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ordered to attend RME by insurance hired doctor
#1
Me again.I live in Tx.I am so upset.After so many issues already I now got a letter in the mail stating that I have a commissioner order to attend a required medical exam by a doctor that is hired by the insurance company.I still havent received any treatment for my back injury and was just waiting for WC to approve a new treating doctor in Dallas.I just got through having an exam by a independent DD through WC and he stated I havent reached MMI and I definitely needed more treatment.I guess the insurance company didnt like this answer so now they are making me do it again by one of their doctors so it will all go in their favor.I called the number on the letter and the person I spoke with rudely stated that whatever this doctor says it will override any other reports or exams I have already had.It scares me because even on my DD exam were they are supposed to have fair and unbiased opinions they didnt have any of my reports showing the most damage such as the mri and they still were not accepting most of my diagnosis as being work related.He stated I definitely needed more treatment only after seeing the horrible condition I was in.Can you imagine how tough it will be when it is a doctor that is totally on the ins.company side and is paid to make sure they stop my medical and weekly monetary benefits?WC
sure doesnt waste any time authorizing and approving all of these requests for the ins company but when I make just one to get permission for a treating doctor I am still waiting.


































































waiting.......
 
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#2
Brneye - i'll pray that it all works out. Yes going there definitely gives you that " fear " but hopefully it will all work out. He / she will see your pain and inform them to treat you to get you better. Please let me know how it goes!
 
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#3
Sorry everyone for the huge space after my post!!Thats what happens when you try to email from your phone I guess.Sad
Thank you so much!I will pray that you get the treatment you need also and hopefully get your life back to how it was before you were injured.I try to stay positive but they just keep throwing something else at ya.Wears ya down after awhile.This doctor I am going to see is known for being rude,condescending,ordering you to go back to work the next day and stopping all benefits.The only hope I have is getting a lawyer and fighting them if I dont agree with the report.I just didnt want it to come to that.Well I guess I will keep having faith that it will work out.Thanks for the kind words!It means alot!
(06-15-2012, 09:33 PM)hurt back Wrote: Brneye - i'll pray that it all works out. Yes going there definitely gives you that " fear " but hopefully it will all work out. He / she will see your pain and inform them to treat you to get you better. Please let me know how it goes!

 
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#4
aren't all your doctor's paid for by the carrier?
I thought you said it was at the commissioner's order?
why do you think the carrier hired the doctor and not the commissioner?


if the records are incomplete or the exam is faulty or you have other evidence that the opinion was not truely the doctor's, you can object.

take your evidence to the fraud bureau and file.

just because both the carrier and the work comp commissioner respect the opinion of the same physician doesn't mean the fix was in.

like everything in the legal system you will need proof/evidence not personal opinion.
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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#5
I got fed up alot earlier than you and got a lawyer to speed things up. Get a lawyer before they stop all payments, because it looks like that's their objective, it'll take a long time to get your payments back if they're stopped, good luck
 
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#6
1171 & jayc both are right here!

I pray it all works out for ya!!
 
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#7
I have been away for awhile, due to school. Anyway; I just read the thread.

1171 is correct as usual. The dr. is on a list of approved drs. by the TDI. The IC will be footing the bill.

quote "Can you imagine how tough it will be when it is a doctor that is totally on the ins.company side and is paid to make sure they stop my medical and weekly monetary benefits." end quote. Not in Texas, the medical (for the injury) will only end when medical is no longer needed or death. Which ever comes first.

In reference to the comment made about getting an attorney. Texas does have an obudsman service.
8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. After going back to school, I received my degree as a mechanical engineer. What can I say, it was the only way I had to beat the system. 
 
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#8
1171 I am not very experienced with any of this so i get confused easily.The letter I received states that the Commissioner of WC approved the request of an RME for the purpose MMI and impairment rating to be done by a certain doctor.What I dont understand is why am I having this done immediately after I just completed this same examination through an independent designated doctor done by WC.After the exam he put in his report I have not reached MMI and need more treatment such as injections,PT and possibly surgery.I still havent received any treatment due to I am still waiting on WC to appro v e a treating doctor.
 
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#9
It sounds like to me that you got the standard letter that everyone get in reference to thier MMI.

If you don't mind? Can you tell me when the injury occured?? meaning the date. Has it been about two years??

I am begining to think that the so called "independent DD" was a second oppinion for the IC, in refence to yur medical condition. Do you have a copy of that report??
8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. After going back to school, I received my degree as a mechanical engineer. What can I say, it was the only way I had to beat the system. 
 
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#10
AQA thank you so much.I thought once they stated you have reached MMI that all treatmet was stopped.I didnt realize in Tx that you could still get medical until you were released by your doctor.I also did not know about the obudsman service that I can reach out to if I need the help.Thanks again!
My date of injury was December 2011 so its only been about 6 months.I did receive a copy of the report.
b][/b]
(06-16-2012, 10:38 PM)AQA Wrote: It sounds like to me that you got the standard letter that everyone get in reference to thier MMI.

If you don't mind? Can you tell me when the injury occured?? meaning the date. Has it been about two years??

I am begining to think that the so called "independent DD" was a second oppinion for the IC, in refence to yur medical condition. Do you have a copy of that report??

 
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