I injured my back at work on August 13th, 2012. I waited about 2 hours with pain radiating down my leg into my feet, then I called our HR person as my supervisor was out of town. I reported the injury and went to a Care Now facility. Big Mistake! The doctor who saw me there did everything but call me a liar for faking an injury. I returned to work the next day and informed my HR person that I wanted to see a different doctor which was ok’d by the insurance adjuster.
I went to a local Orthopedic Clinic and started seeing my new treating doctor who referred me to another doctor at the same clinic who specializes in spine surgery. Needless to say every procedure my treating doctor asked for was denied. All my paperwork from the workers comp insurance company said Sprained / Strained back. They would not accept the herniated disc at L3/4 diagnosis.
I had 2 fusions in 2003 at L4/5 and L5-S1 which complicated the matter even further. So I hired an attorney. He got me an appointment with a state designated doctor who found that the injury caused the ID disorder at L3/4 but not my Radiculopathy, which the EMG tech diagnosed as coming from L5.
After 16 months and 8 denials later I became very angry, depressed and my pain was worse than ever. My surgeon tried to get me a less invasive surgery approved but it meant I would have to have a Myelogram. The Myelogram got cancelled because I could not get off one of the meds I was on. So after trying twice to get me a Myelogram and another EMG it was cancelled by the doctor because he feared not getting paid by WC.
I received a letter last week from the Orthopedic Clinic stating I was being dropped due to my behavior and interfering with the clinic’s ability to get me treatment. Now I have no treating doctor, no surgeon and don’t know what to do.
My question among many that I have is, if I need to go the ER will the ER doctor become my new treating doctor? Or will he refer to another doctor after I’m discharged? Can I force workers comp to give me the proper treatment? How can I get a doctor to give me the procedures that I need? Thank you.
Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.
It’s difficult to understand how you are sure you sustained a herniated disc at L3/4 when all procedures were denied. Absent an MRI or CT Scan confirming your herniated disk, the discovery of the herniated disk is difficult to understand.
You refer to a letter from the Orthopedic Clinic dropping you due to your “…behavior and interfering with the clinic’s ability to get (you) treatment.” Unfortunately, you fail to elaborate on the facts made the basis of the Clinic’s decision.
You certainly can go to the ER, but it is doubtful workers compensation will pay the costs. Under the rather complex and disjointed set of facts you present you may want to seek the advice and counsel of an experienced workers compensation attorney and let her sort this matter out. Most won’t charge for an initial office consultation. Unfortunately, your attorney will now be up against not only the workers compe insurance company, but the Orthopedic Clinic as well.
Learn more here: The Truth About Independent Medical Exams
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.
Best of luck with your claim,
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