IR report

[UndercovrAngel]

Here is what happened with my IR that I had on the 16th. The doctor that did it put me at permanent partial 8% as a whole body for my right arm and wrist, and at clinical MMI. Stated that I would need periodic treatment for the injury, but that everything that could be done for the injury itself has been done. (treatment, therapy, meds, etc) which is funny since I haven't had one of any of these since my claim was started, other than a shot of toradol in the ER. I guess it must be one heck of a med if it can cure all that they found wrong with me since I had that shot.

I am curious though, to see how the 8% IR is going to play out with the 8% body as a whole that I received in 2004 with my first wc injury (wrist and hand). This new IR includes the wrist, but not the hand. So I figure there will have to be some kind of aggregate disability on the wrist, as it is the only part that is common between the 2, and then somehow it will all have to be combined to come up with one total. I guess either my attorney, or my Dr will be able to tell me

He used Guides to the Evaluation of Permanent Impairment, fourth edition, 1st,2nd,3rd or 4th printing, including corrections and changes issued by the AMA prior to May 16, 2000. Isn't there a more recent issue ?? With the way medicine changes every day, you would think there would be.

Hope that you bear with me on this one. Here is a synopsis of some of what he wrote:

treatment history from records received:
3/12/2008 treatment notes from URHE

5/15/2008 Dr. Babalola Oluwole examined worker, determined findings consistent with upper right extremity repetitive trauma injury related to job.

5/19/2008 Dr Jim Mitchell, my current treating Dr of record, examined worker. Determined examinee's signs and symptoms directly related to work injury.

5/19/08 Dr Jim Mitchell evaluated right shoulder elbow and wrist x-rays. No significant clinical abnormalities but did report an artifact at distal radius.

5/28/08 Physical Performance examination performed.

01/08/09 right elbow MRI
1. normal alignment of the radiocapitellar and humeroulnar joint associated with minimal joint effusion
2. subtle bone bruise of radial head and the coronoid process of the ulna
3. probable cell artifact to account for increased signal in the olecranon since not verified on the STIR image
4. tendinosis/tendinopathy and post traumatic inflammatory and reparative change involving the insertion of the common flexor tendons of the medial epicondyle
5. normal radial and ulnar collateral ligaments, common extensor tendon, intact biceps and triceps tendon
6. normal cubital tunnel

01/08/09 right shoulder MRI
1. normal glenohumeral alignment without evidence for labroligamentous disruption
2. subtle bone bruise of the distal clavicle associated with subacute arthritic changes of the AC joint and subacromial bursitis
3. there is intact rotator cuff
(of course the MRI's were taken almost a year since I first started having my troubles)

01/14/09 Upper extremity electrodiagnostic study was performed. Sensory abnormality of the radial nerve on the right, abnormality in the Ulnar nerve in left and bilateral Median nerve abnormality

04/02/09 Dr Mitchell re-evaluated IW and determined that she was not able to return to work.
( I have seen Dr Mitchell on a monthly basis since August, so that he could determine if I was able to return to work).

These are the IR Dr's findings:
Palpatation of R shoulder revealed tenderness on all surfaces, as well as the AC joint, SC joint and biceps tendon

Palapatation of R elbow revealed tenderness of the lateral epicondyle

palpitation of R wrist revealed reported tenderness on the dorsal and radial surfaces

active motion in R shoulder revealed mild to moderate joint crepitation

Active motion on R elbow and wrist revealed no crepitiation

Biceps, triceps and brachioradialis deep tendon reflexes were +2 on Wexler scale bilaterally.

Upper extremity motor evaluation revealed mild weakness (4/5) in grip strength on right. All other motor was within normal limits.

Upper extremity dermatomes evaluated bilaterally using a disposable pinwheel. C5 dermatome reported to have diminished sensation on right.l C6, C8 and T1 dermatomes were reported to have stronger sensation on right than left. C7 was reported equal bilaterally.

Upper extremity vibratory sensation was within normal limits bilaterally.

Hoffman's reflex absent bilaterally

Yergason's test on R shoulder positive for tenderness but negative for instability

Codman's was - on R

Dawbarn's - on R

Mill's + at r elbow

Cozen's + at R elbow

Tinel's tap - in R elbow and wrist

Finklestein's test + on wrist (he actually performed Eichhoff's test not finklestien's)

Phalen's - on R wrist

Circumference of upper exteremity musculature was measured bilaterally Above elbow 31 1/2cm, below elbow 27 cm both bilaterally.

Summary:
the total upper body impairment was 14%. Table 3 (page 20) converts this to 8% body as a whole person. This becomes the final whole person impairment rating. It should be noted that this injured worker would benefit from Periodic care in the future in order to maintain the biomechanical improvement she has achieved under her treating doctor's treatment plan.

I will be seeing my treating Dr on Thursday, and following up with a face to face for the first time since I hired her over a year ago, with my attorney. I think, if it is all played out right, I should have my claim accepted no later than the end of May. Especially since we found fraud committed on the original Employers' first report of injury. And it just wasn't one little error, but three. The adjustor has already filed a new report of injury (this one has the actual reported date of first injury on it) and by the end of the month, instead of having a mess of three claim numbers for the same injury, it will all be under just one that the court will accept. Heck, I may find that come Thursday afternoon when I meet with my attorney that I have an accepted claim and be getting a check soon ~LOL~ as if WC moves that fast !!!

Will let you know what happens at the Dr's and attorneys on Friday.

Angel ^j^

[Bummer Knees]

Good luck UA on Friday.

[halftrak]

good luck on all that hope everything goes your way and you can get all the treatment you need.Boy that right elbow sounds like what i have and its getting worse.got to start going back to the ortho as soon as i get moved for some treatment.by the way ua i am moving closer to you.

[AQA]

UA, I am sorry that I am not more familure with your situation. You made mention of finding that "I have an accepted claim". Can you explain?? I am lost, which is not hard for me to do. You have an imparment rating of 8%. That indicates you have a claim to me. I just reread your post and well, I am as confussed as a redneck can get. I do wish you luck on friday.

[sparkey]

So was this the IC IME or did you hire this IME doctor? If you got a 8% and the IC should agree to that rating as it is not that high you should not have any trouble with them paying that amount. The reason that there was a disagreement with mine is because my doctor said 32% and the IC said 10%. It ended up that the court found the IC doctor more credible and I was paid the 10%. I was paid that right away after the court date. They held it till I had the court date. The court even questioned why they did not pay it to me yet.

Also this has nothing to do with the RSD and WC right? Because I would think RSD would be a higher percentage.

[Lilly]

Good Luck UA.
I have a question though.....I can't recall what kind of fraud was committed on the employer's first report? Are you able to fill me in? Why would they be so dumb to do something like that??

My prayers go with you UA! Lilly

[UndercovrAngel]

halftrak Wrote:good luck on all that hope everything goes your way and you can get all the treatment you need.Boy that right elbow sounds like what i have and its getting worse.got to start going back to the ortho as soon as i get moved for some treatment.by the way ua i am moving closer to you.

Halftrak,

I wish that it was just the elbow. But I have lost a lot of ROM in my shoulder (although it looks like the IR didn't think so), and can barely take care of my hair any longer, and even have problems taking care of my teeth.

I am hoping to be able to see an orthopedic specialist and see what he has to say, if and when we get all this crud settled.

So how much closer are ya moving ?? If you waited till the end of summer or so, you could buy the house we are in now, as it will be going on the market as soon as we have 50 % of the renovations done on the other house.

Angel ^j^

[UndercovrAngel]

AQA Wrote:UA, I am sorry that I am not more familure with your situation. You made mention of finding that "I have an accepted claim". Can you explain?? I am lost, which is not hard for me to do. You have an imparment rating of 8%. That indicates you have a claim to me. I just reread your post and well, I am as confussed as a redneck can get. I do wish you luck on friday.

Not a problem Still. I am finding that I am not familiar with it either, the way they throw things around. I guess I will find out tomorrow (or at least hope I do) exactly what all of this means to my denied claim.

As for mentioning having an accepted claim, this is my attorney and the IC adjustor's way of showing that I have an injury and get it put through Texas Division of Insurance. I know, and you know to a layman that it sounds like my claim was accepted, but the IC can always find a way around making things look like they aren't.

I would almost be willing to accept the IR as the last word on my claim, if they would backpay me since February 23rd and give me the money I am owed for travel (which is going to be more starting tomorrow, as my treating Dr moved into new offices since I saw him on the 2nd) over all of these months. I would almost rather live in pain the rest of my life than deal with the added stress and depression that all of this is causing me.

Angel ^j^

[UndercovrAngel]

sparkey Wrote:So was this the IC IME or did you hire this IME doctor? If you got a 8% and the IC should agree to that rating as it is not that high you should not have any trouble with them paying that amount. The reason that there was a disagreement with mine is because my doctor said 32% and the IC said 10%. It ended up that the court found the IC doctor more credible and I was paid the 10%. I was paid that right away after the court date. They held it till I had the court date. The court even questioned why they did not pay it to me yet.

Also this has nothing to do with the RSD and WC right? Because I would think RSD would be a higher percentage.

Sparkey,

First off, my wc claim and the RSD are two entirely different things. Although with the way I have been screwed on getting any treatment, I am sure when I get insurance back, that my PM will tell me that it has moved into my entire R upper extremity and is now working on my left one.

Pretty much, this IR was something that the IC adjustor and my attorney came up with to show that there indeed had been an injury to my arm, elbow and wrist so that we could get it all back to a BRC and start from square one with my claim again (other than the date of injury) I am now on my third claim number for the same reported injury of 02/20/08. They just want to have it finalized as date of injury 02/06/08 as that was the first day that I noticed all my problems.

I am not going to fight to get RSD added to the claim. I want that all taken care of by the PM that has treated me since January of 08. and he doesn't accept WC. I will be able to get private insurance to pay for RSD in my right arm, as we can't prove if it came from me already having it in other parts of my body, or if it was caused due to delayed treatment of any kind on my arm.

Will have more answers tomorrow.

Angel ^j^

[UndercovrAngel]

Lilly Wrote:Good Luck UA.
I have a question though.....I can't recall what kind of fraud was committed on the employer's first report? Are you able to fill me in? Why would they be so dumb to do something like that??

My prayers go with you UA! Lilly

According to my attorney, there are several things that they did wrong with the Employers First Notice of Injury or Illness.

1. An employer must report the following to its insurance carrier within eight (8) days of the date:

o an employer knows about an occupational disease or illness even if the employee has not missed any work;

>I informed HR for the first time on 20Feb08 and they finally filed the report on 10March08.

2. On the Date of Injury, they wrote 27Feb08 and a few blocks later under date reported to employer, they also put 27Feb08. I have proof of first date of injury being 06Feb08 and them being notified of it on 20Feb08.

3. One question asks if the employee speaks English, they marked no (it was a requirement in order to be hired) and in the block right next to it..If No specify language, they typed in English. (one would think that after all these years, I would know what language I spoke).

4. In the block that asked for part of body injured or exposed, they put down just my hand (I have always stated that it was hand, wrist, elbow and arm).

5. How and why injury/illness occurred?? They wrote in right hand de'quervain's ,believe that it's an reoccurring accident. ( what in the heck is a reoccurring accident?? And neither HR nor I have a medical degree in order to make that kind of diagnosis). In order for them to have come up with that, they would have had to of pulled my hire packet, as I wrote once hired {as required by law} that I did have a physical handicap and why, as well as the restrictions I now had from the work comp injury in 2003/04. Never once did I state to anyone that I believe this was tied in to my previous injury, as I felt it wasn't. It wasn't in the same location, I hadn't had any problems after that injury, and my Dr at the time that I had De'querevain's release stated that I would not ever be able to get the same thing, as he completely removed the sheath.

6. One of the 2 biggies, under Signature and Title (of person filling out this report) they typed in my name, making it look like I was the employer instead of employee, and then it is signed on 10March08 and faxed at 10:28 AM the same date.

A. The form was to have been signed by a supervisor or higher up (HR) in the company after talking to me about what happened. Other than what they got off of voicemail, I was never questioned in regards to what had occurred.

B. The date that I supposedly signed this could not have occurred, as it was a normal day off for me, and Texas Division of Insurance, Division of Workers Comp has record of me on the phone with them filing my state claim at the same time.

7. According to TX WC laws, I was to have a copy of the First Report of Injury within 3 days of them filing..and I still haven't gotten one from the employer. What I have now, the IC's attorney included in a packet of papershe sent to me on 2 July 08 as part of Carrier's Benefit review Conference documentary exchange packet.

8. The final screw up: Supplemental Report of Injury

[Rule 120.3]

An employer must report any changes in an injured worker's pay or employment status to the insurance carrier. The employer must send the Supplemental Report of Injury (DWC Form-6), to the insurance carrier and the injured worker within:

o ten (10) days from the end of a pay period in which an injured worker's pay changes; and
o ten (10) days from the date an injured worker resigns or is terminated; and

The first happened at least 9 times (most recently on 23 Feb when my STD ended, and I am waiting to see if I get one now that my LTD is approved and I am receiving monies from them) that I know of, the second, of course only the one time, after I was terminated on 03 October 08. To this date, I have not received, nor even seen, a supplemental report of injury.

I don't have a clue as to why they would be so stupid to put it all basically into writing. Other than the fact that our HR was dumber than a box of rocks and were only good for the hiring or firing process. Anything else, they had to run to Corporate Headquarters before they would even pass gas. They had anything and everything that they could, outsourced to different companies. One to collect our time, one to write the checks, one to process and print the checks, one we had to call if something was wrong with our paycheck, one to call about our benefits, one to call in regards to FMLA, another for STD and yet a third for LTD. You name it, they outsourced it. I had such a laff the day that I realized my short term check had gone through 5 different states and each having a different function in getting it to me.

One bewildered Angel ^j^