08-30-2007, 09:28 PM
ok- here's situation:
DH suffers back injury on the job 7/18/06. Dr. 1 says he has to see orthopaedist. W/C I/C sends him to Dr 2. Dr 2 tries phys ther., steriod injections- no help, recommends surgery 11/06. W/C I/C says they want another opinion. DH at this point needs cane to walk and in extreme pain. I call case worker who will check with I/C (11/06). After next scheduled Dr's appt, I call again. They're setting it up 12/06). 1/8/07 I call again at 9am because no news and he sees Dr again on 1/10/07- what the hell's going on? (by now DH has to use wheelchair if we go anywhere he has to walk more then 5 min., which was noted on Dr's 12/06 report to W/C I/C)- case worker has to check w/ins co- at 4:30pm they now want him to cancel appt on 1/10 (this is on 1/9) and now they 'magically' have a 2nd opinion set for 1/26. I refuse to cancel because he needs refills on pain meds, and because it's a narcotic they won't refill by phone. I/C is 'annoyed' now, but at least he gets to see Dr. on 1/10 for refills (I suspect because I asked if they were "denying him access to medical treatment for med refills"), and now has appt for 2nd opinion. (I called co. that set up 2nd opinion and they tell me this was set up that day as 'an emergency appt. because he's been out of work for so long!). 2nd opinion confirms need for surgery, has surgery on 2/15/07. Unfortunately, surgery is not a success, he now has FBS (Failed Back Syndrome). Once he's reached MMI, W/C I/C tries to cut him loose 7/07(of course). I request evaluation for a neurotransmitter (implanted device that uses small electric current to block pain signal to brain to at least reduce pain he still has because now Dr. has changed pain med to methadone to get him off narcotics). W/C I/C sends him to ANOTHER SURGEON- (who asks if operating surgeon could have 'nicked the nerve during the surgery'-??!!) not pain specialist who does neurotransmitter and says they have to wait for surgeon's report before they can do anything else. So what constitutes 'Good Faith' in New Jersey because I anticipate another 3 month 'boxing match' with these people at least. Also, does W/C I/C have to cover mileage to Dr's, Phys. Ther., etc...? I have not been able to find anything on mileage. Thanks for any info you have.
DH suffers back injury on the job 7/18/06. Dr. 1 says he has to see orthopaedist. W/C I/C sends him to Dr 2. Dr 2 tries phys ther., steriod injections- no help, recommends surgery 11/06. W/C I/C says they want another opinion. DH at this point needs cane to walk and in extreme pain. I call case worker who will check with I/C (11/06). After next scheduled Dr's appt, I call again. They're setting it up 12/06). 1/8/07 I call again at 9am because no news and he sees Dr again on 1/10/07- what the hell's going on? (by now DH has to use wheelchair if we go anywhere he has to walk more then 5 min., which was noted on Dr's 12/06 report to W/C I/C)- case worker has to check w/ins co- at 4:30pm they now want him to cancel appt on 1/10 (this is on 1/9) and now they 'magically' have a 2nd opinion set for 1/26. I refuse to cancel because he needs refills on pain meds, and because it's a narcotic they won't refill by phone. I/C is 'annoyed' now, but at least he gets to see Dr. on 1/10 for refills (I suspect because I asked if they were "denying him access to medical treatment for med refills"), and now has appt for 2nd opinion. (I called co. that set up 2nd opinion and they tell me this was set up that day as 'an emergency appt. because he's been out of work for so long!). 2nd opinion confirms need for surgery, has surgery on 2/15/07. Unfortunately, surgery is not a success, he now has FBS (Failed Back Syndrome). Once he's reached MMI, W/C I/C tries to cut him loose 7/07(of course). I request evaluation for a neurotransmitter (implanted device that uses small electric current to block pain signal to brain to at least reduce pain he still has because now Dr. has changed pain med to methadone to get him off narcotics). W/C I/C sends him to ANOTHER SURGEON- (who asks if operating surgeon could have 'nicked the nerve during the surgery'-??!!) not pain specialist who does neurotransmitter and says they have to wait for surgeon's report before they can do anything else. So what constitutes 'Good Faith' in New Jersey because I anticipate another 3 month 'boxing match' with these people at least. Also, does W/C I/C have to cover mileage to Dr's, Phys. Ther., etc...? I have not been able to find anything on mileage. Thanks for any info you have.
DH had posterior spinal decompresion, Bi-Lateral laminectomy L3-S1, Excision of L4-5 on L/side. 2/07
