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Immediate relief options????? Need Help
#1
11/04/2013 I was injured in a truck vs truck accident. I was seen on 11/09/2013 by a Dr and had xrays taken and a began treatment to try and get back to normal. I was diagnosed with a lower back strain and disc damage and sprain/strain in my neck. My neck took to the treatments but my back was only relieved a minimally, but I believe the relief was from the frequent chiropractic adjustments I was receiving. I ended up seeing a neurosurgeon and had MRIs done of boths areas and the neurosurgeon recommended Steroid injections in the lumbar of my spine. I had 3 sets of injections and received some relief from them but it was only temporary. My surgeon retired and I consulted a new neurosurgeon and his recommendation was a 3 level (S1-L3) fusion. However, I was forced to have an IME before my 3rd set of injections and like most outcomes. The IME physician said I hads reached maximum healing 2 weeks prior to the actual IME exam, which was in FEB of 2014. Workers Comp cut me off but I was still under Drs orders and restrictions which wouldn't allow me to return to my line of work. I received my last comp payment around the 1st week in April of 2014 and have been without any income since. I had the fusion surgery on 10/30/2014 and I am currently awaiting to begin physical therapy. My Attorney has told me there is nothing we can do until after the surgeon signs off and gives me permanent restrictions. I was told a lumbar fusion could take up to a whole year to fuse completely and my attorney said they need the healing process or at least the permanent restrictions before we can seek financial relief from the workers comp company, which could take another year to happen. I have lost my home and vehicle and currently living with family and it's a burden on them as well as myself not being able to help out.I'm almost 3 weeks out of surgery and my attorney says its probably going to me a minimum of 6 months before we will be able to schedule a hearing,

Isn't there some kind of protection for injured workers that would protect us from the having to deal with the outcome from an IME by a Dr that is not even somewhat familiar with your injury or the treatment you currently going through?
We all know IME physicians are nothing more than paid scape goats for the insurance companies to get out of paying for treatments.
They have 1 Dr that says my injury would have been 100% healed in 12 weeks,
I have 2 that say I would only get relief through having the surgery.(which I had). And even though it was a major surgery, I can personally confirm I feel a lot of relief from the pain I was having and can tell I will be in much better condition after the healing from the surgery concludes.
 
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#2
doctors are governed by the local/county medical board and I'm sure you can file a complaint with them.
your state's work comp board may also have a complaint service.
I'm surprised your atty said there was nothing could be done to restart your temporary disability once surgery was done--I assume comp is still providing medical benefits and you would certainly be considered temporarily disabled post surgery even if you were at MMI before the surgery.

each state has it's own comp laws so I cannot provide specific information for you.
some states have disability insurance coverage for situations not covered by comp.
contact your union they often can provide emergency assistance to their members.
most city and and counties have social service referral centers that can put you in touch with local assistance/support groups.
contact your church or fraternal organizations (elks, lions, veterans, etc.)

for the long term and since you'll be out of work for a year or more you should file for SSDI
https://disabilityapprovalguide.com/gsn3...ation.html

you may also have insurance liability from the vehicle coverage.
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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#3
(11-17-2014, 09:23 PM)1171 Wrote: doctors are governed by the local/county medical board and I'm sure you can file a complaint with them.
your state's work comp board may also have a complaint service.
I'm surprised your atty said there was nothing could be done to restart your temporary disability once surgery was done--I assume comp is still providing medical benefits and you would certainly be considered temporarily disabled post surgery even if you were at MMI before the surgery.

each state has it's own comp laws so I cannot provide specific information for you.
some states have disability insurance coverage for situations not covered by comp.
contact your union they often can provide emergency assistance to their members.
most city and and counties have social service referral centers that can put you in touch with local assistance/support groups.
contact your church or fraternal organizations (elks, lions, veterans, etc.)

for the long term and since you'll be out of work for a year or more you should file for SSDI
https://disabilityapprovalguide.com/gsn3...ation.html

you may also have insurance liability from the vehicle coverage.
My State is Wisconsin and I finally had to apply to the state for the state insurance coverage. That actually made it possible to have the surgery done. But because the Workers Comp had denied any further claims after the IME, I had no way to continue any treatment and my Drs would not release me from restrictions. I was in a Lot of pain and discomfort along with the added stress of not having any coverage I was physically unable to even attempt to return to work.
With my job as a Commercial Truck Driver, we are required to carry a Valid DOT physical examination certificate, which I knew was going to be impossible unless I went to a physician that was unaware of my injury and if I wasn't truthful on the questionnaire. Then if anything was to happen due to my injury I would be liable myself because of being untruthful to get the certificate renewed.
My situation now is I need to begin physical therapy as soon as the Dr feels my surgery wound is healed enough to proceed which should be in the next couple weeks. I was told it would be approximately 90 days of physical therapy but the fusion could take as long as 1 year to complete depending on the rate of the bone growth. However, this still leaves me with zero income and zero possibilities to seek employment to support myself.
I just feel there should be some way for an injured worker to restore temporary benefits or something as long as there is more than 1 Physician that can rebuke the IME findings. I was feeling and doing pretty decent at the time of the IME because I had 2 of the 3 injection series and was scheduled the following week to get the 3rd. I was also getting chiropractic adjustments and decompression treatments 2-3 times a week. but within 2-3 weeks of having to discontinue treatments, I was back to constant pain and discomfort. I also had a FCE after workers comp cut me off which was 1 week after treatment ended and they found I had a 24% disability and I was still feeling fairly good at that time. but if I would have taken it a few weeks later, I am positive the results would have been quite different.
As everything progressed I was asked if I wanted something prescribed to deal with the pain, and I refused. I did not want to rely on anything addictive to live day to day and I still wouldn't be able to return to work because I wouldn't be able to pass a DOT drug test. as it sits. Workers Comp is $15,000 approx in arrears in my estimates and it will be another $28,000 in arrears if this goes another year.
My disadvantage is that I am a single man with no other income helping to support me. I'm just thankful I do not have children that depend on me.
I just can not believe there is no options for getting a hearing that would allow us the opportunity to reopen the claim for temporary benefits and allow us to discredit the IME findings.
Believe it or not, My attorney told me today that I should call him again in 6 months and we can see what the Dr says and see if he is ready to assign the permanent restrictions and release me from treatment.

I also have a personal injury case going on regarding this and the workers comp case almost seems pointless if workers comp gets reimbursed from from the person injury suit and neither can proceed until all medical bills and reports are collected which will not be available until all treatments and healing is done. I only opened the comp case because it is supposed to be immediate relief for inured workers.
 
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#4
You need a new attorney
 
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#5
an IME opinion that you are at Maximum Medical Improvement in not evidence that will support a denial of further benefits or coverage of your injury.
something else is going on here.
if treatment and disability were suddenly denied mid-claim then the carrier must have some evidence that the original injury or your current condition was not caused by your employment.

if you want to contact other attys that specialize in comp you can use the links on this page or try these sites
https://www.wilg.org/index.cfm?pg=publicdirectory
http://www.avvo.com/workers-compensation-lawyer.html
http://www.wisbar.org/forPublic/INeedaLa...awyer.aspx
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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#6
(11-18-2014, 12:44 PM)1171 Wrote: an IME opinion that you are at Maximum Medical Improvement in not evidence that will support a denial of further benefits or coverage of your injury.
something else is going on here.
if treatment and disability were suddenly denied mid-claim then the carrier must have some evidence that the original injury or your current condition was not caused by your employment.

if you want to contact other attys that specialize in comp you can use the links on this page or try these sites
https://www.wilg.org/index.cfm?pg=publicdirectory
http://www.avvo.com/workers-compensation-lawyer.html
http://www.wisbar.org/forPublic/INeedaLa...awyer.aspx
That is the purpose of the IME. (Independent Medical Evaluation) They were dissatisfied with the opinion and treatment of my previous physician and used the IME as a way out.
 
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#7
so the IME's opinion was that your condition was not work related?
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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#8
(11-18-2014, 10:14 AM)dusty boy Wrote: You need a new attorney

That's pretty helpful Dusty Boy.
Ive talked to 3 attorneys and they all confirmed that I currently have one of the best in the State.
What I'm hoping for is that there might possibly be another option I can look into for immediate temporary relief.
I personally think there should be a few protective measures in place to prevent the Workers Comp carriers from buying their way out out a claim by having a paid whore physician give them the written results they want and need to deny a claim.
 
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#9
(11-18-2014, 01:20 PM)1171 Wrote: so the IME's opinion was that your condition was not work related?

not exactly, But it did say it was only a soft tissue injury that would have a Maximum Healing of 12 weeks which which was 2 weeks prior to the IME. So he basically said I was fully healed 2 weeks before seeing him. However I was also in the middle of the injections after all the other treatments didn't seem to work. He also quoted that He felt the injections should not of been necessary in the treatment of the injury.
He basically tried to discredit any treatments my physicians tried and recommended for healing. And HE is also a well known and used Dr with the Workers Comp companies. I've found several articles on him and none of them were favorable by any of his patients.
 
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#10
if false or misleading information was used to deny you benefits, you can contact your district atty about filing a fraud complaint.
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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