Hi once you reach certain maximimum medical care with WC but not better,where you go from that point?how do you get meds,or treatment.so frustrated.any help be appreciated.

WC is different in every state, so you may want to contact your local WC Board. You will have medical coverage for the injured part of your body for the rest of your life, therefore, your meds should be covered. WC may try to modify your claim and have you apply for Social Security Disability.

yes if you ever get it,in NJ it stinks.I'm on SS and get nothing from WC.and SS wants to cut my check due that I have WC but not collecting any checks from them.whole thing is crazy.

Hi apocal ,

Maybe I can help you with these question's . I'm on w/c and collecting SSD . After they find you at MMI all that means is your partial disability starts . Here in pa its 500 weeks of losswage payments . Don't know what NJ is . But it really doesn't mean anything .. BTW I make more money now since I'm getting SSD and comp than when I was working.. Some folks don't know you can collect both.. Heck we payed in for it , why not use it right ?

But if you need anything just ask for me .

Shawley

Hi Shawley how are ya?so glad to hear from you.IN Nj you can't have both SS and WC,they take away 20% of the SS check.I only get $597 a month after you pay the medicare thing.I was getting $700 from WC back in 2005,but it ended in 2006.then went on SS after going to court and had the judge actually see how crippled up Iam.so I get nothing now from comp except the run around.I finally got my radio frequency procedures this week and my meds back.Again pain management can't do much more for me,they still pushing for surgery.looks like one can't remain comfortable for too long.my lawyer going for permanent wc.I saw their doctor says I'm only 10 percent functional

apocalypto22-This is a very good question and I am just about at that same point. I have gotten a lot of help from the disability board, so you may want to check that one out as well. It is my understanding that at MMI, they still have to take care of all of your medical and meds. If you need treatment after your case is closed, you need to contact your lawyer or your case worker from W/C, and let them know that you need further treatment. I have heard that a number of people have been in this situation and when they needed further assistance, it was a fight to get W/C to re-open the case and pay for more services. But then again, if you asked the state to step in, you would win and get you medical help in the end.

Shawley-wow a name from my past;). I would love to know your update, perhaps you could start a thread. I'd also like to know how you get both ss and w/c. I was just approved for SS and was told that I would only get a %, (the difference between 80% of my pre-injury pay and what W/C is now paying me) until w/c closeses out my case. I was also told to make sure if I am offered a settlement with w/c, to make sure it has the right language which will let me get my settlement through monthy payments rather than all at once, so that SS will not be able to get a chunk of the settlement.

Lorie:angel:

hi Foster,
yes its a tug of war to get anything.it seems the SS always got thir hand into something,they act like I'm rich or something.who heck can live on $597.00 a month if you alone?some system.I'm so confused on everything,wc dying to close the case,but I'm afraid if I need surgery won't get it.my pain management doesn't want me on meds,yet most are on meds after this surgery anyway.so you figure.The WC adjuster told me once you reach mmi I would no longer get anything.same if I had the surgery.once surgery I be cut off,again how you would get your meds?you not better after fusion,you get other issues.what a life!

You may have mentioned this earlier, but do you have a lawyer? That would make a lot of difference. If not, you can get a free consultation, just to ask these specific questions, before you are actually kicked out of the system.

I really don't understand why w/c would tell you that once your case is closed (and esspecially if they are saying once you have surgery), that they can't help you anymore. As far as I know, your medical has to continue, unless you were to settle with w/c and tell them you don't want medical to continue.

Has the state ever ordered w/c to pay your medical or is your company voluntarily paying for your services, up till now. That would be a reason for them to just stop paying for everything. Prior to getting a lawyer, w/c was paying for all my bills and sending me weekly checks. I got the copy of their paperwork, stating that they had filed this case with the state w/c division. I assumed that meant that they were accepting responsibility and they would continue to take care of my medical until I was recovered. What I did not know, was this only meant that they were voluntarily paying for my medical and that at any point, and without notice, they could deny services and stop paying me, both my check and my medical. The court did not order them to pay my lifetime medical until I actually filed with the state, on my own. Both sides have to file, or the i/c can stop paying at any point. Also, after 2 yrs. (in vA) if the individual does not file, the state can no longer help you and the co. will most definately drop you immediately.

You really must be a nervous wreck. Still being in so much pain that you still need surgey, yet being told you will not get services once you have surgery. Are they saying they won't pay for any of the follow up or the meds. as soon as you come out of surgery? If so, you really need to consult with a lawyer. If you have a lawyer, consult with a 2nd lawyer. Just write down all your specific questions, outline what you have already had done and what the Dr. says still needs to be done, and take it with you to the consultation. I say this, becasue the consultaion will probably be less than an hrs. and this way you would get the major and most important questions answered. In fact, I think I would type of an outline of it and fax/send it to the lawyer that you want to consult with. Add a note, that you have an appnt. with them in a coupe of days, and wanted to give them an idea of what your situation is. That way, you wont have to waste time going over everything for the first time.

Good luck and keep us posted.

Lorie:angel:

Hi foster,
yes I have a lawyer,in fact he was going to file motion in court for WC to continue treatment with pain management under their doctor I had to see in January.which stated i needed to continue with some sort of treatment.i didn't get treatment until just last month finally after a whole year without annything.I finally emailed WC and literary told them off.in a sort of sweet way.I doubt it had any effect,but I soon got approval for the radio frequency.and my meds back,but problem with pain management they want me to make up my mind whether to do surgery or not cause they want me off the meds.now sounds crazy that people go for surgery and most of time need meds,maybe even stronger for rest of life,makes no sense.I got no beef having the actual surgery,but its the recovery I fear more.my lawyer is working out for permanent WC,he said reason i wouldn't be getting any checks until it goes to court and win to retroact the money from beginning,which not much since it was a part time job.The WC doctor I saw even told me fusion surgery is dangerous and creates further problems on the back

It sounds like you and I are both around the same point in time. I am sorry, that you are being put through the ringer though. I truly hope you can get into a PM center, it has been a life changing experience for me. Has your lawyer already filed for a hearing? Hopefully it comes shortly. Have you already had the radio frequency?

You know, my Dr. hopes to get me off meds too. I have 1 more procedure that may help. It is also another surgery. The Pain Dr. told W/C that this is our last hope. After this, I will have to be on meds for the rest of my life. So, even though your PM Dr. wants to get you off your meds, if the surgery doesn't work, his next goal for you will be to keep you pain free (or down to a minimum) and that would mean meds. I think getting a pt. off of meds, is the goal of most Drs. However, if you try everything and nothing works, then they keep you on your meds.

I totally understand what you are saying about the recovery time being the worst part of the surgery. That is my main concern about the surgery they want to do on me. It will be another 8 weeks minimal and I live alone. I am setting things up now, just in case I end up having this surgery, so I will be somewhat prepared for the recovery. Do you live alone? If you do have the fusion, please let me know and I will gladly help you with how to prepare for the recovery.

I don't know if you know this or not, but keep track of your mileage to and from doctors appnts. and to get your perscriptions filled. When you do get you W/C approved, they have to back pay you for these expenses. I am sorry that you are having to fight to get W/C to do their job and I hope your hearing comes shortly. I know if VA, I have been told that the judges tend to side with the patient over i/c, if there is equal amount of evidence on both sides. Since you already had one of their Drs. say you need more care, that should go over really well for you.

I am thinking about you and would like to keep up with what is going on with you situation. If you want to start a new thread when you get more updates, I will be watching for your posts.

Lorie:angel:

hi lorie,
you alone?oh gosh how heck you do that,another worry I have.the kawyer told me I do not have to get surgery now,but I have 10 years to decide.I just feel it will be my end,don;t know why but seems to plaque me.I'm weak minded I guess.I go this morning for last radio frequency.my pm wants me to take surgery,so quick with the answers.I had enough surgery,back,gall bladder,hysterectomy,knee,tired.I enjoy hearing from you.so you had fusion already?

I;mhere,still have the feet pain,I hope can get PM to authorize from WC to get further Mri and stuff to see if worse or what.so much to worry about.boy I hated the day I got off the cloud and ended up on this planet,misery,pain,one big boring mess.

Yes, I am alone. Some times that is a good thing, like when I am in a lot of pain and just want to be left alone. I can cry without everyone knowing just how often I am crying. As far as recoverying from a surgery on my own, that takes a lot of planning. I am not actually alone, as I have friends from my church that come and bring me meals twice a week and after surgery they came every day or every other day, to check in on me. But as far as being here during the days and nights, yes I am alone. Both my kids are grown and away, and have been for the past few years.

So, you said your lawyer said you don't need the surgery right now...how does you lawyer know what you need medically? Just curious, since it sounded different:). I hope you are doing alright from your RF. Hopefully the pain will lesson ea. day. Mine seemed to take a week or so until I was completely out of the procedures pain. Did it hurt much while you had it done?

You sure have had a lot of surgeries in your day. I don't know how you have been able to take that much recovery time. I guess if it is something that you need, then you find a way to muster up the ability to do what needs to be done. What back surgery have you already had? Was that from this same incident? Also, have you had a problem with W/C stating that what you have going on now might be from an earlier medical problem, like the other back surgery. I know several people whose W/C has told them that they would not pay for their care, because they had problems prior to the injury. I hope that is not your case.

When was your last MRI? I just asked the PM if he thought I should get another MRI because I have new pain and I am going to see a specialist, so I thought it would be good for the specialist to see the most updated MRI. He said the insurance will only pay for them once a year usually, unless the new pain is unexplainable or very different. He is pretty sure he knows why I am having the new pain and my last MRI is back in Aug. (8 mo. ago). So, no MRI for me right now. I don't know if the rules are the same where you live.

I have had 2 fusions. The 1st was L4-5 in 2004 and L3-5 in 2006. I did not fuse, probably becasue I have auto-immune disorders. However, since the surgeon knew that I may not fuse, he put in really strong screws and so my spine is in perfect posture. My pain now, is from permanent nerve damage that happened prior to the surgery. Also, it is from a lack of P/T after the surgery, thus my SI joint keeps popping out of its socket. And then bladder issues because of the nerves being pinched. But the back pain is gone.

Have a good day,
Lorie:angel:

Hi Lorie,
you one strong lady.I often wonder how I'm going to manage or survive alone with not much money.I told the lawyer wasn't ready for the surgery just yet,and that I want it known in case I need it later if WC will cover it.I'm more chicken,not so much having the procedure its the afterwards.I don't do well with anesthesia,it makes me depressed more and weird thoughts.and this surgery would be my first open cut,my other surgeries were laprocope.I had injured my back in 95 by picking up a towel,had to get a procedure where doc went in to relieve some of the juice that pressed on the sciatic,its the same disc that getting smaller now.of course arthritis set in,stenosis,some spongey,i imagine a big mess in there.the RK helped the back pain,but I had to get a neurontin today to try help this foot pain,so an increase in meds.i know once you stop meds its all back again.
wow quite a bit of fusions,they don't check your blood or something to see if you can fuse or not?so had those bone grafts too?still hurt there?my lawyer is the one who keeps telling me to go for surgery it will make you better.yeah sure.just thought of messing with a normal hip,cutting perfect muscles and nerves makes little sense.too bad doesn't fuse by itself,guess god didn't do too hot with the human body.then I got shoulder trouble,and hand trouble now high blood pressure starting,what else?i'm 53 feel like 80.you going for any more surgery or that is that now?I thought I was done.I'm really tired of going through another one,to be able to get up and bathroom etc,when that IV is in I'm up every 5 minutes,you can't do that with a fusion so looks like be bed wetting.