney, or did the attorney end the representation because he/she had concluded the resolution of your case?

     The type of agreement you have and whether or not it is an "Award of Benefits" from the Division of Workers' Compensation is important to know because an award of benefits should not be difficult to enforce against the insurance company.

     For convenience, I can be reached by e-mail at mth2000@yahoo.com.  Thank you.

NOTE: This answer is for educational purposes and does not constitute legal advice.  The use of this site does not create an attorney-client relationship or privilege between the user and the attorney responding.

M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney

Answered 13 years ago | Contributor

What you need to do is to hire an attorney as soon as you can.  Why have they stopped paying?  Was the agreement temporary?  You need to get help. If there is an agreement in place then the agreement is a contract that can be enforced in court.  So yes, you can indeed sue them in court to get them to pay. But my concern here goes beyond the comp agreement.  Is it a permanent award and agreement?  Is it condition upon their assessment of your situation be say a nurse on the case every so often? Obviously your physical condition warrants your need for care so it is not like you are asking for the care based upon a subjective and thus difficult ailment to prove.  Get legal help. Good luck.


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