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Question about pre-existing condition
#1
I was hurt in April at work. First diagnosis was sprain of the thumb, pain didn't get better and was placed on wc. That dr agreed. After 2 more weeks (4 from injury) he does another x-ray, says I have mild osteoarthritis and a bone spur. Puts me in another splint. A week later I am called to go back to the office for a review of the xrays. A different doc says I have an avulsion fracture and cast it. 6 weeks later, cast comes off, told it's healed and start physical therapy. 15 visits later PT says I am at the max improvement. Pain is still there. I am sent for an MRI and CT. Report comes back as severe osteoarthritis. Doc says I have had it for years and is pre-existing. I show him medical records from 11 months ago that state NO arthritis or narrowing of the joint space. These were done because of pain that was said to be De Quervain's. I got 2 shots and no issues since. Now that I proved no arthritis, they are saying that THIS is the pre-existing issue. I don't know how to get across there was NO PAIN until my thumb was hit. I am in New Mexico.
 
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#2
Did the deny the claim?what benefits were denied?
Do they want you to repay the medical and the disability?

Whether there was a preexisting arthritic condition or not, they are still on the hook for the aggravation.
Physical therapist is not a doctor authorized to make an MMI determination.

You can also contact the. Ombudsman
https://workerscomp.nm.gov/Ombudsman
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
(09-05-2018, 09:53 PM)1171 Wrote: Did the deny the claim?what benefits were denied?
Do they want you to repay the medical and the disability?

Whether there was a preexisting arthritic condition or not, they are still on the hook for the aggravation.
Physical therapist is not a doctor authorized to make an MMI determination.

You can also contact the. Ombudsman
https://workerscomp.nm.gov/Ombudsman

They haven't denied anything to date. What I was told was I might have to pay back what I have gotten so far because it was pre existing and not caused by the injury itself. I have a causation appt Wednesday, with the 1st doc who said it was only a sprain.
 
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#4
While Your underlying condition may not be industrial, the consequences from the work aggravation certainly are.
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
After reading my copies of the records to date, I found 3 things very interesting...
1) The first visit to WC doctor, he ruled out De Quevain's. "Finkelstein's maneuver was negative".
2) Also ruled out Carpal Tunnel. "Durkin's test was negative"
3) A progress note refers to a prior visit, but that visit is missing from my records. I checked and the page numbers are in sequence from the visits prior to the missing visit and after.
 
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