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NJ 2005 injury IME 2nd injury fund
#1
I was injured in 7/05 had an ACDF 2 levels during surgery nerves in my throat were permanently damaged. I was sent for a second opinion by NJWC to Boston the ENT specialist found same damages requiring a feeding tube for the rest of my life due to chronic aspiration. The chronic aspiration has led to COPD limiting my lung functions to about 53%. I never smoked. The fusion failed herniating above and below the fusion also led to a second surgery at C7T1 due to nerve root compression. I also developed septic shock due to an infection from a portacath which left me with adrenal failure that WC has not founded relating to my compensable injury. My pain management doctor authorized by WC didn't want to write scripts anymore for patients not living in NJ he referred me to another pain management doctor closer to PA. WC never authorized him, and never sent me to another pain management doctor. The referred doctor takes my personal insurance and I have seen him for the past 1.5 years. I developed severe low back pain & my attorney told me it was not related to my compensable injury. I have been treating this with the same pain management doctor as my neck. I also had surgery on my lower back that didn't work and saw a neursurgeon in Philadelphia who is having my pain management doctor due injections at a different level then the surgery. WC had also sent me to pulmonary doctor for COPD, the original pain management doctor felt Diastat would be an option to help my chronic laryngospasms. It was working. WC had authorized this medication for over 2 years then suddenly stopped about 2.5 years ago I could not afford to pay for this medication and have suffered with the aspiration from chronic spasms since. I have an order for antibiotics if I feel aspiration is leading to pneumonia. I was sent to an IME at an urgent care back in August 2016. I have no idea what the results were. I was told I had an appointment with an IME pain management doctor 2 hours away. WC had sent me to about 5 different pain management doctors prior to the original one I had been seeing.The IC arranged transportation I saw him 12/2016. When I got there he was pleasant, asked me if I heard he was taking over my care for pain management. I said no and him being 2 hours away it would be impossible for me to travel that distance monthly. He did a urine drug screen, evaluated me told me my case was extremely complicated he looked at my peg tube and said he wasn't going to disagree with that, listened to my lungs and found they were very diminished. I told him that was a consistent finding with my PMD & I gave him the pulmonary doctor name I saw in NJ. He did a neuro evaluation found my reflexes abnormal and told me he may be seeing me again so he would recommend a tricyclic antidepressant for sleep. I woke up the next morning not being able to move my neck, barely able to stand on my L leg due to LBP. I had an appointment with my pain management doctor the next day. I told him about the tricyclic antidepressant he told me I would not tolerate this medication. I was wearing a soft collar due to severe pain. My doctor acknowledged this was related to the long drive, which is what did happen. I don't tolerate more then 45 min in a car without suffering after for days. My attorney told me he wants my case to finish up in January. I emailed him about the IME doctors opinion & about my pain from the long drive as well as my pain management doctors advise. My attorney was well aware of the Diastat medication not being approved, also of other previously authorized medication not being approved which I have continued to pay for. I also receive SSD since 2009 in 2015 my youngest child graduated HS I lost the family benefit which has since taken my income to 53% of my ACE. I did ask my attorney if I could do anything about this and was told no. I also asked my attorney about the second injury fund and he has not answered my questions. I did have the second injury occur from the surgery of the original injury. I am lost as to what is going on here. There was also a time frame where the IC said I was noncompliant this was unfounded in court and I was issued part if the money back in a voluntary tender, the remainder I have never seen. I have asked my attorney if I would get this back at the end as well as all the medications I have paid for that were previously authorized. He originally told me yes, now says maybe. is there anyone that can help me answer some of these questions. I appreciate any feedback. Thanks
 
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#2
I cannot answer your work comp questions as I am not from your state. 1171 will hopefully be by soon.

I can provide you with a link that may provide some help for you (not sure). This is a non profit patient advocate foundation that helps patients with chronic, life threatening conditions. They do not help those with work comp claims but I think they may help you with the things you are being denied and not covered by workers compensation especially the medications you cannot afford. You can call and talk to a nurse case manager who may have you fill out an intake form to see if they have any resources to help. I would explain your condition is life threatening and you are asking for assistance with things that are not being covered by work comp or denied. There are non profits that help patients pay for medications and medical treatment, and this is just one. Please let me know if they were not able to help you and if so the name of the person who did not help.
http://patientadvocate.org/

I also wanted to mention since your child is out of high school there may be scholarships available for them to apply to help for college. Kids Chance info is in a link above at the top of this site. Your attorney is correct that once a child graduates from high school they lose the SSDI. While there is nothing you can do about that, if you are interested I recommend checking with your department of social services if you now qualify for other benefits such as food stamp help etc. Most states now provide credit card type of food stamp. Within the link above for PAF they have a resources section that will do a look up of resources in your state for help with things like electric bill etc. Colleges do offer financial help for those who qualify. If your child is interested in attending college, I encourage your child to meet with a financial aid counselor and take advantage of it. There are also a lot of grants out there, that is basically free money for your child to pay for your child to go to college and pay for housing food etc. Applying for grants may help make up for income lost by SSDI and your child benefits by attending college full time.

I am sorry about the difficulties you have had since your fusion. I had a lumbar anterior/posterior 2 level fusion and I am much worse after, but nothing like what you are experiencing, God bless you. Can I ask if you only had your disc removed and not your vertebrae via corpectomy? I ask this because you have some symptoms patients have complained about after having a corpectomy. I also want to ask what surgery your neurosurgeon plans to do on your lower back after injections is it another fusion? I am surprised they are planning additional surgeries on you with your current condition. I don't know the WC rules in your state but I hope you have a second opinion process. I recommend seeing a neurosurgeon at a top university if you have not done so already.

 Do you have a family member or friend to help advocate for you and go with you to doctors appointments? Also, do you have Medicare? Medicare may pay for your denied prescriptions by work comp.

I am sending you a private message with some additional info. Let me know if you cannot locate the pm.
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.
 
Reply
#3
(12-21-2016, 05:31 PM)California_Help Wrote: I crannot answer your work comp questions as I am not from your state. 1171 will hopefully be by soon.

I can provide you with a link that may provide some help for you (not sure). This is a non profit patient advocate foundation that helps patients with chronic, life threatening conditions. They do not help those with work comp claims but I think they may help you with the things you are being denied and not covered by workers compensation especially the medications you cannot afford. You can call and talk to a nurse case manager who may have you fill out an intake form to see if they have any resources to help. I would explain your condition is life threatening and you are asking for assistance with things that are not being covered by work comp or denied. There are non profits that help patients pay for medications and medical treatment, and this is just one. Please let me know if they were not able to help you and if so the name of the person who did not help.
http://patientadvocate.org/

I also wanted to mention since your child is out of high school there may be scholarships available for them to apply to help for college. Kids Chance info is in a link above at the top of this site. Your attorney is correct that once a child graduates from high school they lose the SSDI. While there is nothing you can do about that, if you are interested I recommend checking with your department of social services if you now qualify for other benefits such as food stamp help etc. Most states now provide credit card type of food stamp. Within the link above for PAF they have a resources section that will do a look up of resources in your state for help with things like electric bill etc. Colleges do offer financial help for those who qualify. If your child is interested in attending college, I encourage your child to meet with a financial aid counselor and take advantage of it. There are also a lot of grants out there, that is basically free money for your child to pay for your child to go to college and pay for housing food etc. Applying for grants may help make up for income lost by SSDI and your child benefits by attending college full time.

I am sorry about the difficulties you have had since your fusion. I had a lumbar anterior/posterior 2 level fusion and I am much worse after, but nothing like what you are experiencing, God bless you. Can I ask if you only had your disc removed and not your vertebrae via corpectomy? I ask this because you have some symptoms patients have complained about after having a corpectomy. I also want to ask what surgery your neurosurgeon plans to do on your lower back after injections is it another fusion? I am surprised they are planning additional surgeries on you with your current condition. I don't know the WC rules in your state but I hope you have a second opinion process. I recommend seeing a neurosurgeon at a top university if you have not done so already.

 Do you have a family member or friend to help advocate for you and go with you to doctors appointments? Also, do you have Medicare? Medicare may pay for your denied prescriptions by work comp.

I am sending you a private message with some additional info. Let me know if you cannot locate the pm.

Thank-you for all of the help you have graciously offered me. I was a trauma RN for many years, that is the job I had when I had my original injury. Without the advocacy & support of my ex-husband I am not sure I would still be alive. We have 4 grown children together and a 3 y/o granddaughter who he has custody of. Three of our children live with us and our granddaughter. I had the fusion done anteriorly at 2 levels. I did not have the disc removed.  I herniated above at 2 levels below at 2 levels which c caused the chronic pain insomnia. 
I had a lumbar laminectomy at L3/4 in 03/2016 that didn't work. The neurosurgeon I saw from Philadelphia feels the issue is at L1/2 & asked my pain management doctor to do a diagnostic injection. Surgery after this if it helps I am not sure I would do yet the LBP is stopping me from being able to do anything.
The most devastating result was damage caused by the surgery to the nerves which control the R side of my throat, making swallowing impossible. When this first happened I thought it was just post op issues that would eventually resolve. After seeing a WC ENT who dismissed me with GERD having scoped me at least 10 times I was so frustrated. I constantly found myself clearing my throat a term I now know called "globus". I was sent by "accident" to a NYC ENT because the hospital I was at did not have the medical equipment needed to diagnose my condition. An on call ENT who saw me in the ER told me the tests I needed couldn't be done there because they didn't have the equipment. In NY I had an esophageal manmomenty, & an EMG of my esophagus. After these two tests I was lossing weight rapidly I was 105 pounds and the NY ENT sent me for an urgent peg tube placement. Later he explained the nerve stretching and the myelin sheathing that were causing my problems the stretched nerves never regained elasticity. A year out from surgery chances of the nerves ever going back were less then 1%. I was then sent for a second opinion to Boston the ENT there had the same dx he went on to say if I didn't have the Peg tube I would most likely be dead in 6 years from the chronic micro-aspiration. I had the tube removed due to chronic pain in my abdomen, later understanding I needed a bumper PEG which keeps it in one place stopping the rubbing caused by balloon type. I have had a feeding tube for over 8 years now, I am allowed to eat for taste only. The IC stopped sending the"food" ordered by a nutritionist and for the last 5 years I have used OTC type supplements. I have maintained a healthy weight. 
I had previously been an avid runner, slowly the Chronic progression of COPD has taken that away from me. I feel I have lost so much of who I was, my career which I loved and I was very good at, my one activity I did to relieve stress, my ability to even function as a mom, a wife, even a friend have been taken from me. If it hadn't been for the birth of my granddaughter who has a branchial plexus injury related to shoulder dystocia i know I would have taken my life. The depression is overwhelming the IC has done so many things to make me look crazy, undermine my progressive, fatal lung condition, and make my depression so much worse they approved then the day before denied my appointment at a psychiatrist that I requested for my depression they called the psychiatrist office and told the staff and psychiatrist I was noncompliant with my pain medication the secretary told me this. The psychiatrist sent me a letter stating the IC called and denied payment therefore she did not want to burden me with the expense. They later sent me to a psychologist at one if the many pain management doctor's they tried before settling on one. The psychologist found me to have major depression yet it has never been addressed by anyone. My children are 25,24,22,20 due to my financial situation abd only my youngest went to college, she left after one semester because she didn't want to leave me. I wish everyone could understand this type of injury leaves scars on a family not just the injured worker. The sif I was hoping to be eligible for since 53% of my ACE with my SSD is hard to support a family on.

IC has done so many questionable things surrounding my case. I also find a conflict of interest because the IC uses the hospital/doctor's that were my employer. Thank-you for the advice, more the compassion. I have had a rough time with the lack of compassion NJWC, and the IC express minimizing my medical issues making me question what I know as right. Again thanks. 
 
Reply
#4
(12-21-2016, 07:53 PM)Chanel725 Wrote:
(12-21-2016, 05:31 PM)California_Help Wrote: I crannot answer your work comp questions as I am not from your state. 1171 will hopefully be by soon.

I can provide you with a link that may provide some help for you (not sure). This is a non profit patient advocate foundation that helps patients with chronic, life threatening conditions. They do not help those with work comp claims but I think they may help you with the things you are being denied and not covered by workers compensation especially the medications you cannot afford. You can call and talk to a nurse case manager who may have you fill out an intake form to see if they have any resources to help. I would explain your condition is life threatening and you are asking for assistance with things that are not being covered by work comp or denied. There are non profits that help patients pay for medications and medical treatment, and this is just one. Please let me know if they were not able to help you and if so the name of the person who did not help.
http://patientadvocate.org/

I also wanted to mention since your child is out of high school there may be scholarships available for them to apply to help for college. Kids Chance info is in a link above at the top of this site. Your attorney is correct that once a child graduates from high school they lose the SSDI. While there is nothing you can do about that, if you are interested I recommend checking with your department of social services if you now qualify for other benefits such as food stamp help etc. Most states now provide credit card type of food stamp. Within the link above for PAF they have a resources section that will do a look up of resources in your state for help with things like electric bill etc. Colleges do offer financial help for those who qualify. If your child is interested in attending college, I encourage your child to meet with a financial aid counselor and take advantage of it. There are also a lot of grants out there, that is basically free money for your child to pay for your child to go to college and pay for housing food etc. Applying for grants may help make up for income lost by SSDI and your child benefits by attending college full time.

I am sorry about the difficulties you have had since your fusion. I had a lumbar anterior/posterior 2 level fusion and I am much worse after, but nothing like what you are experiencing, God bless you. Can I ask if you only had your disc removed and not your vertebrae via corpectomy? I ask this because you have some symptoms patients have complained about after having a corpectomy. I also want to ask what surgery your neurosurgeon plans to do on your lower back after injections is it another fusion? I am surprised they are planning additional surgeries on you with your current condition. I don't know the WC rules in your state but I hope you have a second opinion process. I recommend seeing a neurosurgeon at a top university if you have not done so already.

 Do you have a family member or friend to help advocate for you and go with you to doctors appointments? Also, do you have Medicare? Medicare may pay for your denied prescriptions by work comp.

I am sending you a private message with some additional info. Let me know if you cannot locate the pm.

Thank-you for all of the help you have graciously offered me. I was a trauma RN for many years, that is the job I had when I had my original injury. Without the advocacy & support of my ex-husband I am not sure I would still be alive. We have 4 grown children together and a 3 y/o granddaughter who he has custody of. Three of our children live with us and our granddaughter. I had the fusion done anteriorly at 2 levels. I did not have the disc removed.  I herniated above at 2 levels below at 2 levels which c caused the chronic pain insomnia. 
I had a lumbar laminectomy at L3/4 in 03/2016 that didn't work. The neurosurgeon I saw from Philadelphia feels the issue is at L1/2 & asked my pain management doctor to do a diagnostic injection. Surgery after this if it helps I am not sure I would do yet the LBP is stopping me from being able to do anything.
The most devastating result was damage caused by the surgery to the nerves which control the R side of my throat, making swallowing impossible. When this first happened I thought it was just post op issues that would eventually resolve. After seeing a WC ENT who dismissed me with GERD having scoped me at least 10 times I was so frustrated. I constantly found myself clearing my throat a term I now know called "globus". I was sent by "accident" to a NYC ENT because the hospital I was at did not have the medical equipment needed to diagnose my condition. An on call ENT who saw me in the ER told me the tests I needed couldn't be done there because they didn't have the equipment. In NY I had an esophageal manmomenty, & an EMG of my esophagus. After these two tests I was lossing weight rapidly I was 105 pounds and the NY ENT sent me for an urgent peg tube placement. Later he explained the nerve stretching and the myelin sheathing that were causing my problems the stretched nerves never regained elasticity. A year out from surgery chances of the nerves ever going back were less then 1%. I was then sent for a second opinion to Boston the ENT there had the same dx he went on to say if I didn't have the Peg tube I would most likely be dead in 6 years from the chronic micro-aspiration. I had the tube removed due to chronic pain in my abdomen, later understanding I needed a bumper PEG which keeps it in one place stopping the rubbing caused by balloon type. I have had a feeding tube for over 8 years now, I am allowed to eat for taste only. The IC stopped sending the"food" ordered by a nutritionist and for the last 5 years I have used OTC type supplements. I have maintained a healthy weight. 
I had previously been an avid runner, slowly the Chronic progression of COPD has taken that away from me. I feel I have lost so much of who I was, my career which I loved and I was very good at, my one activity I did to relieve stress, my ability to even function as a mom, a wife, even a friend have been taken from me. If it hadn't been for the birth of my granddaughter who has a branchial plexus injury related to shoulder dystocia i know I would have taken my life. The depression is overwhelming the IC has done so many things to make me look crazy, undermine my progressive, fatal lung condition, and make my depression so much worse they approved then the day before denied my appointment at a psychiatrist that I requested for my depression they called the psychiatrist office and told the staff and psychiatrist I was noncompliant with my pain medication the secretary told me this. The psychiatrist sent me a letter stating the IC called and denied payment therefore she did not want to burden me with the expense. They later sent me to a psychologist at one if the many pain management doctor's they tried before settling on one. The psychologist found me to have major depression yet it has never been addressed by anyone. My children are 25,24,22,20 due to my financial situation abd only my youngest went to college, she left after one semester because she didn't want to leave me. I wish everyone could understand this type of injury leaves scars on a family not just the injured worker. The sif I was hoping to be eligible for since 53% of my ACE with my SSD is hard to support a family on.

IC has done so many questionable things surrounding my case. I also find a conflict of interest because the IC uses the hospital/doctor's that were my employer. Thank-you for the advice, more the compassion. I have had a rough time with the lack of compassion NJWC, and the IC express minimizing my medical issues making me question what I know as right. Again thanks. 

There is another poster that may be familiar with your states laws. If you want to check back in a day or so they may be able help with your work comp questions as your state is nothing like mine.

A friend of mine had a lot of complications after his 2 level anterior neck fusion including trouble swallowing and also partial paralysis of vocal cords. He had to get an implant to help him talk. He started losing function of his hands, bladder and leg. He had another surgery to help which removed the bone on the back of his neck to relieve compression and he regained a lot of function. As I mentioned above I am in more pain since my lumbar fusion, but did not have the catastrophic complications that you have had to endure. I am so sorry for what you have been through and what you continue to go through.

It is upsetting to read your WC insurance carrier stopped providing things like the food your nutritionist recommended. I hope you can find another avenue to cover the things you are being denied by work comp. I hope you can get some help from the organization above as they are supposed to help patients in your situation, however they do not get involved with workers compensation issues, but if these are being denied and you do not have alternative insurance or it does not fully cover I would consider you uninsured or underinsured. It will be an nurse you will be talking to if you decide to call. Hopefully someone from your state will answer your work comp questions.

I sent you a pm of some things I did not want to write on public forum.
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.
 
Reply
#5
a second injury fund functions when a worker with an pre-existing non-industrial disability has an on-the-job injury and the combined disability of the two renders the worker permanently and totally disabled.
a more easily understood example would be worker that was blind in one eye loses the sight of the other eye in work injury. the worker gets total blindness benefits while the employer is charged only for the loss of one eye. the difference is made up by the second injury fund.
more here
http://www.workplaceinjurynj.com/2013/08...jury-fund/

if you are dissatisfied with your atty, talk to a few others before deciding to switch.
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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