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Thread: Claim Denied need advise please!

Created on: 01/30/13 10:55 AM

Replies: 2

fdsa487


New Member


Joined: 01/30/13

Posts: 2

Claim Denied need advise please!
01/30/13 10:55 AM

Hi,

I have a problem with alcohol and had to go to the ER for detox. They prescribed me 2 medications for detox because you can die from alcoholic detox. I stopped drinking (and currently am still sober =) ) and called my HR department at work and told them I needed to go to a treatment center. They were okay with this so I took a month off work and went to a treatment center for 30 days. During those 30 I was considered to be "disabled" and I had no access to a phone and was not permitted to leave the facility.

Once I completed the 30 days I was required to get a doctors note to return to work. I had my doctor fill out the CA SDI paperwork and he mailed it in. A few week after he mailed that in I got a call from the SDI office because they wanted to know the dates that I was in treatment and out of work. I'm almost positive the dates were on the paperwork so I don't know why I received a call. I told him the dates and he said my claim will be denied because the paperwork was filled out AFTER treatment and that I needed to be admitted to treatment by a doctor and that filling out out after the fact was not sufficient. He said there is really no rebuttal for this either.

Date out of work: 12/7/12
Date treatment started: 12/10/12
Date treatment ended: 1/8/13
Date SDI paperwork filled out and mailed in by Dr: 1/8/13
Date returned to work: 1/9/13
Date call received about dates: 1/29/13

I do not understand why they are denying this. He said that the ER Doctor that recommended i seek treatment needed to fill out the paperwork in order for the claim to be paid.

I have not received any denial paperwork in the mail yet (or even know if I will get any denial paperwork) but do you think that I may be able to still get paid for my time with a rebuttal despite the fact that he said there I will not receive payment for my time?

This is pretty frustrating being that this is my first claim for SDI ever and i've been paying into it my entire life.

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Larry


Veteran Member



Joined: 09/27/01

Posts: 3,564

Claim Denied need advise please!
02/01/13 1:04 PM

Would like to answer your issues, however, they sound very complicated and I'm not so sure they can be accommodated on the forum without a great deal of more info and time.
You may have to engage the services of a claims consultant... in order to satisfy your concerns.?

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fdsa487


New Member


Joined: 01/30/13

Posts: 2

Claim Denied need advise please!
02/01/13 1:14 PM

thanks! I will look into finding the answers with a consultant if I can't find the answer here. =)

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