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Workman's Comp Dr is trying to deny me treatment
#1
So, in a short version of the story, I had major surgery on my elbow/arm 13 years ago. I've since been completely cleared to work and have been doing my job for close to a year now. I was injured lifting a heavy box at work. My same arm that had previous surgery is swelling constantly and putting me in excruciating pain. I filled out my accident report and was sent to the Workman's Comp Dr.

The WC Dr simply gave me advil (naproxen) and told me to return to 'light duty'. I had to ask for a sling to support my arm, which was reluctantly provided to me.

So I'm told I can ONLY see my WC Dr for the first 90 days of my injury. But, here's the kicker... So the next day I was at work attempting to do anything with my other arm but the swelling started and I was in a HUGE amount of pain. I went to my boss and the people in HR told me I had to see the WC Dr. Only, there was no Dr. in their office to see me. So, I was sent to the ER. After an XRay, 2 Drs from the hospital sat with me and explained that my surgery from before had made my case 'unique' and that the only Ortho Surgeon can (or will be willing to) help me would be my original surgeon. They sent me home with instructions to Ice and Elevate my arm any time swelling occurs, along with a small prescription of pain killers. I also was given a note stating that I am not to return to work until I see my original surgeon.

So... the WC Dr saw me the following day, and was noticeably irritated with me. Constantly telling me how I am fine to return to work, and that my boss will simply have to 'accommodate' me in following the ER Dr's guidelines. I'm under the impression that Workman's Comp is very upset that I saw a different Dr (under their initial panic and approval) and now they don't want anything to do with treating me. My MRI is scheduled for Monday (2 days away) but I have zero instructions or appointments. The only thing I have is a note stating that I should return for a visit 'after consult with original surgeon'.

I'm being told that I NEED to see my original Dr but I have yet to get any approval to see this Dr. My WC Dr is flat out saying he 'doesn't know' and thinks I simply have arthritis. So here I am, working in massive amounts of pain, in the dark about what my next step is.

All I've really been told (off the record) by fellow employees, is to get an attorney. Did they make a mistake in letting me get a second opinion? It seems like they don't want to speak to me or treat me at all now that it might be a serious issue that involves surgery. Everything I have been told is that if the WC Dr says you are cleared for any work, you have no choice but to be there or else they have grounds to drop your WC claim entirely. Are they just trying to put me through work hoping I can't take the pain and walk out? They seem to be trying to get me to 'slip up' to get out of covering me in any Workman's Comp.
 
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#2
determining the motives behind specific human behavior is difficult in most situations and even more so on a public message board with the limited information available.
physicians often disagree about a diagnosis or treatment; second opinions and consultations are standard practice with complex cases.
you have been misinformed. the penalty for failure to report for duty ordered by a physician is not and never has been under any state law the dismissal of the comp claim.
the rules covering treatment under workers comp vary with each state.
without knowing your state no specific information on your rights or options can be provided.

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
Thank you for responding. I live in PA.
 
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#4
here is information about your medical treatment rights under Pennsylvania workers comp laws
http://www.portal.state.pa.us/portal/ser...e=2#doctor
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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#5
I appreciate your post and the link. But there is much more of a gray area in my case.

I have seen two ER Drs when I was sent to the Emergency room. They told me I could not return to work until I saw my surgeon from a previous surgeon as well as having my MRI. The WC Dr, while making it a point to avoid disputing the recommended treatments from the ER Drs, has (in a very angry manor) told me that I am to return to work no matter what. The WC Dr has also offered me no medication for pain that is quite simply, some of the worst pain I've ever experienced. They have not submitted a diagnosis. Only that use of only one arm is recommended. They state that another appointment with them can be made after consult with previous surgeon. But there is no guarantee WC insurance will even grant me the ability to see this Dr. Am I really to just continue to suffer and possibly risk greater injury to myself without treatment, all the while hoping that the insurance agent will allow me to see my former surgeon down the road at some point?

In short, they will not treat or diagnose me. They are simply saying they don't know and that they want nothing to do with my arm. All the while, they are telling me to continue working without any concern or medication for the extreme pain and discomfort I am in. I'm literally brought to tears on a regular basis at work while trying to accomplish even the most simplest of tasks.
 
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#6
you can file a complaint against the doctor here
http://www.dos.state.pa.us/portal/server...ion/599422
if the comp carrier denies payment of your consultation with your prior ortho the bill can be submitted to your health insurer.
the er doctor and the comp doctor are both giving their opinion; you don't know which is correct.
if you wish to challenge then you can take the dispute to the comp court
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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