I am in the state of CT and I was injured 2 months ago. I fell in the parking lot of my job on black ice and snow. The owner's of the building (not my employer) never takes care of the parking lot when it snows or when it is icy. The fall happened so fast the I only remember the top part of back and my head hitting the pavement. I went straight to the hospital after the accident and then seen my physician. My physician ordered X-Rays and a CT scan of my brain. The hospital failed to take any X-rays or a CT Scan. I did have a mild concussion and my physician thinks it is muscle and tissue damage. He also referred me to a Othopedic. My first visit he agreed w/my physician to sent me to physical therapy. I went for 7 sessions (this is all worker's comp. approved me for). The physical therapist called me yesterday and told me they had to cancel all my appointments for next week. They will not approve any more until "they hear from Dr." I went back to the Orthopedic Wed. and he ordered an MRI to look for a herniated disc. I don't have much confidence in the Orthopedic for a few reasons; he spends less than 5 mins. w/me, never looked at or touched my back, did not order the MRI until last week and told me the 1st time I seen him to come back in 6-8 weeks if I do not get better from therapy. I have been home for 3 weeks now and I'm in a lot of pain still. Therapy helped a little however, an hour after therapy I feel horrible again.
I had 2 conversations w/the W.C. adjustor this week. She was aweful because she yells at me, she tries to intimidate me and tells me I am only allowed to see 1 Dr. She told me that I can not my Physician anymore and to only see 1 Dr. - the orthopedic.
Can they do this? Can they tell me I can only see 1 Dr.? I am scheduled to see my Dr. monday however, I'm not sure what to do because she is telling me I can't go back to him. I want to go back to work Monday because I am getting depressed and do see a little improvement. I'm not sure if I should wait until I have the MRI done before I go back to work. I do not like the orthopedic and want to see my physician only. My physician appointment is Monday and I'm wondering if I should put it under my own insurance instead of workers comp? Will W.C pay for this visit?
My HR person at work is no help at all. She didn't even tell worker's comp. I was out of work until the begining of the 3rd week out. She also told me that I would pay for all copays and prescriptions and I found out through research that she was wrong. I've also caught her in lies about saying she will contact W.C. this week and she didn't.
I am also wondering if I should get an attorney. I don't want to talk to this adjustor because she yells at me and doesn't want to answer any of my questions. She just keeps yelling - only 1 Dr. I'm not getting the care I need from the Orthopedic so I am lost and confused. The MRI is still not scheduled yet either - they order it Wed. Please help.
I never had to hire a lawyer for my case but after what I read you should really look into a free consultation of your rights as an injured worker. Talk to the lawyer and see if you have a case. Once you hire a lawyer you will no longer have to deal with the wc adjuster. The lawyer would do all that for you and the lawyer would also fight for you to see other doctors. I have seen over 18 doctors in 2 yrs. trying to figure out my injury.
I have a great relationship with my new adjuster. My first one use to pay my mileage whenever he felt like it. He went out with heart problems and they gave me a new one. This wc adjuster approves everything for me right away and even pays my mileage as soon as I tell him.
I would start looking into a good wc lawyer asap. Do not go back to work before you see your doctor for your restrictions. If you do, you could cause more damage and risk losing your wc if something goes wrong before you are cured/stable.
A wc lawyer will do a free consult to see if they could help you and if you have a case. Start looking now and I hope you are writing down your mileage from your pt therapy and sending it in to your wonderful sweet talking adjuster : ) It should be paid in 30 days to you.
Why on earth would did they send you to an orthopedic surgeon in the first place ? Totally inappropriate in my opinion as a surgeon could care less without a broken bone, knows that spine surgery is really only rarely necessary and they hate comp cases. See an occupational medicine specialist os even a Physiatrist, someone who at least knows something about taking care of non-surgical cases and establishing causal relationships. Ortho = bad choice.
Ask to speak to your adjusters supervisor, in regards to be yelled out. Part of the Patients rights is: the right to be treated with dignity.
The insurance adjuster is trying to brow beat you. Arm yourself with knowledge. Read up on your states comp laws . Located at the top of this page is a link for every states comp laws. Write down every conversation with your Drs and the adjuster. If it were me i would get a LAWYER. Adjusters love people that dont.
Don't you love living in NE! I fell on ice last Feb and broke my leg and permanently messed up my ankle. (Am now ice-phobic and want to move to FL!) I live in CT, but worked in Mass, so the laws/rules are a bit different. My tale of woe is a similar to yours in many regards, especially as I too have the claims rep from hell! Wonder if we have same IC?
The people on here are wonderful resources, and in addition to knowledge, they are very kind as well! I agree with what they have said: question the type of Dr. IC wants you to see-anyone mention a neurologist?, demand to speak to supervisor, and consult an attorney.
My first thought upon reading your post was that you need a separate attorney for a third party liability lawsuit against the owner of the building. When I fell, our family friend, who is an attorney in CT, after hearing of my injury called to tell me the same thing. Removal of snow and ice and treating of the surfaces is law in CT. I fell in Mass, where it is not mandated, so my case is a bit diff.
I will not get rich from my lawsuit, as WC gets reimbursed 2/3 of what they have spent, but due to my permanent injuries and the affect on my life and future, I feel any penny I get is worth all aggravation, as I want someone to be held accountable for what happened to me.
My WC Insurance Company is suing the third party as well. This is a benefit, in that they have seemed to be easier to get approvals from, have kept paying me wage indemnity when they could've stopped and for other reasons. My attorney thinks it is partially due to the fact that they expect to get their money back! Also, in the big scheme of things my injury and salary are peanuts to the WC insurance company, as well as a broken leg, torn ligaments & tendons, and a permanently out of whack ankle are pretty tough to fake! lol!
Good Luck to you!
I think there is a problem, unless you had or need surgery a orthopedic surgeon is just a waste of your time. When I was injured my primary DR sent me to a Physiatrist, and was very good getting my mri's, ct's and exrays ordered. But like as others said there sounds like a third party liability lawsuite and would at least speak with a lawyer about it and your adjuster. I my self have had a decent adjuster, just a few iffy times with meds but over all pleased. I do wish you best of luck and hope you get this worked out. And welcome to the forum.
Start looking now and I hope you are writing down your mileage from your pt therapy and sending it in to your wonderful sweet talking adjuster : ) It should be paid in 30 days to you.
Sparkey,
Not every state pays mileage as they do where you are. In TX the rules for payment are as follows:
(1) medical treatment for the compensable injury is not reasonably available within 30 miles from where the injured employee lives; and
(2) the distance traveled to secure medical treatment is greater than 30 miles, one-way
(3) Total reimbursable mileage is based on round trip mileage.
(4) When an injured employee's travel expenses reasonably include food and lodging, the insurance carrier shall reimburse for the actual expenses not to exceed the current rate for state employees
on the date the expense is incurred.
(5) you have 1 year from date of travel to file for reimbursement.
They don't cover trips to pharmacies and such. I am sure that I am going to have to fight for my mileage on my wc claim once accepted, as there were Dr's closer to me in the town that I live in. But they refused to treat me when they found out my claim was denied. So my attorney sent me to one in her neck of the woods that she knew works with denied cases. We just have to wait and see what my attorney can get the IC to agree to {prior to} or on March 31st, which is when I have my contested claim hearing in front of the judge.
Angel ^j^
Sparkey,
I have to agree with Angel about the mileage issue. Here in Pa., you only get reimbursed mileage to go to and from an IME in which the I/C requested you to go to. I had to go 30 miles one way to many Dr.s appointments and less miles to PT for over a year, but only had mileage reimbursment for the IME appnt.
In_a_lot,
I wish you the best with your case, unfortuantly, I don't know about the laws of your state. I do know that you don't deserve to be yelled at EVER by the adjuster. I also feel that in my opinion, you definitely need to have at least one (maybe a few), free consults with lawyers. First a W/C lawyer, especially with your HR person not doing thier duties correctly or within a timely manner, and with the way you are being treated by the adjuster. Then I would also consult a lawyer in regards to a third party suit due to negligence of the property owner for not clearing snow and ice. Again, this is only my opinion.
I have had to deal with a *itch of an adjuster and an NCM in the past and it all chaged once I got a lawyer. I also was'nt aware of many of my rights, my lawyer explained everything to me, because the adjuster and NCM outright told me lies.
Welcome to our forum, check into the off topic area when you get a chance.
Take care
Vickie
I should have said SOME states pay for mileage reimbursements and mileage to pharmacies. I only get paid to go to doctor appointments or IME's that are requested of me from WC. Not all states pay mileage. I should of put that in there but was not thinking. Sorry.