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Suggestions on what to do......
#1
I am new to the board and I am hoping that someone can help suggest some things for me.


 
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#2
It was three years working thru the courts before my TKR was approved.

Even with that when the court order was received to go to the surgeon it took another three months before the insurance company agreed to pay for the surgery and a another three month wait on the surgery schedule before the surgery happened.

I believe with Bodybuilder it was five years after the injury before the surgery was approved. She found out recently she will need that TKR redone.

Waiting for the TKR was tough, I seldom left the house and when I did it was a medical appointment or to shop and I needed help to do both.

My TKR was 2008 and I still need to use a cane.

Qualifying for SSDI right away is what saved my family financially.
 
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#3
[quote='Bummer Knees' pid='156714' dateline='1400890909']


Qualifying for SSDI right away is what saved my family financially.


Thanks for the reply
 
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#4
[quote='Scooter123' pid='156715' dateline='1400895579']
[quote='Bummer Knees' pid='156714' dateline='1400890909']

Qualifying for SSDI right away is what saved my family financially.
 
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#5
Yes. You must be unable to work for one year or longer to qualify.

Go ahead and apply now as it can take some time to qualify.

I was very fortunate as I qualified within six weeks of applying.

As for knee replacements, insurance companies do not like to pay for them and will fight a battle to get out of paying for them.

".............




(05-23-2014, 10:23 PM)Scooter123 Wrote:
(05-23-2014, 09:39 PM)Scooter123 Wrote:
(05-23-2014, 08:21 PM)Bummer Knees Wrote: It was three years working thru the courts before my TKR was approved.

Even with that when the court order was received to go to the surgeon it took another three months before the insurance company agreed to pay for the surgery and a another three month wait on the surgery schedule before the surgery happened.

I believe with Bodybuilder it was five years after the injury before the surgery was approved. She found out recently she will need that TKR redone.

Waiting for the TKR was tough, I seldom left the house and when I did it was a medical appointment or to shop and I needed help to do both.

My TKR was 2008 and I still need to use a cane.

Qualifying for SSDI right away is what saved my family financially.

Thanks bummer Knees. I know you have been through so much! Sad
To qualify for SSDI, one has to be done with WC first, correct?
I am at my states max payments for WC.....so not sure SSDI would benefit me.

I was telling my lawyer about the web page here and about your longgggg wait for your approval. He stated that it depends on the state and the WC laws for that state.

I am just so over this. I can't imagine going for years as I know I will be in a wheelchair if my downhill progression continues. Muscle mass goes fast when you can't use it.
One good thing is that once approved, I could have the surgery next week as my doctor will squeeze me in he stated. He is da bomb and one of the best in the southern states. He is one of two ortho surgeons who are very well known and do amazing work.

Thanks for the reply

Just googled SSDI and it states you have to be off work for 1 year and they only pay a max of 80% of your normal wage before your accident. So I will have to wait another 7 months before I can apply but for what I can calculate, it would mean a huge difference in my monthly income!

 
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#6
You can apply, if you will be off for a year you can apply. When they put me off work saying they didn't have a job for me I had to apply for SSDI right away because my employer forced me to. Took about 2 and half years for me to get thru the system and get SSDI. And yes they back paid me. And I do get SSDI and worker comp. My SSDI is offset some because of it
 
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#7
(05-23-2014, 07:44 PM)Scooter123 Wrote: I am new to the board and I am hoping that someone can help suggest some things for me.
I fell in Jan/14 injuring my knee, hip, back and shoulder. As a result of the fall, it exacerbated my OA and now as a result of that fall, I need a knee replacement. Before the fall, I had mild, very tolerable pain at times and worked full time with no problems. Now I can barely walk, use a walker 24/7 and it's affecting my other joints that I previously had no issues with.

Have been through a depo, will have a court hearing in a few weeks, have a good lawyer and have seen two ortho surgeons and an IME who all say the same thing: needs a TKR as the fall exacerbated/excelled the need for anTKR. Surgery was booked but then WC/insurance carrier denied it. Before the fall, it hadn't even crossed my mind to even seek a referral for a TKR as I was doing well and never saw any ortho in regards to my knees.

Questions are:

My body is literally killing me from sitting all day. I get up and hobble with my walker as often as I can but I am getting more stiff/painful as the days go by.
Had been doing PT with some effect on the other muscles of the leg but it aggravated the knee and made it swell like a balloon. What does WC think about aqua therapy or a membership to the YMCA pool? Anyone have experience getting that?

Does anyone have experience with getting a TKR reasonably quick through WC?
All the doctors i have seen since the fall have stated " it's not rocket science that it needs to be done" and " the writing is on the wall as far as the need for surgery". Even the IME doctor I saw last week sort of laughed and wondered why I was there to see him as he said, " duh, what are they waiting for".

Another question: what do you do to stay sane? I now suffer with severe depression from feeling like a slug on a stick. I feel useless. We have lost so much- our home, my job (they fired me as I couldn't return and they refused to offer light duty of any kind). Everything is going down the drain. My life as I knew it ended in a matter of seconds and honestly, I'm so tired of their games. I have been waiting for an elevated toilet seat now for 3 weeks. My lawyer has said they have emailed the DA about it and still waiting......

Does this nightmare ever end? Most importantly, how do you cope? I think that is the bottom line. I need help/suggestions as my coping level has left.
Thanks to all who reply.

I agree. You should apply for SSDI now. It can take years for some to get approved and why it is important to do it now. The rules are that if your doctor anticipates you cannot work for a 12 month period then you may qualify. You do not have to be done with workers compensation first, many receive both, but there is an offset.If you are awarded SSDI sometimes there is an offset so you may get a small check on top of your workers compensation benefits for example. There is a deadline for applying for SSDI and I think it is 5 years after your last day worked.

Another benefit from receiving SSDI is after a number of months you will receive Medicare, that you can use for any non work related medical conditions.


Talk to your doctor about aqua therapy. It is allowed in workers compensation. Every state has different laws about how to request medical treatment. It helps many different kinds of injuries.

If you are having depression you can also request treatment for that.

You can also talk to your doctor some exercises that you can do at home on top of the aqua therapy. This is one way to combat depression, and in my opinion the best way, exercise. I know it is difficult with a knee injury, but do the things your doctor states will not cause further injury. Eating healthy, and controlling weight is also important with an injury. While having an injury many may feel they have lost control of their lives, however concentrating on things you can control, like healthy eating, and doing light exercise is something you can control and can help with depression.

Finding positive things that you can do during recovering from your injury is something that will help you cope. For some taking an on-line class at their local college can be helpful. This is one example, and everyone is different. I know of a few injured workers who began doing that, and ended up getting the degree they never knew was possible. There are a few on this site who do some volunteering when they are physically able. There are many free things in our country that are not taking advantage of by many such as the local library etc. If you enjoy reading the library is the best free resource. Keep in touch with your family and friends and do not isolate yourself is also important. Knowing that although you may have to make changes in your life due to your injury, life is not over due to your injury. Concentrating on the things you CAN do is very important. These are a few positive ideas for your question at the beginning of this post about how to cope with an injury. Again, if you need counseling you can talk to your doctor about that as well.

Receiving medical treatment, surgery and things like raised toilet seat can take time in workers compensation system. I do think it is ridiculous you are not getting that seat timely, but I hear about this type of thing often. It is BS, but try not let that get to you too much. Learning the workers compensation laws in your state may help. Every state has a work comp state home page that lists basic laws.

Be well.




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.
 
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#8
(05-24-2014, 11:43 PM)California_Help Wrote: [quote='Scooter123' pid='156713' dateline='1400888686']
I am new to the board and I am hoping that someone can help suggest some








 
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#9
Scooter1323 I have been dealing with WC for 13 years know, Yes it is hard to not be in control of things like we use to do, but we adjust and learn how to handle things the best we can, with our injuries.
I use to work 60 plus hours a week, and now I have been resorted to staying home. I get boared and I am out of shape now, puts on weight, the most I have ever weighed. Became diabetic but I just plug alone and get through the day the best I can. All the furniture in the house now has my butt imprinted on it. Oh well that is my way of life today. I thought the Y was going to be my saving grace, I went there 2 times and have not been back. Was not something I could do when I got there..
I am on SSDI now been on for 5 years now. I am also getting WC payments indefinitely, those just started a month or so back, I am waiting on SSDI to reduce my monthly amount (for the offset). They are very slow at getting this step done. I was awarded back pay by the WC Bureau so SSDI will take some of that also. I am afraid to spend any of the WC money, because If I do, I will get caught with having to repay SSDI and I will not have the funds to do this with. So right now all WC backpay and bi-weekly checks are being deposited and I am holding it all at this time.
But I need to stop ranting about my issues, but yes go ahead and apply for SSDI as it can take some time to get the process done and approved for SSDI, from start to finish and I got my first SSDI check was about 15 months. So you see it can take some time. Also you want to apply while you are getting WC payments as this will lessen the possibility that you will go through a period of not having any money coming in. Mine worked out that way so we did not go without at least some kind of check coming in to help pay the bills. Thank god for that, If I had to go without some kind of money coming in I do not know what we would of done. That is one less stressful thing that you should not have to deal with while healing as you need to be concerned with your health.
Good luck with getting the surgery you need and hope it gets you back to where you can be productive.
Cervical Fusion 2003, c5-c6. Herniated and damaged Disc L1- L4-L5 S1. Lumbar Spinal Cord stimulator implant 09-2008. Cervical ACDF revision with hardware c4-c5-c6-c7 Sept 2009.
SSDI approved 3-2010. NOW OFFICIALY RETIRED
 
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#10
When I had the TKR surgery the surgeon told me it would be one year before he released me from his care.

After a few months I was given restrictions for returning to work although my employer would not work me with any type of restrictions. I worked as an early childhood teacher and did not wants to put the students at risk.

I did have other medical issues going on, the altered gait lead to problems with the other knee and lumbar spine.
 
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