Re: Workers Comp Authorization

[Guest guest]

I'm so sorry to hear of the boards decision. It sounds like your

attorney knows what he is doing. Don't stress yourself about it. That

is his job. Just look at it as bureaucratic BS. They have to turn you

down to justify their job. Now your lawyer will do his job and find a

way. You may not get your new knee for Christmas, but hopefully you'll

have the approvals. I will say a prayer for you. Have a happy

Thanksgiving.

Walters wrote:

>

>

>

> I got a call from my Pain Dr's office this afternoon. They heard back

> from the claims adjuster from Dillard's finally. They had been calling

> to get approval for some time, almost 6 weeks, to authorize a knee

> specialist that the pain dr wanted to have me checked out by for DJD in

> my left knee.

>

> I have had 4 previous knee surgeries on the knee. The last three were to

> scope the knee for torn cartlidges and floating debris. The last surgery

> in 1993 also included the thinning of the entire lining of the left

> knee. The doctor then told me that the next surgery would have to be a

> total knee replacement as there was little or nothing left to do with

> conventional surgery.

>

> Well in their infinite wisdom they have declined to authorize me to be

> seen by the knee specialist. Their rational is that I have had previous

> knee problems and they have nothing to do with the Workers Comp claim on

> my back. I guess they can't or do not bother to read or this would not

> have happened.

>

> It is well documented by both the Pain Doctor and IME that since

> beginning treatment with them that the change in my gait to a limp due

> to my back has caused additional stress and strain to the knee joint. I

> have continued to complain and they have continued to documents this in

> their reports. I was first given a perscription for a cane to help with

> my walking. As time has gone by the knee and back have gotten worse

> which has caused the gait and limp to worsen.

>

> So they wrote me a perscription for a walker and it was approved in a

> matter of days. Here again the documentation shows a worsening of the

> knee, the hip the back and a inability to get around without a walking

> aid.

>

> Today they authorized the Aquatics therapy, but declined the knee

> checkup. I was devestated as was my atty. He has decided that we will no

> longer take a civil approach to this and I have given him the green

> light to hurt them however he can for as much as he can. They filed

> something with the court today that I went by the office and signed

> today.

>

> This is to clarify with the judge that my Pain Dr was chosen by the IME

> to be the dr for the court and what ever he said was supposed to be

> done. However they will drag their feet until the very end and will

> authorize the treatment just days before we go before the judge. Then

> the hearing is moot and the fact that my Dr is this person selected by

> the court is never fully discussed. This next hearing which is supposed

> to be next week I believe will cover this issue and force them,

> hopefully, to approve these treatments. If not then they are open to

> further litigation. This is all been told to me 2nd hand so I am not

> 100% certain of it's accuracy but hope it is true and works out.

>

> I was totally devistated when I got the news on my knee today. I was out

> trying to do my morning 2 mile walk and got the call. I was already in a

> great deal of pain and the anger and frustration pushed it through the

> roof. I have slept so poorly the last 2 nights from the pain. I tried

> increasing my walks to 2 miles twice a day as per the IME. However my

> body could not tolerate it and my pain level was so high that the pain

> meds did little to even take the edge off. That has been 2 weeks ago and

> it is still a fight. I see the IME next week and the Pain Dr the

> following week. I hope something breaks in the mean time or I may very

> well loose control of my depression again.

>

> Please help with a little prayer and some positive vibes this weekend we

> give thanks for so much in our lives. Even though this has happened, I

> still have much to thankful for. My friends and their kindness and

> support online here. My prayers are with you and I ask God to bless you

> and your familys. Be safe if you are traveling and may he watch over us

> all and keep us safe and free of the pain.

>

> Your friend in pain,

>

>

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