In Workers Compensation cases, the first question most attorneys ask when a prospective client calls is: "Have you been controverted?"

A controversion can be formal or informal.  If the insurance company is obeying the law, it will send you a Controversion Notice explaining why it is no longer paying your benefits.  The back side of the form sets out what your rights and obligations are if you wish to pursue a Claim before the Board.  That information is very important, so read it.  If you don’t understand it, you can go to the Board’s office and ask to speak to a legal tech.  Or you can call an attorney.

 Controversion Notice

An informal controversion is when the insurance company resists payment of benefits.  For instance, the insurance company may refuse to preauthorize your surgery.  Because it refuses to preauthorize your surgery, the doctor won’t perform the operation.  Suddenly you’re stuck not being able to get the surgery that you need and you can’t go back to work because your injury isn’t fixed.  Even if the insurance company is paying you temporary total disability or temporary partial disability, it’s not enough to live on.  And you fall farther and farther behind.

 Even if the insurance company has not formally controverted you, you are still entitled to file a Claim to recover your benefits and you can still find an attorney to help you, because once the insurance company has controverted you, or resisted payment of your benefits, and you are successful in obtaining benefits through the services of your attorney, the insurance company will have to pay your attorneys fees.

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