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Getting Tired Of My Ins. Carrier....
#1
Hi everyone...  instead of complaining about my former surgeon and my back problem... Let's add the Ins. Carrier to my headaches..

Since I was in the hospital for cervical surgery, I couldn't go to my Comp hearing in December..   I gave my lawyer some questions that I wanted answers to from the Carrier and the idiot IME they had me go to....   Well, since my lawyer TRIED telling me he did what I asked, I called Comp and asked for the minutes for that hearing....  Got them a week later and not one of my questions asked at all....

1. IME stated I was already on SSDI (nope)
2. IME stated I've been on Hydro's since 2012 (nope)
3. IME stated I'm a heavy drinker (nope, heck I don't drink at all)
4. Ins. Carrier stated I work for Coke in Bronx, NY (LOL)

I might add... I remember going to that last IME... this guy brings me and my hubby in his office and calls me by a different name... I tell him my name and he has to search the folders for the correct one.  He also asks me questions that didn't even pertain to me or my lower back injury..  My hubby had to ask this guy if he had the CORRECT person's file or not....

Well, because of all this...  I went from 75% disabled with all kinds of restrictions to 62% and no restrictions and this IME is stating I can go back to work.   In the minutes from that hearing, I have 3 doctor's all stating 75% and one IME stating less....     So guess where the judge went..

I also just received papers from the Carrier saying that I have to go put in job applications 5 times a week and send them copies of them..  EXCUSE ME????    The Carrier knows full well about my upper spine surgery and that my new surgeon has me at 100% and I can't do much of anything... even picking up a simple gallon of milk!!!  I'm sorry, but if this recovery goes wrong and the bones don't fuse the way they should, I was told I go back for a second surgery... It's bad enough I'm living in a neck brace for the next 5 months, then 3 months of PT after that, then a smaller neck brace for another 4 to 5 months.. and now we have to put in for PT because of nerve damage in my right arm to my hand...  Yeah.. I'm ready to go back to work... LOL

Yes I called my lawyer's office and I see him face to face next Thursday about all of this.  I am going to tell him he better get on the ball about this and those questions I wanted answered or I will get in touch with Comp and complain about this.

(stepping off the soap box)
 
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#2
Get your treating hysician to critique the IME report. They may find additional medical errors & findings.
That report then has to be filed and becomes part of your court file and can be used as evidence that can support a later appeal.

You don't have to get a job,  you only have to apply. Make sure you include your medical restrictions or attach a medical report. A computer can generate them very fast ..all you need are addresses and a generic employment form.
Reminder
........Each state has their own comp system. We need to know your state to provide accurate information.........
 
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#3
I agree with 1171. Having your primary work comp doctor write a rebuttal report highlighting the medical errors should make this easy for your attorney.

Can you send your husband next time if you cannot make it to court? In my state attorneys take on many clients and even they do not always know their clients condition.

You have REALLY been through the ringerSad 

Sending good thoughts and prayers for you to heal from this surgery.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#4
(02-07-2017, 11:53 AM)tbear6410 Wrote: Hi everyone...  instead of complaining about my former surgeon and my back problem... Let's add the Ins. Carrier to my headaches..

Since I was in the hospital for cervical surgery, I couldn't go to my Comp hearing in December..   I gave my lawyer some questions that I wanted answers to from the Carrier and the idiot IME they had me go to....   Well, since my lawyer TRIED telling me he did what I asked, I called Comp and asked for the minutes for that hearing....  Got them a week later and not one of my questions asked at all....

1. IME stated I was already on SSDI (nope)
2. IME stated I've been on Hydro's since 2012 (nope)
3. IME stated I'm a heavy drinker (nope, heck I don't drink at all)
4. Ins. Carrier stated I work for Coke in Bronx, NY (LOL)

I might add... I remember going to that last IME... this guy brings me and my hubby in his office and calls me by a different name... I tell him my name and he has to search the folders for the correct one.  He also asks me questions that didn't even pertain to me or my lower back injury..  My hubby had to ask this guy if he had the CORRECT person's file or not....

Well, because of all this...  I went from 75% disabled with all kinds of restrictions to 62% and no restrictions and this IME is stating I can go back to work.   In the minutes from that hearing, I have 3 doctor's all stating 75% and one IME stating less....     So guess where the judge went..

I also just received papers from the Carrier saying that I have to go put in job applications 5 times a week and send them copies of them..  EXCUSE ME????    The Carrier knows full well about my upper spine surgery and that my new surgeon has me at 100% and I can't do much of anything... even picking up a simple gallon of milk!!!  I'm sorry, but if this recovery goes wrong and the bones don't fuse the way they should, I was told I go back for a second surgery... It's bad enough I'm living in a neck brace for the next 5 months, then 3 months of PT after that, then a smaller neck brace for another 4 to 5 months.. and now we have to put in for PT because of nerve damage in my right arm to my hand...  Yeah.. I'm ready to go back to work... LOL

Yes I called my lawyer's office and I see him face to face next Thursday about all of this.  I am going to tell him he better get on the ball about this and those questions I wanted answered or I will get in touch with Comp and complain about this.

(stepping off the soap box)
I had a 2 level ACDF and it fell apart within a year! That office never had me wear any collar at all nor did they give me any bone stimulator.
I finally went to my primary care doctor and showed him my bright purple throat and it was not going away. He sent me to UCONN and I had the best neurosurgeon ever. (It was NOT WC) He ended up, removing the broken 2 level fusion, and then he had to fuse those 2 levels with the 2 levels above. He said "most neurosurgeons would never do this but I had no choice. I have only done a handful of these in all my years."
It came out perfect. He used drains and he had me in a neck brace 24/7 for 6 weeks. 
If you want a good outcome DO NOT GO BACK TO WORK YET. This is your surgery and your life. Shoving you back too early can compromise the fusing process. IF YOU GET RE-INJURED due to them forcing you, they will pay again.
Tell them that and see what they say.
I wish you all the best.
[color=#181818][size=small][font=Merriweather, Georgia, serif]The greatness of a man is not in how much wealth he acquires, but in his integrity and his ability to affect those around him positively~[/font][/size][/color]
 
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#5
RootsGal... my new surgeon did the script for the Bone Stimulator... My private insurance paid for it... stupid thing cost over 5 grand.. and it'll only be used for 5 months. What a waste of money...

I also have an appointment at a new Pain Management Center that is in my new surgeon's office building on the 27th for my lower back. As of right now, I am TOTALLY out of SOS and Spine & Wellness.. New surgeon and PM are not affiliated with the other places at all... which I like.

1171.. stupid part is, the Ins. Carrier has ALL my reports from the old surgeon and the new one and the doctor I saw over at S&W.. all stating there is no way for me to go back to work because of the damage in my lower back. Carrier was even the first one to suggest I try for SSDI cause I can no longer work...

I am right now, waiting for my cervical surgery to fully heal and then I'll be going for the surgery on the lower back.
 
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#6
Talked to my lawyer on the phone.... Needless to say, we are still going to his office next week. He says Comp and the Ins. Carrier doesn't care about my cervical surgery or the fact my surgeon has me at 100% disabled because of this. If I don't put in applications, I will loose my Comp checks. He says unless I can get it in writing that my lower back IS at 75% or more disabled, I have to job hunt.
I also asked him why he didn't bring up those questions I posted.. he wouldn't even answer that. One reason why I'm going to his office.
Few friends of mine ask if I ever thought of asking for a settlement with open medical... My answer?? If Comp and the Carrier doesn't care that they are putting my neck recovery and my health at risk, what makes you think they'll want to start a settlement with open medical??
 
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#7
(02-08-2017, 03:21 PM)tbear6410 Wrote: Talked to my lawyer on the phone.... Needless to say, we are still going to his office next week.  He says Comp and the Ins. Carrier doesn't care about my cervical surgery or the fact my surgeon has me at 100% disabled because of this.  If I don't put in applications, I will loose my Comp checks.  He says unless I can get it in writing that my lower back IS at 75% or more disabled, I have to job hunt.
I also asked him why he didn't bring up those questions I posted.. he wouldn't even answer that.  One reason why I'm going to his office.
Few friends of mine ask if I ever thought of asking for a settlement with open medical... My answer??  If Comp and the Carrier doesn't care that they are putting my neck recovery and my health at risk, what makes you think they'll want to start a settlement with open medical??

I think 1171 wrote a great reply on what you should do. It is VERY easy to apply for jobs online as 1171 wrote above. Heck send them a copy of your neck surgery incision and lets see how many calls you will get for an interview. I am kidding but do you see what I am saying? Play their game. If you apply for things you are not qualified for you will not be called in for an interview. You do not qualify for any jobs I am aware of right after a multi 4 level fusion. In fact I have never seen a patient who had that many levels fused at one time, ever. Your surgery was VERY evasive and you are in no way a few weeks post op read to do ANY work. I think it could kill you, literally if you wen back to work. I cannot believe your insurance carrier can get away with this. Anyway, I recommend to apply for jobs online. It will take 10 minutes a day or you can do it all in one day. I bet it would take 20 minutes to send in 5 applications a week online. So easy. Let your husband help with typing.

Some job sites have things where you just attach your resume and press send. Please do not lose your disability checks over this. No one will hire you this soon after having the surgery you had. I recommend doing what they want, maybe your husband can help if it is too difficult to do computer work and apply for you. I would be honest when you apply and state you just had this surgery. Most applications have a section that says do you have any physical conditions that may limit the ability to do this job or if you need accommodations type of question. You can probably google companies and send your applications to them as well.

 How are you supposed to send them copies can you just write down where you applied or do they want a copy of the application you filled out? Most large companies have online applications, or maybe your husband can stop by 5 businesses and pick up applications and then you mail them or drop them back but I think online is easiest.

If the neck injury is not work related that is probably why they have this weird rule.

I would not want open medical either, as long as you have other insurance to cover all injuries.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#8
(02-07-2017, 03:50 PM)tbear6410 Wrote: RootsGal...  my new surgeon did the script for the Bone Stimulator...  My private insurance paid for it... stupid thing cost over 5 grand.. and it'll only be used for 5 months.  What a waste of money...

I also have an appointment at a new Pain Management Center that is in my new surgeon's office building on the 27th for my lower back.  As of right now, I am TOTALLY out of SOS and Spine & Wellness..   New surgeon and PM are not affiliated with the other places at all... which I like.  

1171.. stupid part is, the Ins. Carrier has ALL my reports from the old surgeon and the new one and the doctor I saw over at S&W.. all stating there is no way for me to go back to work because of the damage in my lower back.  Carrier was even the first one to suggest I try for SSDI cause I can no longer work...

I am right now, waiting for my cervical surgery to fully heal and then I'll be going for the surgery on the lower back.

Make sure you ask to fill out a "release form" for any more appointments, treatments, procedures, so you can keep a file of all your medical documents. NEVER throw them away, as they can come in handy years later. I am so happy for you and I pray it all goes through without incident.
They act like we like being in pain and not earning our full income. 
[color=#181818][size=small][font=Merriweather, Georgia, serif]The greatness of a man is not in how much wealth he acquires, but in his integrity and his ability to affect those around him positively~[/font][/size][/color]
 
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#9
Well.... didn't go to the lawyer's office.. got a call he would not be there... This is ticking me off too... As it is, I just received another Comp hearing papers for Medical Bill Disputes and should my payments be suspended or reduced AGAIN.... They want all up to date reports on my mid to lower back.. which they have them all. Only new paperwork will be when I finally see someone at the new Pain Management place.... The hearing is March 8th and of course, I have an appt. on the 23rd. for my lower back...
I try telling these people that I can't force places to get me in... they can only schedule when there is an opening... and sometimes, I can get in to the place in 3 months.... no sooner.

As for putting in applications online, lawyer was suppose to send me paperwork for it and haven't even got that and I was told it was in the mail last week.... I don't want to have to get a 4th lawyer or law firm to handle this.... I have so many bills as it is from neck surgery, that I'll be seeing bill collectors real soon.
 
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#10
sounds like you need to settle and get out of the system. how long ago was that discussed?
Reminder
........Each state has their own comp system. We need to know your state to provide accurate information.........
 
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