Workers' Compensation Discussion Forums

I was injured in a trip and fall on May 27, 2008 in San Antonio, Texas. I fell at work in the parking lot of my company as I was leaving for the day. I filed a incident report and went home. The next day, I went to work as I felt fine. When I got off work that night ( I am/was a CSR for my health insurance company) I was in major pain and was having major problems with walking. I went home and the next day May 29th, I was unable to get out of the bed or even walk very far . It took a few days before I was able to drive myself to the doctor, I lived by myself at the time and didnt have anyone to take me. I was told that I probably damaged a disk in my lower back by the ER doc. I called work and they referred me to the W/C insurance provider for our company (in Texas).

So the saga began. I was assigned a WC doctor who sent me for MRI's, Nerve Conduction Studies, PT, and evaulation for Injections to block the nerve. He took me off work totally as part of my problem involved not being able to sit for over 5 minutes, having severe problems walking or standing for very long also. My entire job consists of sitting for long periods.

I had been diagnoised with having caused 2 disks in my lower back to bulge and push against the Siatic Nerve causing intense pain, tingling and numbness that went into my left leg as well as the pain I was having in my lower back. The WC did several bouts of PT and all that goes with it. I exhausted my PT and the insurance company denied me more until they approved the injections. However, the insurance company kept denying the injections over the period of several months. In the mean time I was getting my WC checks, going to see my WC doctor monthly and getting my meds refilled. As time passed I was able to do more as far as sitting longer with out the pain starting so fast. I began discussing w/ my doctor about returning to work. He wanted me to have the injections before hand. During this time I was fired. My company only granted me a 9 month med leave plus and extension. I got the notice on 4/1/2009 (I thought it was a joke ~ It wasnt) so I lost my job and my health insurance that covered my kids and my dependant grand children. All because my company's insurance company was dragging thier heels about the injections.

My employer (or former employer now) changed insurance company's mid stream. My doctor submitted a new request for the injections with the new insurance company. But the doctor who I was sent to that would have done the injections was no longer working with my WC doctor so we had to start all over again. The new doctor office kept losing the paper work and it was about 3 months before they actually submitted the request. I think the new insurance company would have approved it but by this time my WC doctor felt that too much time had passed and that the injections would no longer help. I agreed. I feel that I am as good as I am going to get. And really wanted to return to work.

I began to have issues with my WC doctor office. They wanted me to go to a therapy class each week for 8 hours per day. I told them that if I could do that then I could return to work. So I declined thier offer. They were not happy. Then they refused to refill my meds because I missed 2 appointments when my father passed. When I did go back to the doctor the office assistant got really upset with me about missing the appointments - I told her that my father had died and that I was in Tennessee seeing to the details. She told me that I only showed up for my Rx appointments...not true, but I told the doctor (who was sitting there) to take me off all meds, if that is what she believed. I firmly belive that they were no longer helping me at this point and that the WC doctor and his office was dragging things out trying to get more money from my insurance company. I have not been back to the doctor since mid August. I have been waiting for the state to assign me MMI so I can get on with my life.

I can sit for longer periods now and have been released to go back to work w/ restrictions. I notifyed my former employer and the insurance company and have been activly seeking a job, but then Saturday (10/18/2009) I get a packet of letters from the inurance company about LTD. I dont know that I applied for it.

I dont know what or how to answer it. I am not seeking LTD and just want to return to work. But that in itself is becomming a problem. I was told that because I had a WC case that no employer would hire me. I mean its not as if they are going to come right out and say "we cant hire you, because you got hurt at work and we think you could be a problem", no they are going to find a dozen other reasons or even none at all.

So I guess what I am am asking in this long drawn out saga of mine, is do I have to go through the LTD process? Can I just say "thanks but no thanks"? And how will that affect my WC checks that I am getting. Will I continue to get them until I go back to work?

I havent found a job yet and would not be able to survive long without them.

Thanks for reading this and I would appreciate any input.

I'm not sure in your state but since you refused the therpy classes I'm surprized they didn't stop the WC checks. You are getting frustrated with the system and that is not a good thing for you. I know it's hard not to but you need to remember nothing is fast in WC but the bottom line is you need to do anything possible to get yourself the treatment you need. If you just want out and don't get things taken care of you may never find any insurance company that will pay for anything down the road so if you need treatment that may run many times more then any settlement you will get. Employers can't refuse to hire you just because you filed a WC claim but they also don't have to hire you if you can't do the job. What if you can't sit for a long time or stand? These are simple things but a new employer doesn't have to work you with restrictions. If you can't work you can't file for unemployment. I don't mean to sound like you are a bad person I'm just saying you need to learn all you can about what can happen and if possible you need to work with the WC people and get your life back as close to normal as you can. You don't want to live in pain the rest of your life if they can do something to help. The doctor could be delaying thing to get more money but this could just be the delays with WC. WC got me delayed in getting my SCS a year and I had to get my insurance to pay for it but now WC has to pay that bill too.

The class they wanted me to attend was not for PT but to help me deal with me out of work for so long. A Depression class if you will. Trust me if I am depressed I have a whole slew of doctors who can treat me. I dont need a class for it. I was even told by the lady doing the eval that I didnt need the class, but my WC doctor sent it in for approval anyway.

I am truly as good as I ever will be. I can sit for at least an hour or two. Which is about how long I would have to in my typical job setting. I never had to stand for long periods of time, but I can do about 30 minutes.

I just want to return to work. I have been off more then 18 months. I lost a job I love doing. Even though it was no fault of my own. I even reapplied back to them, I have heard nothing. I was a excellent employee and had gotten a 5 grand raise because of that fact. I had a above expection rating on my last eval. I know I was a good employee....but they have not given me my job back. I have kept in touch with my former supervisor and she is being told nothing. I do knw that they are hiring for my former job however. So why not hire someone who would need minimal training or re-training?

The checks are comming from the new insurance company which by the way is owned by my former employer.

I think if UnderCoverAngel comes on and reads this she might be able to share some information on the LTD that can help you. lets wait and see ok?

I sent her a message to stop by and see if she can help...

I tired to call the Insurance Co today to find out what the letters entail. Basicly they are telling me that 180 days after my injury LTD should have kicked in. It didnt. We are now 17 months into my injury and I want to go back to work. They want me to give them 2 years worth of treatment information going back to 10/12/2007 (prior to my injury in May 2008- and 2 months before I was hired) to check for pre-exsisting conditions. They tell me that I would have recieved a monthly stipend of $100 and that since I didnt get it, then it would all be back pay. That would equal to about $1000 give or take. But is it worth it? I know that I dont/didnt have any condition that would have resulted in my fall but I really dont want them nosing through my medical records. I would really like some help with this. I am afraid if I tell them I dont want this, they can stop my WC payments. I am also leary of the fact that this is just NOW comming up. Why after all this time - past thier own 180 day rule would they bring it up?

They bring it up because they want to find anything they can to stop paying you. As for medical records I think they are fair game and they have a right to them, but I could be wrong

Manely I halted the access of my medical records. The only medical records I would allow were only the ones that would pertain to my Injuries. It's been fine since.

Still waiting for UnderCoverAngel to come, hang in there...

in your state can you receive both wc and ltd? not sure if its a state thing or a policy thing.