Hello There, Guest! Login Register
Index    |     Search    |     Members    |     Help

Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
15yrs on WC In California. 1171 help
#1
Hi Everyone. It's been awhile since I've been on here.  I need your opinion what to do next... I was sent to a new orthopedic surgeon by my pain mgmt doctor.  The initial appt was typical history, X-rays and then follow up appointment. Appt #2 lasted 2 minutes 53 seconds. Appt #3 MRI review lasted 7minutes 36 seconds... this last appointment he told me there's nothing I can do for you... you can go back to work!  I almost fell off the exam table. My son who accompanied me said "Are you kidding me? You have the nerve to tell my mom she can back to work after all these years?" Then the doctor walked out of the room! 
My pain mgmt doctor says I'm P&S, I do need surgery to fix the levels above and below my cervical fusion C2-C3 and C7-T1. I have instrumentation on C4-C6! Apparently having a Z-Track plate should be replaced after 10 yrs! But he said "don't do the surgery unless you really need it and can't bear it!  
 I spoke with an ER doctor friend who said, You need to seek legal advice based on the Orthopedist comments.. you were robbed of gainful employment....
So here's my question...
What would you do?! 
What should I do?  I'm so confused!
Thanks!
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#2
Welcome back ---it,s been awhile.
Refresh my memory---- what's the status of your claim? Award? Litigated? What benefits are you still getting? Any court decisions ? Any PD rating?

The opinion has not affected your benefits yet, has it?
What was the opinion of your prior orthopedist?
The exams were short because the doctor reviewed your extensive medical records, tests, and history.
That probably told them far more then more questions to you and a few probing pinches and pulls in an office visit.

To me the biggest problem is not that you are permanent & stationary or that they don,t think it's likely that more surgery/treatment will improve your function. It,s the vagueness of what type of work they think you can do?
What kind of permanent restrictions will they impose?
It may just mean you are not permanently totally disabled but only partially permanently disabled. The question will be how much? What kind of a rating will you be given?

Those answers will have to wait for a written report and more detailed in nformation.

You should familiarize yourself with the QME process for getting a second opinion.
http://www.dir.ca.gov/dwc/medicalunit/faqiw.html
Fact sheets D, E:
http://www.dir.ca.gov/dwc/iwguides.html
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.
 
Reply
#3
Hi 1171, claim settled in 2006, lifetime medical. Getting a monthly annuity plus social security. Totally disabled...I don't know what PD rating. Prior orthopedic said surgery because at the time of original fusion he couldn't do 5 level fusion so he only did 3 levels. My pain mgmt doctor sent me to another ortho who told me "there's nothing we can do for you, you can go back to work". So I'm suppose to go back to my original surgeon but considering Stanford or UCSF if W/C will honor it.
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#4
it's been too long for them to change anything as far as your disability. your work status and disability is fixed and locked in as far as comp is concerned.

Medical treatment is still up to utilization review rules. comp should not have an issue with which hospital; there is a fee schedule in place no matter where it's done.
I don't think the doctor had been updated on the status of your claim and his "return to work" comment does not apply to post-award comp cases. don't be upset by it. there is nothing for you to do until they decide whether you are good candidate for more surgery. this doctor obviously doesn't think so.
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.
 
Reply
#5
1171 knows a lot more about your situation as I only know what is on this post.

You do not have to return to the ortho surgeon who stated you should return to work. Do you physically feel like you can work? Can I ask how you did with your first fusion and did it make your pain any better?Having 5 levels fused is a lot, especially in the neck. I recommend getting another opinion if the plate needs to be replaced and also if you need additional fusion. You can get a second and third opinion through work comp. The process is listed on the states webpage.

If your insurance company has an MPN you can pick a doctor from the list and if they do not have an MPN you can see any doctor that will take your work comp insurance. I think going to a major university would be a good idea.

I am a little unclear how you exactly ended up with this ortho doctor. You wrote your pain management doctor sent you to him. These types of things usually go through UR or the claims adjusters can just approve the request. If your claims adjuster approved the request for ortho consult she may have been the one who sent you to this ortho, or your pain management doctor may have picked him as 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.
 
Reply
#6
(12-11-2016, 12:50 AM)1171 Wrote: it's been too long for them to change anything as far as your disability. your work status and disability is fixed and locked in as far as comp is concerned.

Medical treatment is still up to utilization review rules. comp should not have an issue with which hospital; there is a fee schedule in place no matter where it's done.
I don't think the doctor had been updated on the status of your claim and his "return to work" comment does not apply to post-award comp cases. don't be upset by it. there is nothing for you to do until they decide whether you are good candidate for more surgery. this doctor obviously doesn't think so.

Thanks 1171... I was so pissed by the Ortho Doctor (ref by Pain dr) I felt as if I've wasted 15 years being home per Dr orders when I could have been working making decent salary and could have finished Nursing school...my goal was to be a NP.  Not being able to work, limited exercise (no neck turning) has been very hard on me since I use to be a very active woman.  To be honest, I wanted to Sue the heck out of my original surgeon who didn't do 5 levels when he should have, who told me to have a "couch potato life" no exercise nothing, who also told me "when your ready for your next surgery call me and schedule an appointment and I will be more than happy to do an Xray & MRI and your surgery, until then, see you in a year!"  After reading on here about filing a civil suit while on W/C, I wish I could have done that when I was going through the process. Now stuck on w/c, sitting on the sofa, one day at a time
Babebahn..."Tongues don't have erasers"
Injured 1999 3 level anterior cervical fusion 2001
Settled Work Comp Case 2006 w/ Lifetime Medical Currently, C7-T1 is being watched will possibly need surgery front/back fusion from C3-T2, lower back needs another facet injection.
 
Reply
#7
yep. it's often a real disservice to most workers to "give" them disability when they need good treatment and a productive life. too many docs rush to judgement.
although I also know that many workers are so tired of the pain that they push for the "miracle" surgery.
doctors get caught between.
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.
 
Reply
#8
For you and others reading this when a doctor states you are permanently disabled or can never work again it is his opinion. This does not mean you cannot work ever again. If you feel like you can work you should be able to do so. It is important to talk to your doctors if you want to attempt to work or go to school. There are many people who are attending school that have disabilities and/or restrictions. If there is a job you think you can safely do discuss this with your doctor. All colleges have disability counselor student services that will work with your restrictions. You do not need to be sitting at home if you want to get out there. It sounds like you are on SSDI. They have a ticket to work program so you can try to work during a period of time and your SSDI will not be lowered. Also, you can work part time and it will not affect your SSDI as long as you do not go over the threshold. I think it is around $900. per month.

This is going to be a guess but the ortho that was only with you a few minutes and stated you can return to work maybe did not read your records and had no idea how long you were out of work or your medical condition.

I think you have a good plan to see a surgeon at a major university for a second opinion. There is a second opinion process with work comp if you disagree with the other ortho.
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.
 
Reply
  


Possibly Related Threads...
Thread Author Replies Views Last Post
  1171 wc denying all authorizations California Babebahn 4 993 09-15-2020, 11:57 AM
Last Post: 1171
  ppd in NY for 15yrs,can i lose comp for not looking for work pdw55 5 6,066 05-06-2014, 04:01 PM
Last Post: 1171
  1171, Others from California -- Discussion?? chrischris 12 7,805 09-09-2011, 08:35 PM
Last Post: DYAN1000
  California Injured Workers -- **1171 see post #4 question chrischris 9 16,142 03-03-2011, 03:28 PM
Last Post: murphsmom
  California Question -- 1171? chrischris 2 3,735 09-20-2009, 06:09 PM
Last Post: chrischris
  Question for 1171 or anyone else in California who might know monster 5 4,015 01-23-2008, 11:25 AM
Last Post: monster

Forum Jump:


Browsing: 1 Guest(s)