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*no names please* is sending me for 2nd IME and want to settle before lumbar hearing
#1
[/font]This is a long read, I appreciate anyone who will take the time and then give opinions:Thank you for your time~

C5-C6 Cervical Fusion Huston TX 2001 By Dr AJ Byndal post surgery no symptoms' Doc did a fantastic job.
Date of injury 2/17/2005 Retail job. I was used to pack the store, remove all lighting fixtures,etc. 2/17/2013 unpack and set up store in new location, The manager and assistant Manger were quarrelling and both left the store for several hours after leaving me instructions to bring everything for a small tight space upstairs to the downstairs sales floor. From 7:30 am to 12:30 pm I worked alone bringing all clothing racks downstairs and bundled clothes 20pieces each and place on racks. Lifted boxes etc. The Mgr came back with lunch, I sat long enough to eat half a sandwich and returned to work. There was tremendous pressure on me to hurry because they wanted the store to open in the morning. Once I was back up stairs I reached straight forward to remove a small empty box when lightning type pain took me to my knees and to the emergency room. I suffered two area's of injury. Cervical and Lumbar. Within a week I had a Occupational Doctor. We started with medications for the pain and PT. The Cervical pain was the most severe once the lumbar relaxed from the spasm. MRI reported injury to C6-C7 cervical and 3 discs and a tear in my Lumbar. I was first referred to a neuro surgeon whom said I was a candidate for cervical disc replacement. However upon suggestion from his assistant I obtained an Attorney, after which I was suddenly no longer a candidate and told I could only have a fusion. I was referred to other surgeon whom could and would do the disc replacement but Pinnacle denied the disc replacement on the grounds that it was not FDA approved. My surgeon obtained special FDA approval for me and still they denied it. I was in too much pain to fight any longer so we went forward with the fusion C6-C7. Shortly after my surgery I was returned to work. I was experiencing new pain and it was even worse than before. I was brushed off. But after continued efforts on my part I was afforded a second opinion with the original surgeon. He ordered an in office X-ray which showed that the treating surgeon had removed the plate from C5-C6 and the graft bone had not healed and I was subjected to horrific pain. I returned to the treating surgeon whom had to do a second surgery to remove all levels of bank bones and the new plate from C6-C7. Then he placed new bank bone C5-C7 and used BMP protein. After this surgery I again suffered from new pain. Once again they brushed me off when it I through a friend discovered on the MRI report that I had a Syrnix/Lesion a hole in my spinal cord and leaking fluid which was collecting in the hole and shutting off my left side. I found another surgeon whom specialized in Srynixes but not my type which was from trauma during the second surgery. This lead me to Dr *no names please* at Craig Hospital where I had a spinal cord untethering and pig heart lining to patch the hole. He wanted to do another fusion C7-T1 at the same time but found that he would have to tilt my head forward 2-3 inches perminately so he chose not to go forward at that time but rather another surgery after I had recover from the untethering. While I was an inpatient it was discovered I had a spinal fluid leak which filled up at the C7 range on the back of my neck. It was the size of a cantaloupe and caused yet more pain. The doctor aspirated 3 times and they placed a lumber drain in for 1 week. It was checked every hour for the entire week. The swelling finally went down and after 7ish weeks I returned home. I now suffer with pain from instability C7-T1. I have been on the surgical table twice. He tried to go in through the back first and the second was through the front, both separate events were aborted because I was loosing signal on my left side. Each time they woke me to say they had to abort I just sunk emotionally. I then decided it was time to take care of my lumbar spine to at least get relief from the pain I continued to suffer from. I was in the process of seeking opinions and having shots to stave off some pain when Pinnacle forced me to have an IME. This doctor is working for *no names please* and the bottom line she said I am taking advantage of the insurance company and that my back should not be covered. Guess what they stopped treating my Lumbar. For the past 3 years I have be stuck in bed more days that not with pain. I am depressed and overwhelmed. After me doing the leg work I finally got a rebuttal letter from my primary doctor so we can go to trial for my lumbar and now they have said they want to talk about a settlement and they are forcing me back to the same office for another IME. Even though it's a different doctor it's the same offices which have a known reputation for denied patients treatment with false information they extract from area's of my file to put together their findings which become cement once they are done. The last IME doctor sent a copy of her letter to everyone that has ever seen me stating I am taking advantage of them. Not nice. Today is October 25, 2013 and I am facing December with an *no names please* owned IME doctor and them wanting to try and force me out with a settlement. I have no savings and I am 52 turning 53 Dec 2nd. I suffered everyday what am I worth in a settlement + MSA


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#2
Does anyone no what Colorado Workmans comp allows for unfinished medical treatment and TTD settlement may be. Also do I have to settle? Can they force me to settle
 
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#3
the comp laws in colorado are different then those with injuries from texas. which is it?
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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#4
(10-25-2013, 08:13 PM)1171 Wrote: the comp laws in colorado are different then those with injuries from texas. which is it?



I have knowledge from living in Texas 14 years before here in Colorado. Even thought wc is left to each states conditions there is still Federal oversite if I'm not mistaken
 
Reply
#5
You are mistaken.
If your claim was in Texas then Texas comp laws control no matter where you live.
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.
 
Reply
#6
[quote='1171' pid='154231' dateline='1382763656']
You are mistaken.
If your claim was in Texas then Texas comp laws control no matter where you live.
[/q



My case is Colorado based, sorry about my mistake in the Texas thingy. Do you have knowledge of Colorado wc laws" Do you have any advice pretaining to my post and my concerns? Thank you for your time I appreciate any help/feedback I can get.
Cheri~
 
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#7
you can find out more about Colorado comp here
http://www.colorado.gov/cs/Satellite/CDL...0336932511
permanent disability benefits are determined by your rating.
everyones future medical needs are different.
if you are buying out all future benefits and an MSA is involved, Medicare will have to evaluate how much of any settlement should be put aside for future treatment.
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.
 
Reply
#8
(10-26-2013, 03:57 PM)1171 Wrote: you can find out more about Colorado comp here
http://www.colorado.gov/cs/Satellite/CDL...0336932511
permanent disability benefits are determined by your rating.
everyones future medical needs are different.
if you are buying out all future benefits and an MSA is involved, Medicare will have to evaluate how much of any settlement should be put aside for future treatment.

It has been a while since I was last here...... I went to a settlement conference..... what a scam....Though I was in too much pain to really be there in person, I thought it was in my best interest to allow them to have a face rather than a name and number on papers. Just prior to my day in court opposing council decided that I did not need to attend an IME and that they accept by back/lumbar. That said, they did not approve a long over due decompression surgery and remove a mass that has popped up L4. The mass would be tested after the fact. Rather than allow me to have some relief, they denied surgery stated that we would allow for the surgery through an MSA after settlement that is.....At the conference they offered 50K lump sum and 100K in an Annuity that the insurer will still own. Life expectancy of 34 years. Based on the fact that I have been stuck at the rate of pay for life minus 1/3 the 2/3rds pay rate is barely enough to stay afloat and too much to receive any additional gov. assistance, such as food stamps and electric/heating help... Now considering my body is broken and I will never be able to work again, the insurer thought it made since to their best interest to offer me some packet change along with the pocket lint.... If I live for an additional 34 years the insurer will pay$707,200 at the rate of $400 per week.... Their offer of $50K and an insurer owned and managed amount of $100k in and annuity. They are taking into consideration that the annuity would pay 4% interest and therefore deduct the interest over the life of the annuity as a lump sum and deduct that amount as a whole from the settlement as though I am being given this amount in a lump sum. They also want to take another 25% off for disability that they expect me to receive in the future ( I've been denied 2x). The judge gave me a value $344K based on what it would cost them to buy an annuity which would in turn provide me with and amount of interest that would equal to $400 per week for life. Not only does the insurer carry the annuity in house and make money off of the proposed annuity, they plan to keep what ever is unused when I die.... nothing to my heirs but rather back to the insurer. I cried out loud when I was faced with such horror. Before I left I was given a counter offer to my offer. I said I would agree to $337K lump sum... Their counter was $80K lump sum and $50K in an annuity... If I am correct their offer went down and not up... First offer $50K/$100K annuity to $80Kand $50K annuity. Total's 1st offer $150K to $130K mixed value.... If I look at this right $707,200 - $130K = $577,200 um yeah no where near half. Keeping in mind the woman on both sides of my family have lived well past their 80's and up to 98 years of age. I will never see a cost of living increase though, I have already felt it in my recent years. I am scheduled for the second settlement hearing Feb 5th. This is all a game to the insurer and what they call legal math. Their goal is to pay as little in an up front lump sum and what ever they must place on paper in an annuity (we they own) and then hope I die sooner than later so they can reap the benefits..... Oh as I mentioned, they decided I didn't need to have an IME because they had one done without me. Yes the two doctors play this game from the game offices. I recently re-read the first IME doctors report which was painted. And of coarse the second IME doctor just said ditto what she said. I had gone back through my medical history on paper as well as lived it and I will say this doctors flat out lie and distort the truth on paper. I went back through reports which did not state the same as was reported. But this is the deal: the insurer has the right people in their pockets to say what ever needs to be said for an administrative decision to be made. This particular decision caused my lumbar not just go untreated for over 3 years but worsen and they know this, but the insurer's people don't feel bad, no because they say you have waited this long for treatment what's a few more months while we try to force your hand, after all we are not saying you can't have your long over due surgery, we are just saying not until we have settled and you can pay for that surgery out of an MSA.. The insurer is saying to me we know you hurt and we know we did wrong by you, but wait we are not done yet.. and to top it off I was threatened with you know we can starve you out by letting your TTD run out and in the interim while you wait for us to say you are perminately disabled you will be on the street and begging us for our pocket change and the lint to keep you warm. The insurer have deep pockets and nothing but time. At this point I know what is real and that is I was injured and my injuries have not all been treated. My two level injuries have been my own night mare, my cervical spine in it's self was bad enough and then surgical mishaps caused no end in sight while my lumber was put on hold , it did not heal thy self, it has and does still need surgical intervention well documented by MRI's which can not change their appearance even on paper and continue to show evidence of date of injury injuries and nerves fusing them selves together. I have vented and shared enough for now, and I will do my best to update. In the mean time I missed the birth of my first grand baby because of their calendars and then they switched the dates again so I would have been there for my son but right they don't have to concern themselves with my petty little life, they just need me to go away and off their books to another place called hahahah we can get away this because no one can stop us.Big Grin
 
Reply
#9
(01-25-2014, 07:17 PM)CheriLovesJesus7 Wrote:
(10-26-2013, 03:57 PM)1171 Wrote: you can find out more about Colorado comp here
http://www.colorado.gov/cs/Satellite/CDL...0336932511
permanent disability benefits are determined by your rating.
everyones future medical needs are different.
if you are buying out all future benefits and an MSA is involved, Medicare will have to evaluate how much of any settlement should be put aside for future treatment.

It has been a while since I was last here...... I went to a settlement conference..... what a scam....Though I was in too much pain to really be there in person, I thought it was in my best interest to allow them to have a face rather than a name and number on papers. Just prior to my day in court opposing council decided that I did not need to attend an IME and that they accept by back/lumbar. That said, they did not approve a long over due decompression surgery and remove a mass that has popped up L4. The mass would be tested after the fact. Rather than allow me to have some relief, they denied surgery stated that we would allow for the surgery through an MSA after settlement that is.....At the conference they offered 50K lump sum and 100K in an Annuity that the insurer will still own. Life expectancy of 34 years. Based on the fact that I have been stuck at the rate of pay for life minus 1/3 the 2/3rds pay rate is barely enough to stay afloat and too much to receive any additional gov. assistance, such as food stamps and electric/heating help... Now considering my body is broken and I will never be able to work again, the insurer thought it made since to their best interest to offer me some packet change along with the pocket lint.... If I live for an additional 34 years the insurer will pay$707,200 at the rate of $400 per week.... Their offer of $50K and an insurer owned and managed amount of $100k in and annuity. They are taking into consideration that the annuity would pay 4% interest and therefore deduct the interest over the life of the annuity as a lump sum and deduct that amount as a whole from the settlement as though I am being given this amount in a lump sum. They also want to take another 25% off for disability that they expect me to receive in the future ( I've been denied 2x). The judge gave me a value $344K based on what it would cost them to buy an annuity which would in turn provide me with and amount of interest that would equal to $400 per week for life. Not only does the insurer carry the annuity in house and make money off of the proposed annuity, they plan to keep what ever is unused when I die.... nothing to my heirs but rather back to the insurer. I cried out loud when I was faced with such horror. Before I left I was given a counter offer to my offer. I said I would agree to $337K lump sum... Their counter was $80K lump sum and $50K in an annuity... If I am correct their offer went down and not up... First offer $50K/$100K annuity to $80Kand $50K annuity. Total's 1st offer $150K to $130K mixed value.... If I look at this right $707,200 - $130K = $577,200 um yeah no where near half. Keeping in mind the woman on both sides of my family have lived well past their 80's and up to 98 years of age. I will never see a cost of living increase though, I have already felt it in my recent years. I am scheduled for the second settlement hearing Feb 5th. This is all a game to the insurer and what they call legal math. Their goal is to pay as little in an up front lump sum and what ever they must place on paper in an annuity (we they own) and then hope I die sooner than later so they can reap the benefits..... Oh as I mentioned, they decided I didn't need to have an IME because they had one done without me. Yes the two doctors play this game from the game offices. I recently re-read the first IME doctors report which was painted. And of coarse the second IME doctor just said ditto what she said. I had gone back through my medical history on paper as well as lived it and I will say this doctors flat out lie and distort the truth on paper. I went back through reports which did not state the same as was reported. But this is the deal: the insurer has the right people in their pockets to say what ever needs to be said for an administrative decision to be made. This particular decision caused my lumbar not just go untreated for over 3 years but worsen and they know this, but the insurer's people don't feel bad, no because they say you have waited this long for treatment what's a few more months while we try to force your hand, after all we are not saying you can't have your long over due surgery, we are just saying not until we have settled and you can pay for that surgery out of an MSA.. The insurer is saying to me we know you hurt and we know we did wrong by you, but wait we are not done yet.. and to top it off I was threatened with you know we can starve you out by letting your TTD run out and in the interim while you wait for us to say you are perminately disabled you will be on the street and begging us for our pocket change and the lint to keep you warm. The insurer have deep pockets and nothing but time. At this point I know what is real and that is I was injured and my injuries have not all been treated. My two level injuries have been my own night mare, my cervical spine in it's self was bad enough and then surgical mishaps caused no end in sight while my lumber was put on hold , it did not heal thy self, it has and does still need surgical intervention well documented by MRI's which can not change their appearance even on paper and continue to show evidence of date of injury injuries and nerves fusing them selves together. I have vented and shared enough for now, and I will do my best to update. In the mean time I missed the birth of my first grand baby because of their calendars and then they switched the dates again so I would have been there for my son but right they don't have to concern themselves with my petty little life, they just need me to go away and off their books to another place called hahahah we can get away this because no one can stop us.Big Grin

Have you ever filed for SSDI? This would allow you to get SSDI and the settlement to my understanding will be spread out over the course of your lifetime? I am curious as you had a fusion in 2001 then sufferred another injury that casued a fusion to C6-7 did the IC fight that as pre-exisiting from previous surgery or not?

 
Reply
#10
No the IC did not contest the second cervical.
 
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