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First visit with Nurse Case Manager
delete please thanks billy
it's difficult to have it both ways:
to want to be present when nurse and doctor talk and yet not want nurse to be present when you and doctor are together.

the employer, carrier, nurse will want to influence the medical outcome just as patient does; tough for one to exclude the other
workers comp has joint and shared responsibility for the injury even though either might not like it.

like two people at the steering wheel: often develops control issues with neither side wanting to work with the other and each acting like the other has too much say so. comp is a difficult system to manage.
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.
delete please thanks billy
I mean no offense, but I don't know any other way to address this

quote " My main thing is though that if I am in pain why can't he send me to the pain management instead of giving me a bunch of medicine that isn't going to do anything and is probably costing them more? ".

1) any dr. worth thier weight is going to take the most conservative route possible and the move on from there. There are only so many testes that can be done. I think I have had them all. That reminds me, I have a sc scan on 4 weeks, but that in reference to having two balloons put in my nose.

2) What do you think that a PM dr. is going to do??? After all, the name says it all. There are only three things that I can think off that a PM dr. can do, other than a bunch of pain meds.. 1) tens unit, 2) SCS, 3) epidural injections. I forget what your symptoms are, so all of the three may not be an option.

Take Care

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. 
delete please thanks billy
Ah yes, the ncm can and will power your dr, if there is somw whispering going on then you might want to change your mind and let her in durring the visits.. This way you will know what is being talked about...... The emg tests will. help in determining where the pinched nerves are..... There aint hardly any dr out there that will perscribe pain meds without the standard steps they follow....

If you are in severe pain, go to the er, afew trips there might influence your dr to get you on some type of pain med...
delete please thanks billy
You can refuse the case manager being in the room, but you cannot stop her from communicating with the physician.

As far as advice that you should go to the ER a few times and maybe that will convince them to move you to pain management, that is a terrible idea. A few times going to the ER asking for pain meds is going to do nothing other than make you look like a drug seeker, and the I/C will jump all over that.

A pain management doctor is going to follow a script. You'll sign a contract, get some medications. Next, they'll want to do an EMG and/or and epidural injection, the latter you've already said made you worse. If that's the case, maybe they'll try a facet injection instead. If that helps, they may try medial branch blocks and further, a rhizotomy.

If the facet injection doesn't work, they might recommend a spinal cord stimulator. With your MRI, no way does it get approved. I still think it would be worthwhile for them to run some testing on your sacroiliac joint. Not testing like MRI's etc, but a manual exam and maybe a diagnostic injection. If the SI joint injection helps, you may have found the pain generator.
Hurt back, it does sound fishy to me, I have done it and wc did pay for it.... What does your lawyer have to say on this.....?

I have had the same senerio, low back pain and left leg pain, I had always asked them to concentrate on my back but after 18 esi injuections and a total of 5 rfa's it still remains the same.. emg test came back abnormal, surgeon says he can help with the leg pain by fusing l4-l5---l5-s1 but it will not help with my back pain... I said no to surgery .......

Woodlawn------ not all pain drs work the same and if pain is to bad there is nothing wrong with going to the er,, it doesnt make you look like a abuser unless its every other day...
delete please thanks billy

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