need medical treatment

[feelinscrewed]

Need advice! Ok, first off, I'm from Virginia. I was involved in a car
accident (while traveling from one work location to another) in April.
I was rear ended and shoved into the vehicle in front of me. The result was a knee injury (which has pretty much healed with the exception of occassional soreness), back, neck, shoulders, arms & hands, buttocks and into my thighs. I did three months of PT. I was sent to a spine doc by w/c. He diagnosed me with herniated discs in the L-4, L-5 & S-1 area with probable nerve damage including the sciatic. He also stated that I'm probably suffering with nerve damage in the cervical area (my left arm stays numb and tingly, the right arm comes and goes). He said he wanted to treat the lumbar area first, then we'd deal with the cervical area. Well, w/c allowed him to treat me with spinal injections, one in August and one in Oct.
(Had to go for a "second opinion" with w/c doc before second injection was allowed.) The injections didn't help. The doc then wanted to do a discogram and CT of the lumbar area involved. My case worker wouldn't allow it and made me go for an IME, the appt. was set up for Jan. I was told no medical treatments or prescriptions would be paid for until then. Well, you can just imagine what the IME doc said. He insisted it was all preexisting due to the MRI showing degenerative disc. I have never had back problems, have never been treated for back problems and in my eleven years of employment with the company never complained of or called out due to back problems. If I had DDD, I certainly didn't know it!! The IME doc also insisted that the pain was nonanatomical, which according to my lawyer means the doc thinks it's all in my head. Well, then w/c had their lawyer file to terminate my benefits and they stopped my payments along with refusal of medical treatments and/or prescriptions. I have been paying for my own prescriptions and my monthly visits with my primary care doc (can't afford the discogram and CT scan). On top of all of this, two months ago, my primary care tells me I have fibromyalgia as a result of all of this. I FINALLY got a notice of the court date in the mail yesterday, it's not until June!!! Is there ANYTHING I can do to receive the treatment and tests? It's been almost a year since my accident and I feel like I'm only getting worse due to the lack of treatment. Oh, yeah, my employer terminated me after three months of absence. Some crap about the FMLA. Eleven years of hard work didn't count for crap. This whole situation is really starting to get to me. I don't understand how this is allowed??? You work hard, you get hurt in an accident that's no fault of your own, you lose your job/benefits/health insurance. Then, the w/c i/c gets to kick you while you're down. Please, please, please someone advise as to what the heck I'm supposed to do now???

[Manley2]

First I would like to say hang in there. Do you have any insurance that could pay for any of this? My work was paying for mine under WC until my PM doc wanted to try a SCS. They stopped all WC payment after that. Well that was in July 2007. Took until Nov 2008 to get an emergency petition hearing and til Feb 2009 to get an answer. Well I won that hearing but the company is appealing it. I have been lucky in that I've have insurance that has been paying it's part of my medical. I understand how you feel because I too have felt that if work had been more forward in the medical care maybe I would be better now, but thats hard to tell. Took me a month of seeing the nurse at work before they let me see the doctor.

[1171]

health insurance should handle denied work comp care. you also should have 3 rd party suit against the other driver with coverage from that. either should suffice until you get a court date with your work comp commission.

[sparkey]

What the heck is your lawyer doing about all this??? The same thing happened to me as far as after my IME I lost the fact that the WC IC was paying for my meds till the IME doctor said I did not need any for recurring carpal tunnel and now I have been diagnosed with RSD. Thank god I have health insurance. I know you said you were let go by your work but do you have cobra or anything like that?

Also people had mentioned about the 3rd party for the accident. Who was at fault and do you have a lawyer handling that case?? Just hang in there and take one day at a time. I know it is hard and very depressing at times when things get refused and we all have been through it. WC is not a easy thing to be in and not one of us asked to be in this system. We fell into it unfortunatly and if we could just get out it would be great. I know it would be for me. It has just been one big headache after another.

[feelinscrewed]

I do not have health insurance, Cobra was too expensive to get. And, even if I'd gotten it, I wouldn't have been able to afford it after getting my money cut off from w/c. The other driver was found 100% at fault, nobody has tried to deny that. He was twice the legal limit of intoxication. My w/c lawyer just keeps telling me we have to wait for the court hearing. I had to answer discovery questions for the w/c lawyer and am supposed to be going to my lawyer soon to go over the answers. Believe you me, I'll have a list of questions for him to answer. If I don't like his answers, then I guess it'll be time to find a new lawyer. But, thanks for the advice about the using the 3rd parties insurance. I'll contact my personal injury lawyer to find out how to do that. I KNOW I'm hurt, I deal with it every day. If I can get the discogram and CT done before court date then there shouldn't be ANY question about my injury. The IME doc says it was preexisting, but the VP of the company is willing to testify that it wasn't. The company is upset with how w/c is treating me, but they say there hands are tied. None of it makes any sense to me. And, yes, it's very depressing at times. To have the IME doc say I should be able to do anything that I was able to do before the accident is a big JOKE! There are many things I would love to do. I can't go to the mall, I can't dance with my husband, I can't hold my grandkids, I can't lift them up into the swing, etc. Needless to say, you can't explain this stuff to the grandkids, they're too young to understand. In the meanwhile, I'm missing out on the chance to make those kind of memories for them. It sucks! The whole system sucks and needs a great big overhaul. But, once again, thanks for the responses and the support. I always know I can turn to y'all for suggestions and answers!!!

[vickinat]

Feelinscrewed,
My personal opinion is that if your W/C lawyer can't or won't help you with the 3rd. party suit against the negligent driver's auto ins, you should get a 2nd. lawyer for that. Make sure that you or your lawyer has or gets a copy of the accident report.

I myself was involved in an auto accident after leaving my PM dr's appnt. for my W/C injury. I was not at fault. I was sitting at a red light in the right turn lane when a driver hit another car and pushed him into my driver's side. I had to be taken out of my car by the ambulance personel from the passenger side, my car was totaled and my W/C injuries were made worse and several more injuries were sustained in the accident.

The W/C ins. used the fact that there was someone else at fault and pushed for settling my case. Refused to pay for any medical from the date of the auto accident. After my auto ins medical was exhausted, my lawyer that I was using for W/C filed a 3rd. party suit against the at fault drivers auto ins, as well as getting me the underinsured portion from my own auto ins.

After being denied by W/C and exhausting my auto amount, my health ins. covered some of the expenses. At the time that settlement was made for the auto accident from the at faults ins. the health ins. had to be reimbursed what they had paid out. The main thing is that I had finally gotten the much needed medical treatment done. 3 surgeries within 5 months last year and restrictions for life.

I hope my experience helps you. I also found that my auto ins. agent was a big help by telling me to ask my W/C lawyer if he handled personal injury suits. I wish you the best of luck.

Take care
Vickie

[Still in Limbo]

Hi Feelin', and Welcome to the Forum!! You are Receiving Great Advice from the Others, I just wanted to Jump on and Let You Know You are not alone when the W/c System and Delays get You Down, and the Loss of Your Job after 11 Years isn't Easy to Take! My Best Advice for You, You See I was 42 when I caught a Falling 450lb. 7' Tall Main Frame Computer Mid-Air to Save an 18 Year Old Workers Legs from getting Crushed, and Blew Out My Lower Back, leaving Me Totally Disabled! The Key to this, and it's Very Hard to do, I know, is Patience!! And the Other Main Problem I had was getting Used to being a Case File and a Number to My Employer and w/c, We All became just a Liability to them, and Personalities and Relationships Formed with Our Employers go Out the Door! You can Make Memories with those Grand Kids, just Different Ones, and You'll Figure that Out over Time! Just don't Fall into the Trap that You don't Matter, because at Times w/c will Make You Feel that Way, Pull Your Strength from Your Family and Friends, and don't let them have the Upper Hand!! It Took Me a Couple of Years to Figure Out what I just Posted to You, and I still Battle with it Daily, but You Will get by, and with Patience and Hard Work from You and Your Attorney, You Will get what You Deserve!! I'm going on 5 Years now, I've Won 13 1/2 out of 14 Petitions, and I never would Have been able to do that without Patience, and a Very Good Attorney!! Hang in there and Keep Fighting, it may Take Time, but You have Honesty and Patience on Your Side!!