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Getting Tired Of My Ins. Carrier....
#41
Well, it seemed SSDI went pretty good... Lawyer seemed happy.. Had a women from Vocational there as well asking questions. They had all paperwork from every job I've had since I was 16... With what my restrictions are right now, plus 75% on my lower back and 100% on my neck, she said I wouldn't be able to do those jobs anymore... or really any job...

Hotel Maid - Janitorial - Cashier - Stock - Receiver - Aquatic's Specialist (fish dept)...

Lawyer says it'll take up to 3 weeks to get the results from this hearing... but he has his fingers crossed... When we got out of there, we talked about the Comp Hearing. He thinks it's going to be by the end of this month, but I haven't heard anything yet. He is going to bring up the Carrier denying shots that my surgeon wants me to have too.. and to get my checks going again. If the Carrier says no, then he's going to bring up the settlement in front of the judge and tell her what the Carrier has been doing and not doing, the amount of pain I've been in because they won't approve anything.. and he said we will start with 6 figures...
I'll let you know what happens at my Pain Management appt. next Tuesday..
 
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#42
Comp Hearing on the 16th...
 
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#43
Had my pain management appointment yesterday.... first saw a PA and he asked about why the Carrier denied the shots the last time. We honestly told him,,,, the report you sent in from my first appointment in February was all on my neck surgery and NOT my lower back, which that was the reason why I was here in the first place. So in comes the doctor..... he looks in the computer and sure enough, it says Lower Back Injury and it all reads for neck and comparing MRI's, Scans and X-Rays of the neck and nothing about lower back. We told them I have a Comp Hearing this Tuesday 16th and is there any way to get a report to them again for the shots??
The doctor called in someone who does those and told him he needs a letter written to the Comp Board right now stating they concur with my surgeon on the different Nerve Block Shots and it's for the lower back injury and nothing else.
So now we cross our fingers they get that done up and it gets to the board ASAP....

In other words, I did get SSDI.... They are gonna retro the first check back from March 2015 to May 2nd... then I get monthly checks.
 
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#44
Doctor ( or someone else in the office) did not proof read the written report when it came back from dictation and just signed their name and mailed it.
There are many many hands in the whole process and there can be human errors.
Glad yours got discovered in n time.
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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#45
Us too... When we finally got a copy of it in March, I was ready to raise HE**.... sent a copy to my lawyer and he wasn't happy either. I called back there to find out what was going on and was told the report was correct... HOW??? I was there for my lower back.. that's not even near my neck... All we talked about was my lower back.... So how could that report be correct... Seems the new PA that saw me looked at any info in their computer system on me... And compared just stuff before and after my neck surgery so submitted that.. and the one above him said it was all ok...
This time I told them I didn't want a PA or a new doctor or whatever.... I wanted someone who KNEW what they were doing... I got him and he was not a happy camper. He said the other 2 really messed up my Comp with that report... That is why he had that one person come into the room and he told him what he wanted typed and for what body part and no other part was to be mentioned in it.
Here's hoping this happens....
 
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#46
(05-11-2017, 08:08 AM)tbear6410 Wrote: Us too... When we finally got a copy of it in March, I was ready to raise HE**.... sent a copy to my lawyer and he wasn't happy either. I called back there to find out what was going on and was told the report was correct... HOW??? I was there for my lower back.. that's not even near my neck... All we talked about was my lower back.... So how could that report be correct... Seems the new PA that saw me looked at any info in their computer system on me... And compared just stuff before and after my neck surgery so submitted that.. and the one above him said it was all ok...
This time I told them I didn't want a PA or a new doctor or whatever.... I wanted someone who KNEW what they were doing... I got him and he was not a happy camper. He said the other 2 really messed up my Comp with that report... That is why he had that one person come into the room and he told him what he wanted typed and for what body part and no other part was to be mentioned in it.
Here's hoping this happens....

Very relieved you were approved for SSDI and you will receive a lump sum back payment check minus SSDI attorney fees, which have a cap. In a few months you should get a Medicare card, then when you are denied treatment through work comp you can then see if Medicare covers it.

Stay strong.
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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#47
Hearing was ok... Judge reinstated my comp checks at 75% and will retro back to March 30 when the rating was upped. Shots denied for a second time which ticked me off.. The head doctor that I saw last week 9th never sent in that letter explaining why they want to do shots instead of surgery... Carrier didn't want to start the checks back up, Judge asked me
How long have you been out of work... Since June 2014..
When was your neck surgery.. December 19th, 2016..
Are you cleared from that surgery.. No.. they say it could take up to a year or so for the fusion to complete. If it doesn't fuse right, then they schedule another surgery.
Why won't they do surgery on your lower back.. They say I have Chronic Pain and surgery could make the pain worse. This is why they want to try stronger shots in different places to see if that will work.

My next hearing is in July and the Judge is hoping for complete records on my lower back to approve the shots. If the Carrier refuses once more, then we bring up the settlement with open medical.... They kept talking about PM dr. not listing the right variances or whatever that they need to approve the shots. Did all this change? When I was at my other place, there was no problems going for shots...
Also, when we got home from the hearing, I called Pain Management and asked where that letter was... the girl on the phone said there was nothing in my file about needing one... just the second request for the shots. I told her, well... they're denied.. so you can stop waiting for it.. I also explained to her what the doctor told us last week and about the letter he wanted sent to the Comp Board by the hearing time.. she put me on hold, then got back and said no one know anything about it.. I told her this is the second time that office has messed things up.. First in February and now.... I sent a message over to my first place to see if I can get back in there since it's only been since January of this year and they have all my records still.... So now we wait...
 
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#48
(05-17-2017, 09:23 AM)tbear6410 Wrote: Hearing was ok... Judge reinstated my comp checks at 75% and will retro back to March 30 when the rating was upped. Shots denied for a second time which ticked me off.. The head doctor that I saw last week 9th never sent in that letter explaining why they want to do shots instead of surgery... Carrier didn't want to start the checks back up, Judge asked me
How long have you been out of work... Since June 2014..
When was your neck surgery.. December 19th, 2016..
Are you cleared from that surgery.. No.. they say it could take up to a year or so for the fusion to complete. If it doesn't fuse right, then they schedule another surgery.
Why won't they do surgery on your lower back.. They say I have Chronic Pain and surgery could make the pain worse. This is why they want to try stronger shots in different places to see if that will work.

My next hearing is in July and the Judge is hoping for complete records on my lower back to approve the shots. If the Carrier refuses once more, then we bring up the settlement with open medical.... They kept talking about PM dr. not listing the right variances or whatever that they need to approve the shots. Did all this change? When I was at my other place, there was no problems going for shots...
Also, when we got home from the hearing, I called Pain Management and asked where that letter was... the girl on the phone said there was nothing in my file about needing one... just the second request for the shots. I told her, well... they're denied.. so you can stop waiting for it.. I also explained to her what the doctor told us last week and about the letter he wanted sent to the Comp Board by the hearing time.. she put me on hold, then got back and said no one know anything about it.. I told her this is the second time that office has messed things up.. First in February and now.... I sent a message over to my first place to see if I can get back in there since it's only been since January of this year and they have all my records still.... So now we wait...

Consider sending this office something in writing if they do not help you. It sounds like there is a disconnect and it may be the person who is making the requests for treatments. They need to state rational to why the shots are necessary. Good luck to you.
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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#49
That was supposed to of been done. The PM doctor and my surgeon both agreed surgery would probably cause more pain. They said what type of shots they wanted to do and where....
I got a call on Thursday from Spine and Wellness and they got me down for next Wednesday 24th. Then on Friday, another doctor from PM on Fly Road called and was asking all types of questions. I told him what was going on and that twice, that office has screwed my up with Comp. I also told him since the Judge didn't get that paper from the doctor, she denied the shots for a second time. Think it went in one ear and out the other... he told me the paper was faxed to some Jason and he named my lawyer. Told him I don't know any Jason and the Comp Judge didn't have that paper.. he tells me he's hoping to hear about the nerve shots that were put in for approval on the 9th... I told him once more that the Judge denied them. I also told him about my appointment at the other place. If they can get everything straightened out and I get the shots, then I won't be going back to his office...
 
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#50
Update time...

The Office of the Chair over ruled the Comp Judge and Ins. Carrier and approved the Nerve Blocks. Had that done on July 26th.. only problem now is I have more pain in my lower back, the burning in the spine and my legs have been giving out. PM had me come in today to see what is going on.. The Dr. who did the procedure thinks because the one part is now blocked, other pain and problems are showing their ugly head... She put in for a MRI stat for my lower back. She is hoping not to find too big of a problem and it can be taken care of with epidurals.. if there is a change, then we all go chat with the surgeon. I'm crossing my fingers for the shots. It hasn't been a year yet since my neck surgery.
She also agrees that my rating should be changed from Temporary Partial to Perm. Total. She says my lower back is getting worse, not better and this isn't a Temporary problem either...

This is bad enough that I actually purchased a wheelchair and use that when we take our grand-daughter out places because I can't walk far... But Comp and the Carrier are STILL telling me to find a job or I loose my checks..
 
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