Re: (OB) Workers Comp

[Guest guest]

I vote for Evidence Based Care for EVERYBODY ELSE!!!

Good luck trying to get everyone on the same page for TOS!

I have an MVA patient with pre-existing DJD/DDD at one level, and a new herniated cervical disc at another level, and symptoms of bilateral ulnar neuropathy along with an emerging CTS... The MD, neurologist, and othtopods have all "theorized" how he must have struck or strained BOTH OF HIS MEDIAL ELBOWS at the moment of impact, and then also probably traumatized his wrists on the steering wheel...

My gosh...they still think, "If it hurts here...the problem must be here!"

I think we should dumb-down the Chiropractic profession, get us some white coats, a couple of prescription pads, and next year you can all visit me in any one of my 12 vacation homes located throughout the world (that was just a joke...DO NOT FORWARD THIS TO THE AMA!!!).

But, man, you've got a messed-up claim. Most docs would probably advise you to not even take such a messed-up w/c claim... I know you want--and are certainly just as qualified, or MORE qualified--to help this patient, but the bureaucracy is going to get you on this one.

They will "have at her" for a while, and when the dust (and her claim) settles, then perhaps you will be able to pick up the pieces...(because remember, things run down-hill, and when the bus goes up hill...everything slides to the back; THAT'S when we pounce on 'em and treat them!

M. (really not as cynical as I sound) s, D.C. (:-)

Workers Comp

Man, tis been a goofy week and only half way through.

Have a patient that came to me on her own volition for pain in hands arms and neck bilaterally and she's only 23. Said she was diagnosed with carpal tunnel by MD, but during the exam CT was ruled out pretty quickly and it ended up being a pretty clear case of T.O.S..

Her MD ordered NCV test and it came back negative so she dropped the CT diag, and now referring her to Hand Specialist, meanwhile still doing PT at same office. Well now the PT agrees with me and the patient just mentioned yesterday(her 4th visit) that this is actually a workers comp case. So, I'm not the attending, but the attending has no idea whats going on with patient and the patient knows this and conveyed her displeasure with her in general. She is told to continue her PT. PT on what diagnosis, I don't know.

sigh

So, do i need to get referral now from attending in order to bill WC? her health ins. will deny claiming it's a WC thing no?

BTW, Vern, she claimed her company told her to specifically go to Concentra Med Center. SHe said they did not tell her she could initially go anywhere she liked.

signed, spinning in NE Portland

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

[Guest guest]

HA!!! That was great. You're right

Although, i just spoke with the claims rep at Liberty and they seem to be concerned as well and are doing and IME on her as her case is still pending. I told her that i concur with that and hopefully the IME doc will shed some light on this. I mean Hand Specialist???? NCV test?? PT on Carpal Tunnel and now it's not Carpal Tunnel??? Lots of money going down the drain.

Now the PT is on my wagon and is attempting to do PT off of my diagnosis, but she was doing traction which is contraindicated in TOS!. Wow. what a mess. And they limit US to 12 visits 30 days??? This is a perfect example of how we could save them A LOT of dough.

Thanks for your reply

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204

Workers Comp

Man, tis been a goofy week and only half way through.

Have a patient that came to me on her own volition for pain in hands arms and neck bilaterally and she's only 23. Said she was diagnosed with carpal tunnel by MD, but during the exam CT was ruled out pretty quickly and it ended up being a pretty clear case of T.O.S..

Her MD ordered NCV test and it came back negative so she dropped the CT diag, and now referring her to Hand Specialist, meanwhile still doing PT at same office. Well now the PT agrees with me and the patient just mentioned yesterday(her 4th visit) that this is actually a workers comp case. So, I'm not the attending, but the attending has no idea whats going on with patient and the patient knows this and conveyed her displeasure with her in general. She is told to continue her PT. PT on what diagnosis, I don't know.

sigh

So, do i need to get referral now from attending in order to bill WC? her health ins. will deny claiming it's a WC thing no?

BTW, Vern, she claimed her company told her to specifically go to Concentra Med Center. SHe said they did not tell her she could initially go anywhere she liked.

signed, spinning in NE Portland

Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204