Doctors can't fix wrist injury?
I am writing for my son (25 years old) who was injured at work on 25 February 2013 in Oregon. His wrist was slit by some metal (he's a metal fab guy). He has gone through major surgery to reconnect tendons and such, and physical therapy (2-3 months) but is still having a lot of pain. When he rotates his wrist, there is an awful pop and a very unusual motion to his wrist (it was hard to watch).
He has seen three doctors in his area, including the original doctor, about the movement issue and none of them have any answers as to why his wrist behaves this way. He even talked with the PT person and it was minimized. One Dr’s solution was that after the wrist makes the weird motion, it’s in the proper position and to put a cast on it for 6 weeks. The Dr. said that may or may not work.
My sister works at Oregon Health and Science University (OHSU) and I advised my son to contact her for the name of an MD who specializes in his type of injury. He relayed the desire to visit the other doctor, by name at OHSU, to the Workman’s Comp (WC) representative. The WC representative told my son he will have to see a doctor within their pool of doctors.
The reason I advised him to seek a specialist out of town is that I’m concerned about the “good ‘ol boy” network in his area. I believe the original doctor that performed the surgery botched it, and the other doctors don’t want to contradict his work. He has received under $1,000 from WC for lost wages (from what he remembers).
What can he do to get the treatment he needs? Is there a way to get around workers compensation? How can we get WC to allow him to see another doctor that can actually fix his problem? Any suggestions would be great, thanks.
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ANSWER for "Doctors can't fix wrist injury?":
Sheila (Suitland, MD):
In most cases a Maryland injured worker is restricted to treatment by doctors who have been approved by the workers compensation insurance company. That doesn't mean your son can't seek medical treatment from an independent doctor not on the insurance company's approved list. As you well know, your son's health is paramount.
Your allegation that there's a "good ol'boy" network of doctors may not be too far from the truth. This type of network is not limited to doctors in your area. Doctors all over the country are always hesitant to criticize other doctors. The same holds for attorneys and other professionals.
If your son seeks medical treatment from a doctor outside the workers comp insurance company's network, and that treatment confirms your son's injury and required treatment, the insurance company may accept that treatment as necessary. If so, they may decide to pay. An alternate action would be to seek representation from a workers compensation attorney. An experienced attorney may be able to convince the insurance company to permit your son to seek independent medical treatment.
Often insurance companies change their minds when attorneys become involved. Most insurance companies would rather modify their positions rather than enter into a contested hearing. In your son's case, retaining a workers compensation attorney may be your best course of action.
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.
Best of luck,
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