workmans comp say herniated disk....never herniated

[bagpussinamerica]

I just got a letter from workmans comp saying that, in their opinion, the MRI that I had on several occasions did not show a herniated disk, but a Tarlov Cycst, which mimicked the appearance of a herniated disc. And to top that, they are also saying that the original surgery that I had was nothing more than an extensive exploratory surgery! They are now bypassing my surgeon and asking for another opinion from a surgeon of their choice. In the meantime, I am finding it more and more difficult to walk, sleep, sit, move, etc. I am not sure, but if their surgeon says that, yep, it was a mimic.........then I have to pay for the origional surgery? Or pay back all of the temp payments? They have set me up an appointment for December, which I have been told I have no option but to attend.

Has anyone ever had this happen before? How can all of my symptons be blamed on a cyst that I had for years, and only caused pain when I had the workplace accident?

[AQA]

The issue is one of medical oppinion. You have yours and they want thiers. The only reason they want thiers is because the reports and films that they have indicate another possibilty.

As far as having to pay anything back. HHHMMM, are you a doctor????? I think not. Meaning, you did not take yourself out of work and you did not operate on yourself. How can you be responcible for the action of others. Not to mention, if you were operated on without cause, would that not be grounds for a malpractice suit????

Just my thoughts.

[bagpussinamerica]

That is an interesting thought, about malpractice that is. Still, the Tarlovs cyst does not explain away the current pain and problems I have been getting since the day of the accident. And the first MRI done did show the cyst as well as the herniation. I have had that cyst for a very very long time. Oh well.

[lfoster21]

I don't know if this will help in your case, but when I had 2 Drs. saying one thing and they had 2 drs. saying another thing, my lawyer gave me the option to get a third opinion from my side, but I would have to pay for it out of pocket. W/c obviously would not pick up the tab and my reg. insurance would not cover it, since it was part of a w/c case. She said the if it were something that I could afford, not only would it be an additional opinion on my side, if that dr. agreed with what my 2 drs. originally said, but it may carry a little more weight since both of my drs. were seeing me as a w/c case and just as their drs. spoke up for the companies side, my Drs. could have been seen as making thier judgement to help me make my case. This third independent Dr. would be seeing me as any other patient and would not be wording his report for a w/c lawyer or a judge. I don't know if I worded that in a way that it makes sense, but I just thought about this being an option that my lawyer put out there.

[AQA]

That makes perfect sense!!!! Thanks for sharing.

[bagpussinamerica]

I don't know your situation, but why so many doctors involved? I mean initially two for you and two for them? Were w/c trying hard to disprove the claim? If it comes to is, I would definately get, somehow, another opinion. I have no idea how much these things cost, having come from England in the first place. Do they just go over the files and reports and films? Or do they need to order new MRI's etc? I know I could not afford to pay for an MRI.

Just for further info. It looks as if the doctor they have asked to review my case, is actually a collegue of my own surgeon. And I know that he has already gone over my case with his collegues just as a thing that was interesting and asking them what they thought. Still, the way the paperwork is worded, it pretty much slams my own surgeon as being pretty incompetent. And I personally don't feel that way about him. I am not a doctor, but I am a nurse in England and can tell a good doctor when I see one.

[Cycler]

You may be missing crucial pieces of information; the quality of the MRI ( open is bad closed is good ) and the qualifications of the radiologists involved. Tarlov cysts are rare. Symptomatic Tarlov cysts are rarer but asymptomatic cysts have been thought become symptomatic in cases of falls. trauma, and lifting type back injury. The treatment for a tarlov cysts is the same as for a herniated disc, surgical, and the location is basically identical. They may be hard to distinguish on MRI.

Again, they are so rare that I think the argument is pointless. No one knows enough about them to say one way or another and SYMPTOMATIC Tarlov cysts can be work related as much as a disc herniation since ALL HNP in adults are degenerative first absent severe truama.

[Bad Boy Bad Boy]

http://www.wrongdiagnosis.com/t/tarlov_cysts/intro.htm

http://www.wrongdiagnosis.com/sym/back_pain.htm

Without seeing the surgical report from the last surgery, it's had to say more at such time. But, was the cyst present then? And what did the surgeon do about the cyst while in there?

[bagpussinamerica]

I have read through what notes that I have regarding the surgery and it appears that the surgeon did nothing with the Tarlov cysts. There are two. One is at L5 and was apparent pre surgery MRI, the other, at S1 was not apparent on the MRI and was discovered on surgery. I do remember him saying that the surgery was more complicated because of the cysts and the the next surgery would be hard because of them as well. That is why he would have to come in lower than the origional surgery and try to come up under the cyst at S1. He made no mention of removing them or anything like that.

Having said all of that, when I saw my surgeon recently and viewed the most recent MRI it is really clear that you can identify the cyst at L5 and the disc herniation is very clear as well. It is somewhat larger and moving downward than the first MRI done. I personally couldn't see the second cyst, but the surgeon indicated where it was.

I havent been able to find much when I researched on Tarlov's cysts. But perhaps I am googling the wrong words or such.

[Still in Limbo]

I have had to Deal with this Issue also Bags! My Attorney Deposed the IME Dr., with Their Attorney Present, and then They Deposed My Dr., with My Attorney Present. It was left for the Judge to decide which was More Credible, and My Medical Evidence and Dr. Won!! It's a Stalling Game, and with Your Medical evidence You should be Fine! They had Asked for Supercedeaues, and they were not Granted it, so they had to Pay Me TTD throughout the Entire Process!! My Very Best to You, I Hope All Goes Well!!