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Dr's letter to attorney
#1
HISTORY:
I was injured in 2005 and am in need of total knee replacements.
Going without treatment for my knees has also lead to low back
problems and S! nerve radiculpothy. Most recently I have been having problems with my hip and see the doctor next week for it.

Wc Ins refuse to pay for medical treatment dues to pre-existing conditions and according to my attorney this has become an issue in my case. My attorney directed some questions to my family physician also a D.O. about my medical condition. (I have not seen a doctor for my knees previous to the accident)
……………………………………………………………………………………………..................
This is a part of the letter my doctor wrote to my attorney.

I have cared for MS XXX for 17 years. The work injury she sustained in 2005, undoubtedly accelerated and aggravated the pre-existing degenerative condition of her knees.

I would be my medical recommendation that MS XXX be referred to and evaluated by an orthopedist that specializes in total joint replacement.

Due to the injury and degenerative process in MS XXX knees, her gait has been affected adversely. This would aggravate and accelerate the degenerative process in her low back. It would also intensify the pain that she feels in her low back.

Sincerely,

XXXX, D.O.
………………………………………………………………………………………………

Has anyone ever been refused treatment due to a pre-existing condition?
Were you ever able to get medical treatment by wc?
 
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#2
not me...but the letter sounds good...I hope they finally follow thru with your treatment....good luck...has your attorney responded yet?
 
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#3
No, my attorney is suppose to call me.
 
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#4
bummer knees good luck i am going to be battling a workmans comp case myself
 
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#5
Mel, What is your story?
 
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#6
Hi Bummer...in NJ there is a case that can be made when pre-existing conditions. The reality is that anyone over the age of 40 most likely will have some DJD or DDD in their bones. My husband was sent to one doctor and then to another until one said that he has DJD. He does but what they neglected to say is that he also has 2 herinated disc, one bulging disc, all in his cervical where he has never had an injury. So I believe that you have a definite case. What they do to people just creates a sense of unrest ... this is just so unfair and unjust that a insurance company can delay your care related to pre-existing conditions. That means that most likely at 80% over the age of 40 is not covered...sad..Red
Be who you are and say what you feel, because those who mind don’t matter and those who matter don’t mind.
 
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#7
Thanks Red

I really like my doctor, he started the letter with........It has been a pleasure to take care of MS XXX as a patient for 17 years.

This is a doctor that will set down and listen to what I have to say.

Bummer Knees
 
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#8
hope and pray all goes well for you keep up the fight dont let them win remember we are on the winning side
worry changes nothing prayer changes every thing
 
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#9
Hi, Sounds like an effective letter to me! Hopefully it will get things rolling (treatment-wise) for you!
You are in in my prayers, LillyBig Grin
Injured worker, & tired of it all! I'm too old for games!!

A careless word may kindle strife, a cruel word may wreck a life, a timely word may level stress, and a loving word may heal and bless!
 
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#10
I just got off the phone with my attorney and we are going to court.

He said the doctor's letter wasn't perfect but it was 90% of what we needed and it is enough to take to court to try and get treatment.

I told my attorney that I am going to the doctor next week for pain in my hip joint and if I need treatment for my hip then I want it added to my claim.
 
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