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Won 2nd Appeal !!! Rec'd IME Rating 1% NO JOKE
#1
Ohio here,

Broke my ® foot 07/08, at work sustained (Fracture Right Fifth Metatarsal). Developed (L) foot sprain while being in air cast boot for 5 long months.

Last week I posted a thread regarding Defense Attorney and Trickery. This thread in a continuation.

June, 09 an IC District Hearing Officer allowed my L foot sprain add on. The company attorney appealed the R & L Foot claims, he was denied the appeal for the R Foot, but was allowed the appeal to be heard again for the L Foot.

With having said all that, Last Monday, August 3,09; I attended the 2nd hearing and the Staff Hearing Officer once again allowed the L Foot add on and ruled in my favor. This is what the Staff Hearing Officer said this time.

Quote:
It is the finding of the Staff Hearing Officer that the injured worker did develop a left foot sprain due to her overuse of her left foot and altered gait as a result of the previously allowed condition in the claim. The injured worker's altered gait and overuse and reliance of her left foot was caused by the extended wearing of a boot on her right foot in an attempt to treat the previously allowed condition. Therefore, it is hereby the order of the Staff Hearing Officer that the claim is amended to include the additional condition of Left Foot Sprain.
Quote:

Well the company attorney's trickey didn't work, and the hearing officer saw right through what he was doing. My attorney pointed out to the Hearing officer that the Defense Attorney's information was inconsistent and way to long, and that the wc doctor sounded like he was explaining someone else’s injuries. I couldn't believe my attorney was saying these things.Quote


Now, you all want to hear the kicker. I had an appointment with an IME doctor on July 27th. The medical report came out last week and was posted to the BWC website the same day the Staff Hearing Officer posted his decision, which was Friday Aug 7th. The IME only gave me a 1% rating for pain, for my left foot. There is no prior medical evidence that I had a sprain or gait before I was made to use my left foot to heal the right foot. How dare they, they almost cripple me and then to add insult to injury they rate me at 1% and that was for pain. Who do they think they are kidding, I can hardly walk. The WC doctors are hard at work for the companies, well in my case this is what happening.

OK, you guys, I need your help with trying to sort this craziness out. I have two questions because I don't understand whats happening.

1. His medical report reads ALLOWED CONDITION: 825.25 FX Metatarsal-closed rights, 845.10 Sprain of foot left. What do they mean close? IME said they focused examine on L foot sprain, gait. Again I don't have any prior medical evidence that I had anything wrong with my feet. They did a 10 yr background check, and it came back with the injury I sustained when I worked for them, nothing else, it is blank.

2. I plan on objecting the 1% finding for the left foot sprain, gait. I have 20 days to appeal the IME report. How can this be happening when the Staff Hearing Officer ruled in my favor? IME doctor said this 1% was an addition. I am confused, I never received my percentage for right broken foot.

I need to hear from my friends, please tell your thoughts. It was a long hard week, waiting for the decision from the hearing officer, I do believe I have some dark circles around my eyes.


THE FIGHT FOR MY RIGHTS GOES ON.
 
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#2
I Would Love to Answer this for You, and make Your Week-End a bit Better, but these Questions are Better Left to Your Attorney to Answer! It's Probably another Game being Played, I wouldn't Worry too much until Your Attorney Tells You to, Patience and Faith in Your Attorney are Paramount Right now! I'm Sure Your Attorney will Straighten this Out, or File for a Hearing to do so!! Have a Great Day!!Wink
 
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#3
Sounds about right for an Ohio claim.

There is really no award for subjective pain complaints and adequate pain allowance is included in the ROM sections. healed Fx's and sprains are almost always zero percent.

Ohio uses the AMA GUides 5th ed and awards only impairment, not disability or pain. So if you had a problem, it was treated and then it got better so that there was no residual impairment you would be awarded a zero percent; i.e. there is no impairment.

CLosed refers to the classification of a fracture, open or closed, and open means through the skin, that is a big gaping hole with a bone sticking out of it.

It's not like a car accident. THere is no pain or suffering or anything else not impairment in a BWC award. So 1% sound about right, maybe a little high.
 
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#4
Ok, so why does the defense want to offer me a settlement?
 
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#5
Netta, if they could Talk You into Settling for an Amount they Choose, and Close Your Medical, You would no Longer be a Liability to Them, and the Future Medical will be on You!! If any Injured Worker with an Accepted Claim, and an Injury that May Linger can be Bought to go away, the Ins. Co. would Settle Immediately!! I have already Turned Down Low 6 Figures, because My Claim is Worth at Least Twice of what they Offered. But had I said Yes, they would have Carried Me around on a Feather Pillow until I Signed!! That's why We need Attorney's We can Trust, Mine could have had a Nice Pay Day had I Said Yes, but even He said if I did He would do Everything He could to Talk Me out of it!! W/C as Cycler said doesn't Care nor will they Pay for Our Pain and Suffering, We are a Claim Number and a File, and a Liability to them!! If You Trust Your Attorney, be Patient and Allow Them to do Their Work! Mine told Me it's His Job to Worry, and Mine to Deal with the Pain!!Wink
 
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#6
I can imagine a couple of scenarios but FWIW they get to put it all behind them forever for a few dollars and you can never come back at them the next time your feet start to hurt.

Netta Wrote:Ok, so why does the defense want to offer me a settlement?
 
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#7
Hi Still in Limbo and Cycler,

You all have brought me through the fire, with excellent advice on how to handle all my appeals, wc, and the defense attorney. I will calm myself down and follow you all's advice and trust my attorney to handle everything and be patient. OK, well I guess I will go do some light exercise, I am feeling better now that I talk to you guys. Thank you.
 
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#8
You're Quite Welcome Netta! Trust and Patience is the Key to Survival in the Bizzaro World of w/c!!Wink
 
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