huntingfor
10-18-2002, 10:58 AM
Hi,I had replied to the "what else can I get from W/C" thread,but for some reason it didn't submit my post.
Any how I have a benefits review hearing in Jan,and somewhat intimidated
by this.My att. said they will take depositions from me and my doc,as he will as well.Can some one offer me some insight on all this.If at the benefits review we can not settle this then it goes to regular hearing.UGGG.. :(
Also I have read about people getting orthopedic beds,how did you go about this? I have a portable tens,handicap parking permit,pain meds(lortab 10),anti-inflammitories,muscle relaxants.Mornings are the very tough times,due to poor support.Any ideas,words of comfort!!Thanks all.
Any how I have a benefits review hearing in Jan,and somewhat intimidated
by this.My att. said they will take depositions from me and my doc,as he will as well.Can some one offer me some insight on all this.If at the benefits review we can not settle this then it goes to regular hearing.UGGG.. :(
Also I have read about people getting orthopedic beds,how did you go about this? I have a portable tens,handicap parking permit,pain meds(lortab 10),anti-inflammitories,muscle relaxants.Mornings are the very tough times,due to poor support.Any ideas,words of comfort!!Thanks all.
Sponsor
davidc66
10-18-2002, 01:15 PM
Hey Looking. I would imaging that you would need a doc to say that you need assistance in sitting up and can't get comfy or have significant problems getting in and out of a flat bed. A bed that raise your head would facilitate this.
Just remember that the future medical care is what they want to get out of, and it's what you want.
In VA people on standard workman's comp, meaning non civil servant or maritime workers basically are capped with 2/3 of 10 years lost wages and lifetime medical. You don't have to settle, if your totally disabled and say paralyzed, the most responsibility they would have is to pay 2/3 pay for ten years and cover medical for life.
This in no way makes anyone rich. Unless there was negligence on the part of the employer there is no pain and suffering money in comp. Every state is different and the industrial commission should have sent you your program guidelines and restrictions. IF your able to work but at a lesser paying job they calculate 2/3 the difference in the pay cut you take for a set number of years.
So you have to decide if what you want is in line with what the industrial commission would award you. Are you willing to sell your future medical benefits, then you have to place a value on those beni's. When I had medical ins in addition to Medicaid that paid my scripts I could take the best meds and that ran about 3k a month.
Now that I have no script ins I have switched meds and reduced dosages to what I can afford, about 200 a month and that's too much. Living on Social security disability. I make to much money on SSD to qualify for any state assistance.
Are you disabled or do you expect to return to another line of work. Normally part of the settlement is that you leave your job due to future liability. I guess what I'm saying is that it's pointless to ask for more than the industrial commission will award you and they have a formula that you should be aware of as far as lost wages.
IF you opt for lifetime medical, and your totally disabled the best you can do is the industrial commission's formula for lost wages and lifetime medical if that's even an option in your state.
Be sure you have the ability to consult with other docs should you not get along with the comp doc. That's the bad part, dealing with comp docs that you know are looking out for the ins carriers interests.
What do you want? And How disabled are you? Just out of curiosity? The industrial commission is there so you don't get scr#$#$, IF you can afford to wait this out till that hearing you know you have more than your attorney on your side. Be aware they can cut off your lost wages for any reason and wait you out. They obviously have more time and money than you. You have recourse, an industrial commission hearing but unless you have another income in the home it gets rough fast. Good luck, David
Just remember that the future medical care is what they want to get out of, and it's what you want.
In VA people on standard workman's comp, meaning non civil servant or maritime workers basically are capped with 2/3 of 10 years lost wages and lifetime medical. You don't have to settle, if your totally disabled and say paralyzed, the most responsibility they would have is to pay 2/3 pay for ten years and cover medical for life.
This in no way makes anyone rich. Unless there was negligence on the part of the employer there is no pain and suffering money in comp. Every state is different and the industrial commission should have sent you your program guidelines and restrictions. IF your able to work but at a lesser paying job they calculate 2/3 the difference in the pay cut you take for a set number of years.
So you have to decide if what you want is in line with what the industrial commission would award you. Are you willing to sell your future medical benefits, then you have to place a value on those beni's. When I had medical ins in addition to Medicaid that paid my scripts I could take the best meds and that ran about 3k a month.
Now that I have no script ins I have switched meds and reduced dosages to what I can afford, about 200 a month and that's too much. Living on Social security disability. I make to much money on SSD to qualify for any state assistance.
Are you disabled or do you expect to return to another line of work. Normally part of the settlement is that you leave your job due to future liability. I guess what I'm saying is that it's pointless to ask for more than the industrial commission will award you and they have a formula that you should be aware of as far as lost wages.
IF you opt for lifetime medical, and your totally disabled the best you can do is the industrial commission's formula for lost wages and lifetime medical if that's even an option in your state.
Be sure you have the ability to consult with other docs should you not get along with the comp doc. That's the bad part, dealing with comp docs that you know are looking out for the ins carriers interests.
What do you want? And How disabled are you? Just out of curiosity? The industrial commission is there so you don't get scr#$#$, IF you can afford to wait this out till that hearing you know you have more than your attorney on your side. Be aware they can cut off your lost wages for any reason and wait you out. They obviously have more time and money than you. You have recourse, an industrial commission hearing but unless you have another income in the home it gets rough fast. Good luck, David
huntingfor
10-18-2002, 07:09 PM
Thanks David for replying:> )
My dx is severe DDD l3-4,l4-5,l5-s1,
HNP l4-5,and l5-s1 these are small herniations I am told.Also disc desiccation at l4-l5 and l5-s1.l5-s1 is the worst one and markedly collapsed.(Not sure what this one is).Patient has instability(some) with retolisthesis at l5-s1. I am refering to docs notes as I write this.I just got from GP,and I had him write me a script for water therepy.So I'll see if they will approve it.
Thanks
My dx is severe DDD l3-4,l4-5,l5-s1,
HNP l4-5,and l5-s1 these are small herniations I am told.Also disc desiccation at l4-l5 and l5-s1.l5-s1 is the worst one and markedly collapsed.(Not sure what this one is).Patient has instability(some) with retolisthesis at l5-s1. I am refering to docs notes as I write this.I just got from GP,and I had him write me a script for water therepy.So I'll see if they will approve it.
Thanks
davidc66
10-19-2002, 02:21 PM
Hey Hunting, Have you had a laminectomy at L4-5 or S1, This can cause the retrolisthesis, the vertebrae moves from front to back during flexion and extension, this can occur naturally or a lami can cause the instability. When they remove the posterior spinus process you loose one of three joints that holds everything in place. That explains the movement from front to back of L5.
The only answer for instability is to do a fusion. There are so many variations on how to due a fusion though it's hard to say what the right way to do it is. But it sure sounds like you will be having surgery at some point unless you have an excellent PM doc that can manage your pain.
Are you neurologically intact, leg pain, foot drop, loss of reflexes, etc? With a report like that I would be leary of settling this too soon. If you need surgery it can mighty spendy. My last surgery , the surgeons fee alone was 32k for 11 hours. Good luck, David
The only answer for instability is to do a fusion. There are so many variations on how to due a fusion though it's hard to say what the right way to do it is. But it sure sounds like you will be having surgery at some point unless you have an excellent PM doc that can manage your pain.
Are you neurologically intact, leg pain, foot drop, loss of reflexes, etc? With a report like that I would be leary of settling this too soon. If you need surgery it can mighty spendy. My last surgery , the surgeons fee alone was 32k for 11 hours. Good luck, David
huntingfor
10-19-2002, 07:19 PM
Hi again David.
I forgot to ad that one good thing about KY W/C is that I have lifetime medical benefits.So if ten years from now I need the fusion,they have to pay for it.Also,Ky goes by AMA disability guidlines(% disabled) if A doc says I am 5% more disabled than I am right now,then I can reopen my case for the extra %.So if later on if I have a fusion,I am covered.My neuro says I remain neurologically intact,Most of my pain is in the hip/back area.Once in a while it goes down left leg.But I have noticed that if I twist,I can feel a pop in lower left back,it feels like something pops out and back in.Its somewhat painful any ideas?
Also,I have not had any surgery on my back.What do you think caused the restrolisthesis? Thanks
I forgot to ad that one good thing about KY W/C is that I have lifetime medical benefits.So if ten years from now I need the fusion,they have to pay for it.Also,Ky goes by AMA disability guidlines(% disabled) if A doc says I am 5% more disabled than I am right now,then I can reopen my case for the extra %.So if later on if I have a fusion,I am covered.My neuro says I remain neurologically intact,Most of my pain is in the hip/back area.Once in a while it goes down left leg.But I have noticed that if I twist,I can feel a pop in lower left back,it feels like something pops out and back in.Its somewhat painful any ideas?
Also,I have not had any surgery on my back.What do you think caused the restrolisthesis? Thanks
davidc66
10-19-2002, 09:44 PM
Hey Hunting, The retrolithesis could be caused by Pars deffect, It's a birth defect that basically limits the growth of the spinous processs, those things that stick out of the back of each vertabrea. They clip those doing a laminectomy to get to the damaged area of a disc sometimes.
They can also wear down if you had a very physical job, degeneration basically. The more they have rubbed against each other the more they wear. If you shoveled coal for 20 years that would expalin it.The constant lifting and twisting. That popping is probably the vertebrea shifting front to back or vice versa. You can actually develop some stability by improving the muscle tone of your stomach and back.
Bracing would also give you stability. Prior to fusions they make you a custom brace. It felt so good at the final fitting I wanted to keep it till surgery. I sometimes get my old one out and wear it If I'm crunching alot and getting alot of movement in my fusion. Yup, fusions can fail and then only the hardware holds you together, eventually hardware can break too, that happened with my first set.
It's great you have lifetime medical. All the LA pain meds are just rediculously expensive. Meth is the only thing afordable but it has it's own set of unpleaseant side effects. Good luck at the sit down, are you guys in agreement as far as % disabled. I guess you wouldn't be having the sit down if you guys agreed. I finally left my area and got an IME to refute the comp surgeons. It was their job to say I was OK and wouldn't need more surgery, seems more like mal practice but different opinions don't qualify.LOL
They aren't patient freindly, that's for sure.
I thought it was worth taking a lousy settlement just to get out of the system. My brother died way into it and that became the cause of all my pain, one doc wanted to hospitalize me for depression a week after his death. Of course comp wouldn't pay for that but it was easy for them to blame everything on that and make me miserable to boot. They didn't use a formula of disability on me, They said I was fine after the first surgery, 27 young and strong,Yeah right!! I basically sold my lifetime medical for 25k after going 6 months with no pay. Hardly my lifetime expenses. I hope you do better than me.
I guess we are better than other countries that have no comp system but like I said, You don't get rich. Take care and good luck, David
PS, You know, a back brace wouldn't be a bad thing to ask for. You have the instability. Do a search on back braces and you will find some Cadilac orthodics out there.
[This message has been edited by davidc66 (edited 10-19-2002).]
They can also wear down if you had a very physical job, degeneration basically. The more they have rubbed against each other the more they wear. If you shoveled coal for 20 years that would expalin it.The constant lifting and twisting. That popping is probably the vertebrea shifting front to back or vice versa. You can actually develop some stability by improving the muscle tone of your stomach and back.
Bracing would also give you stability. Prior to fusions they make you a custom brace. It felt so good at the final fitting I wanted to keep it till surgery. I sometimes get my old one out and wear it If I'm crunching alot and getting alot of movement in my fusion. Yup, fusions can fail and then only the hardware holds you together, eventually hardware can break too, that happened with my first set.
It's great you have lifetime medical. All the LA pain meds are just rediculously expensive. Meth is the only thing afordable but it has it's own set of unpleaseant side effects. Good luck at the sit down, are you guys in agreement as far as % disabled. I guess you wouldn't be having the sit down if you guys agreed. I finally left my area and got an IME to refute the comp surgeons. It was their job to say I was OK and wouldn't need more surgery, seems more like mal practice but different opinions don't qualify.LOL
They aren't patient freindly, that's for sure.
I thought it was worth taking a lousy settlement just to get out of the system. My brother died way into it and that became the cause of all my pain, one doc wanted to hospitalize me for depression a week after his death. Of course comp wouldn't pay for that but it was easy for them to blame everything on that and make me miserable to boot. They didn't use a formula of disability on me, They said I was fine after the first surgery, 27 young and strong,Yeah right!! I basically sold my lifetime medical for 25k after going 6 months with no pay. Hardly my lifetime expenses. I hope you do better than me.
I guess we are better than other countries that have no comp system but like I said, You don't get rich. Take care and good luck, David
PS, You know, a back brace wouldn't be a bad thing to ask for. You have the instability. Do a search on back braces and you will find some Cadilac orthodics out there.
[This message has been edited by davidc66 (edited 10-19-2002).]
huntingfor
10-20-2002, 01:23 PM
Boy David,you have really been through a lot,then getting screwed by comp :(
Most people do get screwed.
My att put an offer for $35k,and they came back with $4,400 He said forget it.Mt treating neuro who they bullied my first GP into sending me,gave me 13% perm disability,and that was the max he could give me because they won't approve a discgram for us to find out more.Their IME doc gave me a 5%.My att said the judge based on my records MIGHT give me a 20% or 25%.I am just nervous about all this depositition stuff.
Did you apply for SSD? I am getting ready to.My neuro said that I can't sit,stand for more than 15 min,and no lifting,bending, pushing,pulling,etc..
so I am going to try.
I did a search on ortho adjustable beds,and thry are expensive!I will have heck getting them ***holes to approve it.Plus I need a king(I am married)and don't think my husband would want to sleep in the same positions.Any advice on approval?? Hope your day is going better than mine :)
Most people do get screwed.
My att put an offer for $35k,and they came back with $4,400 He said forget it.Mt treating neuro who they bullied my first GP into sending me,gave me 13% perm disability,and that was the max he could give me because they won't approve a discgram for us to find out more.Their IME doc gave me a 5%.My att said the judge based on my records MIGHT give me a 20% or 25%.I am just nervous about all this depositition stuff.
Did you apply for SSD? I am getting ready to.My neuro said that I can't sit,stand for more than 15 min,and no lifting,bending, pushing,pulling,etc..
so I am going to try.
I did a search on ortho adjustable beds,and thry are expensive!I will have heck getting them ***holes to approve it.Plus I need a king(I am married)and don't think my husband would want to sleep in the same positions.Any advice on approval?? Hope your day is going better than mine :)
davidc66
10-21-2002, 12:30 PM
Hey Hunting, An IME with a comp doc is hardly independent. You would likely have to pay for your own IME but it would likely be worth it. Any doc that doesn't get with comps program will loose their lucrative contracts with comp. Some docs do nothing but comp patients.
Have you seen a shrink. Depression is part of CP and just as disabling, It prevents clear thinking, completing tasks in a timely manner, The shrink is really the best person to evaluate your cognative abilities living with the level of pain you do. They access your ability to function in the work place without doing a functional capacity test.Don't do one of those if you haven't already. They are subjective and a comp doc is going to say what comp wants to hear.
I did apply for SSD after being bed riddden for 10 months after my last surgery. I was turned down the first time and on appeal. While waiting a year for an admin judge hearing when the judge finally looked at my case he overturned the previous ruling and I did win and was awarded my back pay. Unfortunately it took 2 years for SSD to get through this process and give me a dime. By then I had taken out a second mortgage that is costing us our home now. A shrink can be very helpful with SSD and your cognative abilities. You can't conccentrate and focus like your old self when in extreme pain. If your lawyer is worth his weight he will get exactly what he needs from his depos with your docs. If they are favorable be sure you keep a copy for SSD should you need to go to the hearing stage. Good luck, David
Have you seen a shrink. Depression is part of CP and just as disabling, It prevents clear thinking, completing tasks in a timely manner, The shrink is really the best person to evaluate your cognative abilities living with the level of pain you do. They access your ability to function in the work place without doing a functional capacity test.Don't do one of those if you haven't already. They are subjective and a comp doc is going to say what comp wants to hear.
I did apply for SSD after being bed riddden for 10 months after my last surgery. I was turned down the first time and on appeal. While waiting a year for an admin judge hearing when the judge finally looked at my case he overturned the previous ruling and I did win and was awarded my back pay. Unfortunately it took 2 years for SSD to get through this process and give me a dime. By then I had taken out a second mortgage that is costing us our home now. A shrink can be very helpful with SSD and your cognative abilities. You can't conccentrate and focus like your old self when in extreme pain. If your lawyer is worth his weight he will get exactly what he needs from his depos with your docs. If they are favorable be sure you keep a copy for SSD should you need to go to the hearing stage. Good luck, David
huntingfor
10-22-2002, 09:56 AM
Thanks for all the info! You seem to be the "Been there,done that" person.This is unfortunate for you though.
2 years to recieve your back pay? Why so long? I thought once you were approved that it was a matter of a couple months max that you got your back pay.That really stinks!
My att said that a judge would put more consideration into a treating doc,then one who spends 15-20 minutes with you.So as long as my neuro is going with the flo,we should stick with him.One thing that also helps,is my neuro is recognized world over.So hopefully he won't fudge our depo's.I am just sick of this whole process!! They try to make us feel like criminals,when they are.
I just want my life back!!
2 years to recieve your back pay? Why so long? I thought once you were approved that it was a matter of a couple months max that you got your back pay.That really stinks!
My att said that a judge would put more consideration into a treating doc,then one who spends 15-20 minutes with you.So as long as my neuro is going with the flo,we should stick with him.One thing that also helps,is my neuro is recognized world over.So hopefully he won't fudge our depo's.I am just sick of this whole process!! They try to make us feel like criminals,when they are.
I just want my life back!!
davidc66
10-22-2002, 11:19 AM
Hey Hunting, It took so long to get a hearing set because in VA there is a one year back log of people waiting for an SSD hearing. I was told it was on the judges desk for almost a year. I'm trying to imaging what this judges desk looks like but that's the time frame we were looking at here in VA.Perhaps we need more judges or something. Or perhaps there are just two many people applying for disability that have frivilous cases that the judges have to sort out.
The biggest Irony of the SSD system was on the back of every SSD envelope was a stamp that says" we are there when you need us", I was thinking when, after I loose my home and l am living in my car.
It took so long that I am loosing my home anyway because of the second mortgage we took out to live on during that 2 years. It's definitely a waiting game. Good luck, David
The biggest Irony of the SSD system was on the back of every SSD envelope was a stamp that says" we are there when you need us", I was thinking when, after I loose my home and l am living in my car.
It took so long that I am loosing my home anyway because of the second mortgage we took out to live on during that 2 years. It's definitely a waiting game. Good luck, David