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    Old 02-21-2006, 12:14 PM   #1
    cornburner
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    Between Work Comp and This DAMN pain.

    3 yrs of Work Comp, everyday the pain gets worse. Sometimes I don't know how to continue. With Comp, it's been nothing but denials and delays. Closure was to be last week with my day in court. Comp canceled day before. I WILL NEVER give them the satisfaction of quiting. My Myofacial therapist was telling me Comp Never wants to be in court. If they lose there, they have to pay in full all the doctors/hospitals/etc. in full. If you settle, comp then only pays pennies on the dollar. He had two cases settled last month, for 25 and 30 cents on the $. What a sad state, the people that our employer pay for coverage, do everything they can to stick you and all the doctors, therapists, clinics, hospitals, etc. I waited 3 yrs for my day, the pain is still there and getting worse. How can I expect someone to help me, and then see them stuck like I am....

     
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    Old 02-21-2006, 02:02 PM   #2
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    Re: Between Work Comp and This DAMN pain.

    Cornburner sorry to hear of all your problems with WC. I'm going on almost 2 years of WC denying my treatment. I finaly last month went and had my surgery on my own. WC has canceled several hearing and mediations and this last one they canceled because they want to send me to 1 more doctor. The doctor that did my surgery was the second doctor they sent me to that said I needed surgery. They found one that said no. I don't know what this new doctor is going to do? Say no you don't need surgery, I have already had the darn surgery and i'm starting to get feeling better for the first time in almost 2 years. I still have a long way to go. I had 4 levels in my neck done and the neurosurgeon said i'm going to be healing for a year. I can no longer do my job as a CNA. But even if I could my certification expired during this WC crap. Good luck.
    Terri

     
    Old 02-21-2006, 02:21 PM   #3
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    Re: Between Work Comp and This DAMN pain.

    So far I've been relatively lucky with my WC case, though if I was doing this through my own insurance and at my own speed I would've probably had surgery last April or May instead of waiting until December... But at least it was covered!

    The only thing they've denied was a 4th round of epidural injections, and I didn't expect them to approve it anyway (neither did the pain doctor, but he wanted to show them that he had done his part...).

    Now, if I could just get them to stop sending me disability checks! Yes, I know that is exactly the opposite problem most people have, but it is still a problem. I received my first check exactly 2 weeks to the day after my surgery, and have received them regularly since then. I was only out 4 weeks total, so when I got the 3rd check I deposited it in my savings account and waited for a return call from my lawyer. He told me to keep it, that they ins. co. would just take it off my settlement on the back end of the case and that he would file a notice of some sort to make them stop. He was worried about them yelling "fraud" later on. He said that many people just keep cashing the checks and never mentioning the clerical error.

    I thought it was all taken care of when another check arrived in the mail (don't you wish they happened that way when you are expecting them instead of when you're not??). I sent this one (intact) to the lawyer to send back the insurance company (paper trail and all...).

    I start post-surgery PT tomorrow (already had the assessment done). I hope it does the trick. I, too, just want all of this to be over and to get my life back.

     
    Old 02-21-2006, 02:23 PM   #4
    HurtinHouston
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    Re: Between Work Comp and This DAMN pain.

    Hi, Cornburner.

    3 years!!! OhMyGosh! I've been dealing with WC for 6 months and it's been awful. First it took 2 weeks to get in to a physical therapist. By then, I was in worse shape than right after the accident and the 1st therapist I got in to, yanked on my leg so hard, I almost came off the table. He said he was trying to align my pelvis. Ha! I was in even worse shape after that.

    Another week of delays and I finally got in to the therapist that my Orthopedist wanted me to see, but after 2 months, they threw up their hands and sent me packing.

    I love my Ortho...he's a family friend, but not a spine specialist. He only gave me increasing doses and formulations of different medications, none of which helped and most of which I had reactions to. Then he wanted me to have ESI's, but I started running low grade fever and kept having to cancel the procedure. I was also having a lot of pain all over my body, not just my back and legs. Six weeks later, I saw a Rheumy doctor for tests that turned up nothing, so he sent me to another doctor for evaluation for ESI's. Because I had a really bad reaction to the oral steroids the Ortho gave me at the beginning and I also researched the procedure and after reading the Burton Report and writing to the FDA and confirming with them that Depomedrol and Kenalog are not approved for epidural injection (these are the 2 drugs that the 2 different places use), the PM doctor decided that I was not a good candidate for the ESI's and referred me to a Pain Management clinic that does integrated therapy...doctor for medications, Physical therapist, and psychologist. Meanwhile, I went to see my DO to get some test results from a bone scan she had done before the accident and she prescribed Lyrica for my nerve pain out of pity.

    I went to the PM clinic for evaluations and the doctor prescribed additional medications, saying she was not happy with what I was taking, but I had a bad reaction to either the Lyrica or the Zanaflex she prescribed and had to come off of them until the reactions subsided. I'm only taking the Lyrica now with Lidoderm patches for 12 hours. In a few more days, I'll try taking the Zanaflex and see if I react again.

    Anyway, they said at the PM clinic that they will have to get approval from WC for treatment and warned me that it could be weeks before they can get me back in...even that WC might turn it all down in which case they will appeal.

    What I really like about WC is that as soon as the ESI doc said I wasn't good for the procedure, WC set me up with a Designated Doctor to evaluate me for MMI (Maximum Medical Improvement). I had to see him yesterday. He said that I am obviously not at MMI with my back, but thinks that I may have another problem and need to go outside of WC to a neurologist, so I'm dealing with trying to find a good neuro that will take my insurance.

    After the initial delays with PT, I hired a lawyer in the hope that WC wouldn't screw me around too much, but who knows. I can't see that it's helped a whole lot. do you have an attorney working on your case?

    Golly, if you're in increasing pain, you really need to get some treatment, not just settle with WC. Make them pay to make you better.

    Anyway, my friend, I hope you are feeling much better and pain free very soon. Best of luck with WC.

    Houston

     
    Old 02-21-2006, 02:39 PM   #5
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    Re: Between Work Comp and This DAMN pain.

    Xinerevelle:

    I am not a big fan of epiduals anyway, but I do know that you should never have more than 3 ESI's in a 12 month period, so it's good the WC declined approval.

    As for WC checks, I started getting them (although I hadn't applied for them) and my old employer immediately cut off my short term disability. I went months making over $1000 less than the STD was paying until my LTD policy kicked in (that was whole other nightmare).

    It seems that if you are hurt on the job, you are automatically penalized. Had I been hurt elsewhere, I would have had to foot the medical through my own insurance, but I would have been paid at 60% of salary until the LTD kicked in and not lost a big chunk of savings trying to pay the bills.

    Even though WC theoritically is supposed to be there for the employees if hurt on the job, they are really there for the employer and their own interests. It's just another insurance company that wants to keep the guys paying the premiums happy and not pay on the claims.

    Best wishes for success with your post-op therapy.

    Houston

     
    Old 02-21-2006, 02:47 PM   #6
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    Re: Between Work Comp and This DAMN pain.

    [QUOTE=HurtinHouston]Xinerevelle:

    I am not a big fan of epiduals anyway, but I do know that you should never have more than 3 ESI's in a 12 month period, so it's good the WC declined approval.

    Houston[/QUOTE]

    Correct. I was only illustrating that of all things that WC insurance co. HAS approved that they were necessary. In fact I was surprised that they were able to actually keep track of how many LESIs I'd had and deny it appropriately!

    Interestingly enough, the PT told me yesterday that he thinks some of my pain may be from the SI joint and not from a failed surgery. I guess I'll find out within a month as he does some manipulation/mobilization treatment on it and then I do some additional strength training for the rest of the visits.

     
    Old 02-21-2006, 04:09 PM   #7
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    Re: Between Work Comp and This DAMN pain.

    Well, I certainly hope you are back on your feet and pain free very soon and that he's wrong about the SI joint and that you're just still a little sore from surgery.

    My experience is that WC keeps very good and close track. I got my DD letter from them 8 days after the ESI doc said no to doing it. If I weren't such a nice person, I'd wish a pox on all the CEO's and upper managers of every insurance co. to suffer what we go through, but I really don't wish this sh-- on anyone.

    Take care.

    Houston

     
    Old 02-21-2006, 06:58 PM   #8
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    Re: Between Work Comp and This DAMN pain.

    3 yrs ago fell 12 feet to a cement floor, landing flush on my buttocks/tailbone. It was at work, nobody denies that. But my symptoms kept getting worse and worse. I have 5- 10 spasms start 15 months ago, so hard I have no voice left sometimes from screaming. I have had trigger points-7 steroid injections-2 sets of nerve bloc. At 1 yr, I hired an attorney, every dr told comp my pain was real, yet could not pinpoint exact problem, but it is in the cervical and thoracic region. Comp would cancel my appointments a day or so just as I am doing what the neurologist and other dr's asked. Comp would cancel, then it was always another 2-3 months before I could get rescheduled. Lawyer told me to go for whatever the dr told me to do, he would take care of work comp. Comp would not allow refills of drugs, delaying until lawyer forced them. The narcotics and other drugs are not suppose to be stopped abruptly. Serious reactions could kill you.
    My specialist in the U of MN finally connected all the dots, all the different symptoms of numb hands and feet-full sweats while doing nothing-and these spasms, they scare my wife to watch me, fearing my heart won't be able to take it. Sometimes they last an hour, stop for 20 minutes or so and kick in again. Work comp cherry picks what they will pay, have not paid me tempory or even mileage for alost 2 yrs. I had some nice savings getting ready for retirement in 10 years or so. Now dr won't let me work-no savings any more. When I do find something to earn a couple of Dollars, comp jumps all over it, claiming if I can do alittle, I should be able to work fulltime. I told them to come and live in my shoes. It takes money, they are ruining my credit. sorry to vent. just tired, in pain, broke. BUT I WON"T GIVE IN TO THEM! As I said before, it's not fair for comp collecting premiums, and when someone needs to collect, they start their games. I won't let the people that are treating me to get stuck by them with pennies on the dollar for all they do for me.

     
    Old 02-22-2006, 04:48 AM   #9
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    Re: Between Work Comp and This DAMN pain.

    Cornburner, have you applied for Social Security Disability (SSDI)? If not, you need to do so as soon as possible. This is another gauntlet to run and they will probably deny your claim the 1st time, but that's pretty typical. At that point, you need to hire a good SS attorney to appeal. Once you have the SSDI income for 2 years, you will automatically receive Medicare to help. Depending on your circumstances, you may also qualify for additional assistance in the form of Supplemental Security Income (SSI). Anyway, the longer you wait to apply, the greater the chances that SS will reduce your benefits.

    I've been looking into this because my LTD requires that I apply for SSDI once I've been disabled for 6 months...which will be tomorrow...so they - LTD- can reduce what they're paying me by that too, including any lump sum payment from SSDI...really sucks, but better than a sharp stick in the eye. LOL

    Houston

     
    Old 02-22-2006, 10:13 AM   #10
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    Re: Between Work Comp and This DAMN pain.

    Thanks, I have applied, denied twice, now will have court date sometime within 1 year. What's wrong with me doesn't come through on paper. So I look forward to that day in court along with my date in court with comp if they ever show up.

     
    Old 02-22-2006, 12:07 PM   #11
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    Re: Between Work Comp and This DAMN pain.

    Best of luck to you. I hope it doesn't take too much longer.

     
    Old 02-22-2006, 12:38 PM   #12
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    Re: Between Work Comp and This DAMN pain.

    Cornburner:
    Please know that you are not alone in this fight against WC. I've been at it for over 6 years and it can be a nightmare at times. The first few years were the worst. Just like you are dealing with, the denials, the set backs, etc. I've had mediations postponed the MORNING of, hearings postponed the day before, more denials for medical treatments than I can count. Try to hang in there, it's a long battle, but don't let them take away your hope. Make sure you have a good attorney. I put it off for a long time thinking I could handle it by myself. It's just not worth the stress (and the added pain that causes).
    Good luck! I hope things start going better soon

     
    Old 06-28-2007, 11:16 AM   #13
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    Unhappy Re: Between Work Comp and This DAMN pain.

    [QUOTE=cornburner;2209804]3 yrs ago fell 12 feet to a cement floor, landing flush on my buttocks/tailbone. It was at work, nobody denies that. But my symptoms kept getting worse and worse. I have 5- 10 spasms start 15 months ago, so hard I have no voice left sometimes from screaming. I have had trigger points-7 steroid injections-2 sets of nerve bloc. At 1 yr, I hired an attorney, every dr told comp my pain was real, yet could not pinpoint exact problem, but it is in the cervical and thoracic region. Comp would cancel my appointments a day or so just as I am doing what the neurologist and other dr's asked. Comp would cancel, then it was always another 2-3 months before I could get rescheduled. Lawyer told me to go for whatever the dr told me to do, he would take care of work comp. Comp would not allow refills of drugs, delaying until lawyer forced them. The narcotics and other drugs are not suppose to be stopped abruptly. Serious reactions could kill you.
    My specialist in the U of MN finally connected all the dots, all the different symptoms of numb hands and feet-full sweats while doing nothing-and these spasms, they scare my wife to watch me, fearing my heart won't be able to take it. Sometimes they last an hour, stop for 20 minutes or so and kick in again. Work comp cherry picks what they will pay, have not paid me tempory or even mileage for alost 2 yrs. I had some nice savings getting ready for retirement in 10 years or so. Now dr won't let me work-no savings any more. When I do find something to earn a couple of Dollars, comp jumps all over it, claiming if I can do alittle, I should be able to work fulltime. I told them to come and live in my shoes. It takes money, they are ruining my credit. sorry to vent. just tired, in pain, broke. BUT I WON"T GIVE IN TO THEM! As I said before, it's not fair for comp collecting premiums, and when someone needs to collect, they start their games. I won't let the people that are treating me to get stuck by them with pennies on the dollar for all they do for me.[/QUOTE]
    I can relate with you about workers comp I injured my back at work 3yrs ago my lower lumbar r/side and then my sacroilliac. Only to reinjure my back again in Dec.06 I have been off work for six months and have only received 4 checks from workers comp. they sent me to one of their drs. and he said that I can return safely back to work despite my back pain I have had cortisone shots-2,epidural trigger-point injections and physical therapy and nothing helps I too had to hire an attorney but no money is coming in. Workers Comp is ruining my credit with their games.

     
    Old 06-28-2007, 10:54 PM   #14
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    Re: Between Work Comp and This DAMN pain.

    I had to apply for state disability because w/c wouldn't pay. When SSD approved me, w/c kicked right in. The State filed a lien against them for their money back from the state disability. They just deny, deny, deny. They are the reason of my failed back surgery and they are the reason for my ongoing pain. No doubts in my mine. I put them lower than an HMO!! I was injuried in 2001 and 2002 and had surgery in 2005. I had two different insurance companies fighting it out as to who was responsible for the injuries I had. Then when it was decided who was going to pay, they tried to use the other insurance company's second opinion doctor. The judge told them no, no, no. The doctor that was agreed on with them said I needed surgery. It was another 1 1/2 years and another court appearance before the surgery was done. Now I need another surgery and they are again denying the surgery. Stalling while I suffer in pain. I asked my doctor once what are they waiting for? He said, "For you to die". I thought that was a weird statement, now I don't.

     
    Old 06-29-2007, 06:46 AM   #15
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    Re: Between Work Comp and This DAMN pain.

    [COLOR="DarkRed"]Houston are you getting LTD and w/c checks ? I had STD and LTD from work but they said I could not use it if I was collecting w/c checks is this true ?
    Shawley[/COLOR][QUOTE=HurtinHouston;2209378]Xinerevelle:

    I am not a big fan of epiduals anyway, but I do know that you should never have more than 3 ESI's in a 12 month period, so it's good the WC declined approval.

    As for WC checks, I started getting them (although I hadn't applied for them) and my old employer immediately cut off my short term disability. I went months making over $1000 less than the STD was paying until my LTD policy kicked in (that was whole other nightmare).

    It seems that if you are hurt on the job, you are automatically penalized. Had I been hurt elsewhere, I would have had to foot the medical through my own insurance, but I would have been paid at 60% of salary until the LTD kicked in and not lost a big chunk of savings trying to pay the bills.

    Even though WC theoritically is supposed to be there for the employees if hurt on the job, they are really there for the employer and their own interests. It's just another insurance company that wants to keep the guys paying the premiums happy and not pay on the claims.

    Best wishes for success with your post-op therapy.

    Houston[/QUOTE]

     
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