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Denied treatment for old injury - Printable Version

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Denied treatment for old injury - salvador5266 - 01-04-2016

In Oct. I injured my back at work and have been receiving treatment for that. During the course of my treatment an old injury to my shoulder flared up, I think due to some of the exercises my PT had me doing. I informed my employer of it and they told me to get my shoulder treated by the same doctor I was already seeing. Then this morning when I was at the doctor they told me the IC adjuster denied any treatment for it. So I set up an appointment to see an orthopedic specialist on my own. 

Now I am wondering what happens if the specialist says I should not be working, when the workers comp doctor says I can do limited duty with my back injury. Can my job make me work even if the specialist says I shouldn't be?

Any input would be greatly appreciated.


RE: Denied treatment for old injury - California_Help - 01-04-2016

What state are you in as workers' compensation laws differ by state?


RE: Denied treatment for old injury - 1171 - 01-04-2016

a "flareup" is not an aggravation or new injury under most comp laws.
no, all employment is voluntary and you cannot be forced to work under any circumstance.
 unless the old injury is covered by workers comp, you will not be paid for any lost time due to it's disability.
if your employment is covered by FMLA, you may have up to 90 days of unpaid leave.
http://www.dol.gov/whd/fmla/


RE: Denied treatment for old injury - salvador5266 - 01-04-2016

I am in the state of texas.

I guess I don't understand what an aggravation to an old injury is then. Describing it as flaring up is the best explaination I could come up with.


RE: Denied treatment for old injury - 1171 - 01-04-2016

It,s not your words that count.
You need medical opinion to support a claim for benefits.
If you want to try and reopen the prior injury you,ll need a medical report for the carrier.


RE: Denied treatment for old injury - salvador5266 - 01-05-2016

Can you give me some insight into how strict they really are about restrictions outside work? I hurt my back again on Friday while I was at home. All I did was bend over to pick something up off the floor (a cat toy) and something in my back popped again. My doctor told me they may no longer treat me because I violated my restrictions by bending over.

If I have to go strictly by these guidelines they have I can't even live in my house then because they have down 0 stairs/climbing. Doesn't that mean I am violating my restriction every time I take the three steps into my house, and how exactly does a person sit down when they are restricted to no bending/stooping/squatting? Yet they have down I can sit for 8 hrs a day. It just seems absurd to me.


RE: Denied treatment for old injury - 1171 - 01-05-2016

Some doctors are more rigid then others; yours seems worse then many.
he should have hospitalized you if you were that bad off.
Sounds like he,s looking for an excuse to drop you.
You need to change doctors.
More comp info here
http://www.tdi.texas.gov/wc/employee/index.html
If your employer uses a medical network, you can see any doc in the network.
You can get additional information from the ombudsman or office of employee counsel


RE: Denied treatment for old injury - salvador5266 - 01-05-2016

I've been reading some about cumulative trauma claims and I am wondering if I should file a new claim for the problems I am having with my shoulders.

Obviously it is the repetitive nature of my job causing the problems or it would not be getting worse. I notified my employer but did not actually file a separate claim they told me to just see the doctor I was already going to.

Should I file a new claim and find a different doctor?


RE: Denied treatment for old injury - 1171 - 01-05-2016

you should discuss it with your doctors first; they are the ones you need in order to get benefits.
you get the evidence first, then you file for benefits.
you don't file a claim and then wait and try to prove it; that often wastes time and energy if you can't get solid persuasive medical opinions to support your claim.


RE: Denied treatment for old injury - salvador5266 - 01-05-2016

(01-05-2016, 09:54 PM)1171 Wrote: you should discuss it with your doctors first; they are the one's you need in order to get benefits.'
you get the evidence first then you file for benefits.
you don't file a claim and then wait and try to prove it; that often wastes time and energy if you can't get solid persuasive medical opinions to support your claim.

That makes perfect sence except the doctor I'm seeing won't even talk to me about it. So I guess I have no choice but find another dr. Do you know do I need approval for that or can I just find a different dr and go to them say tommorow? I'm in TX, I believe I can go to any dr I want but not sure if that's the case.