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lots of w/c ?
#1
my girlfriend was injured on her job 01/11/2010. She is a nurse working in an asst living facility, a patient fell on her and she caught his weight, all on left side.( he weighs 225 and her 120) instant paine in back and loud pop in left knee. was sent to their dr. not given a list. he listened to what happened never touched her, refered her to hospital for x rays and p/t. she was approved for p/t and went about 3 weeks until knee cap slipped out of place while doing p/t. went back to dr. he reffered her to an orthapedic and nero surg for back. took w/c until april to get her into both. had mri on knee and back. 1st visit with orthapedic he said was arthiritis and wanted to give cortisone shot, needless to say knee still popping and knee cap sliding to left, he said only seen 3 case of knee cap going to right and said noting wrong with mine, released 4 light duty. had already seen nero, had mri for back also. said l4 disc degenerated also had xrays done sitting, standing, lifting. finally release for light duty lots of restrictions only if see another specialist because do have nerve damage. forgot ortho said needed p/t. as of today still no p/t and no nerve specialist approved yet by w/c. had to go back to ortho , knee cap slipped to right, wanted to know while not in p/t. he refered to orto surgeon. still have not been approved 4 that either.
she was ordered to go to work may 3 with restrictions, she went they did not meet restrictions, in extreme paine, had to go to er, er dr told her she irrated l4 and nerves, follow up with nero dr asap, stay out until. still not approved for that. w/ c instisted she go back to wrk again light duty, and she did. still in extreme paine cant sit 4 long , nor stand. yet w/c still has not set her up with p/t ortho surgeon nor nerve specialist as of 2day. yes she had an attorney, and he has been on them but they still have not complied. he finally quit, she hired another attorney last week. my question is why does she have to comply and not w/c. they have not given her the medical attention she needs, even tho ordered by thei w/c docs. sorry so long, just soooo much has happened and not to even go into her checks. which they have screwed up also. mostly i just want her to have medical attention. does she still have to continue to try light duty??????
 
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#2
just one ? for you:
http://www.workerscompensation.com/forum...?tid=10146

many first timers spend too much time writing and not enough reading. it's a common mistake.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
1171 Wrote:just one ? for you:
http://www.workerscompensation.com/forum...?tid=10146
 
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#4
forgot, we live in tn
 
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#5
Mike in 4 / 2010 you said it was you that was injured...
http://www.workerscompensation.com/forum...?tid=10180

You said here the employer didn't have work that meet the restrictions, and then said the girl friend is working light duty.

If you have doctor's why are you saying the Insurance carrier is finding doctor's. The treating doctor's set everything, up, the IC gives the approvals.

If possible, can you let us know how to help you all little better.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#6
sorry i did put wrong info (i instead of girlfriend) it is my girlfriend, and she is not seeing her own dr. she was on w/c from date of injury. it is the w/c that has not responded to the w/c ortho dr or the w/c nero dr to get p/t or approval for ortho surgeon nor nerve specialist. still waing after 5 weeks for panel of drs for these. she was sent back for light duty without these approvals for drs with alot of restrictions. they @ first put her cooking. was suppose to have stool for her to sit, no stool!!! she was to sit and stand with restrictions since she has 2 injuries, no lifting, no stretching, no bending, no twisting, not lifting over 10 lbs. she stood on cement floor, lifted huge bowls, no stool to sit own, lots of twisting. cooking for 250 patinets in assts living home. they did not meet requirements of her restrictions. then they put her since then pulling patients files and checking to see if all info in there. files are all the way to top of shelves as high as ceiling, they made this job up. so guess i am frustrated for her. they wanted her to do light duty but w/c has not approved what the other w/c drs ordered. no p/t no orthapedic surgeon, and nonerve dr. so does she have to comply to light duty
 
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#7
Tennessee uses utilization review procedures to control medical treatment.
delays and denials of treatment can be appealed.
http://www.state.tn.us/labor-wfd/wcfaq.h...tionreview

Since her case is litigated those utilization rules and procedures have to be followed and challenged thru the work comp court system.
there is not much she can do without doing it thru her atty and the legal system.
workers comp is not like regular health benefits the worker pays for.
it's the employers insurance and is highly regulated.
she does not have to continue light duty but the carrier doesn't have to pay disability either.
she doesn't have to use workers comp at all. she is free to provide her own care at any time.
if she uses the employers insurance then she has to use the comp system.
that's why it's important to know how it works before the frustrations set in.
she can find out more here
http://www.state.tn.us/labor-wfd/wcomp.html
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#8
thank you for your help, just feel at a loss. the state has already dealt with w/c about her benefits. they were paying her wrong. state mandated they pay on 52 week. they have took care of that. but since they put her on light duty she has not received check. my concern is her health.
 
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#9
yes, the frustrations with high cost, inadequate health care have been growing for years.
unfortunately the reforms will take a while to kick in. until then there are many that are making difficult choices.

P.S.
there are also claims handling standards
http://www.tennessee.gov/sos/rules/0800/...-02-14.pdf
and penalty provisions
http://www.tennessee.gov/sos/rules/0800/...-02-13.pdf
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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