12-09-2018, 04:27 AM
Background:
I am a 38yo Male. 37 at time of injury. Married with 3 kids. I have an 18-month old son (he was 4 weeks old when I fell). Colorado claim.
I was injured at work last summer when I fell through A roof. 15 feet. CRPS was apparent immediately in LUE. Diagnosis confirmed by positive QSART, Stress Thermogram & Sympathetic nerve block with EMG showing nerve damage for CRPS Type 2. SNB was working to diminish pain and increase mobility. IC has stopped approving that only treatment that decreased pain and increased Mobility. CRPS spread to LLE, confirmed by positive QSART and stress thermogram.
Both limbs are constantly Swollen & freezing cold to the touch, highly sensitive to touch, wind, anything.
I use an electric wheelchair to get around the house because I am not able to walk. I can’t move my toes, foot or ankle. CRPS pain extends from toes to knee.
I have no use of my wrist or fingers. Elbow ROM is about 75%. CRPS pain extends from all fingers to 3/4 up the forearm. EMG shows damage to both radial and ulnar nerves.
Left knee has torn meniscus from fall.
Right knee has partial MCL tear from trying to hop from wheelchair to toilet.
I was diagnosed with PTSD. I wake up from nightmares about the fall about three times every week. I rarely sleep and I’m constantly waking up from pain.
I’ve had 1 direct IME and 1 recent “medical records review” IME.
I have a hearing in February to address denied medical care. Current denials: wheelchair, shower bench, toilet seat bars, in home care, sympathetic nerve blocks for arm and for leg, ketamine infusion, PT/OT, massage, acupuncture, biofeedback, chiropractic, psychotherapy and several medications. All these ordered by Dr.
Questions:
1. In CO, what part of the AMA is used to determine MMI? Or WPI? Which is it for CRPS?
2. At what number is it considered total and not partial?
3. Can I seek and pay for non-approved medical treatments from IC without jeopardizing the claim? Will it be seen as patient directed care?
4. At what point does it qualify for bad faith?
I’m losing hope
I am a 38yo Male. 37 at time of injury. Married with 3 kids. I have an 18-month old son (he was 4 weeks old when I fell). Colorado claim.
I was injured at work last summer when I fell through A roof. 15 feet. CRPS was apparent immediately in LUE. Diagnosis confirmed by positive QSART, Stress Thermogram & Sympathetic nerve block with EMG showing nerve damage for CRPS Type 2. SNB was working to diminish pain and increase mobility. IC has stopped approving that only treatment that decreased pain and increased Mobility. CRPS spread to LLE, confirmed by positive QSART and stress thermogram.
Both limbs are constantly Swollen & freezing cold to the touch, highly sensitive to touch, wind, anything.
I use an electric wheelchair to get around the house because I am not able to walk. I can’t move my toes, foot or ankle. CRPS pain extends from toes to knee.
I have no use of my wrist or fingers. Elbow ROM is about 75%. CRPS pain extends from all fingers to 3/4 up the forearm. EMG shows damage to both radial and ulnar nerves.
Left knee has torn meniscus from fall.
Right knee has partial MCL tear from trying to hop from wheelchair to toilet.
I was diagnosed with PTSD. I wake up from nightmares about the fall about three times every week. I rarely sleep and I’m constantly waking up from pain.
I’ve had 1 direct IME and 1 recent “medical records review” IME.
I have a hearing in February to address denied medical care. Current denials: wheelchair, shower bench, toilet seat bars, in home care, sympathetic nerve blocks for arm and for leg, ketamine infusion, PT/OT, massage, acupuncture, biofeedback, chiropractic, psychotherapy and several medications. All these ordered by Dr.
Questions:
1. In CO, what part of the AMA is used to determine MMI? Or WPI? Which is it for CRPS?
2. At what number is it considered total and not partial?
3. Can I seek and pay for non-approved medical treatments from IC without jeopardizing the claim? Will it be seen as patient directed care?
4. At what point does it qualify for bad faith?
I’m losing hope