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Lost in the WC system
#1

Hello All,
I've been at desk jobs all my life. I've had a few aches and pains here and there but nothing to really complain about. My current job was for 3 years. I woke up one Monday with a stiff neck and arm pain. By Friday with no relief I told my manager that something was going on. We filed a WC claim and it's been hell. I have never received this type of treatment (very disappointing and confusing)
I've been out on disability for 3 months now pending the WC outcome. The doctor put me in PT twice weekly which has been no long term help. MRI on cervical spine only says mild stenosis most likely born this way. Had RF blood work done, this was also very mild. I've been seeing a doctor that obviously did not specialize in neck and shoulder issues. Was finally, after 3 months, sent to a specialist only to be told I have frozen shoulder and that I had to try to break up the scar tissue on my own doing certain exercises.
All i wanted was to get this pain under control, understand what was happening and go back to work. If i was treated properly in the first place would this frozen shoulder have happened? I'm sure they will deny the claim, I do not even know what to do or where to begin? I hate this pain and only want my life back.
Any advice would be wonderful
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#2

It's tough man, especially for repetitive motion/trauma type cases. I'm on my 11th month in the system out here in CA, and have only had 6 weeks of TTD benefits paid and nothing has been done to correct my injuries...I finally got my AME and Surgeon evaluations done, they both said surgery - duh - so now I wait until the benefits get reinstated and the retro $$ get paid...my wife and I are trying to hold on, but, it is a challenge. The system is what it is, I knew the horror stories going in and waited until I couldn't possibly do my job any longer before I filed. It's no consolation, I know, but you are not alone, not alone at all.
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#3

you still retain your right to file a 3rd party medical malpractice suit against a physician.
workers comp has the right to reimbursement from any recovery.
it sounds like you are developing emotional problems from your injury. talk to your doctor about a consult with a counselor.

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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#4

(06-10-2011, 02:15 PM)1171 Wrote:  you still retain your right to file a 3rd party medical malpractice suit against a physician.
workers comp has the right to reimbursement from any recovery.
it sounds like you are developing emotional problems from your injury. talk to your doctor about a consult with a counselor.

Thanks for the reply. Yes I have become very depressed....something I have suffered from in the past but have had under control until this happened. I have a busy life that has been put on hold with really no answers as of yet. My doctor was very nice and actually took his time and my job has really worked with me in this whole process. I feel guilt, anger and frustration, not to mention confusion. I almost just want to quit my job and get help without all of the red tape from WC. I honestly believe that If this happened outside of work, my health care would have been different.
(06-10-2011, 02:03 PM)socal Wrote:  It's tough man, especially for repetitive motion/trauma type cases. I'm on my 11th month in the system out here in CA, and have only had 6 weeks of TTD benefits paid and nothing has been done to correct my injuries...I finally got my AME and Surgeon evaluations done, they both said surgery - duh - so now I wait until the benefits get reinstated and the retro $$ get paid...my wife and I are trying to hold on, but, it is a challenge. The system is what it is, I knew the horror stories going in and waited until I couldn't possibly do my job any longer before I filed. It's no consolation, I know, but you are not alone, not alone at all.

Wow...11 months! I'm in CA also and am really disturbed behind the treatment you get. I understand they have to make sure its work related and all but 3 months is a long time to go through pain. If they deny my claim after the 3 month waiting period do you know what happens then? Do they just drop everything and you go find a doctor that will help?
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#5

(06-10-2011, 02:27 PM)moonflowers Wrote:  If they deny my claim after the 3 month waiting period do you know what happens then? Do they just drop everything and you go find a doctor that will help?[/b]

Well, first off, do you have a Workers Comp Attorney? That's the thing. If not, you need one, yesterday. Mine wasn't 'denied', but the UR board would not let any treatment be done...so the PTP quit trying to help me after 6 weeks...my Attorney immediately requested (or whatever they do) an AME examination...that is the key, getting an AME exam. if you are in the LA area I can give you my Attorney's name -( if the mods are okay with that)
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#6

moon:
california will pay upto $10000 in medical care during the 90 day delay period.
see page 26 of the guidebook
http://www.dir.ca.gov/CHSWC/Reports/Work...-3rdEd.pdf

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.
Reply


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