Am I Getting Wrong Advice from my Attorney

[lynnsy]

First how I want to begin this. If I am hurt on the job again, I will never, ever again report the injury to my employer. I will go home, call my own Health insurance carrier, make an appointment, and lie that I did the injury at home. Had I done my injury at home last March, I would have already been fixed by now, on the road to recovery, and working. Live and learn..
OK, now for my questions. I'm going to try to simplify this. I have a sevear back injury. In L-3, L-4, L-5 and S-1, ruptured disc, cracked vertebrea, degenerative bone desease, one vertebrea has been pushed out of allignment with the others, one is twisted. I have been through the mill for the past 6 months, and still am.
1. At my last office visit to the work-comp physician, she wrote on her form, "patient can only sit for 5 minutes at a time, and can only lift 5 lbs." She could see that working was out of the question. The following day I had an appointment with the surgeon (that wants to do a spinal fusion) that I had already seen before. That day he wrote out his report on his recommendations for surgery. The work-comp physician did not receive his report for about 20 days. The third day after I saw the work-comp physician, she received a proposal from my employer. She signed off on it. In this proposal they offered me a part-time position, lowered my pay. (Keep in mind the last I saw on the work-comp physicians report, I could only sit for 5 minutes at a time.) On this proposal she wrote, "patient can sit for 30 minutes at a time, then stand up for 30 minutes, sit, stand and so on. (rediculas!) So before she even saw the Surgeons recommendations, and the last I saw was "sitting for only 5 minutes", she signed off on me working. She was aware that I was in need of this surgery.

My question is: Can she do this without for-warning me that she accepted their proposal? That I am to sit for 30, stand for 30? When last I saw (and knew), was I could only sit for 5 minutes at a time. Can she do this without seeing the report from the surgeon? And can they lower my wages and hours? My attorney told me (when this proposal arrived via certified mail) not to sign it, not to worry about it. Making me think if I signed it, I agreed to the working conditions. I only signed the certified mail card. Was that misconstrued as "my signature?" Because of this, they stopped my work-comp benefits, without a warning. And is it legal for the work-comp doctor to write something totally different on the insurance companies form than what I was advised?

2. I was offered another position (dream job) with a different office during the first 2 months of being injured. I called my attorney to see if I could go on the interview, discuss my situation with them, and see if anything could be worked out. He said absolutely not. Now, my husband and I are in dire straits financially. I cannot work for those insulting wages from my employer, to top it off only part time! I have got to do something until my surgery is approved. (oh I forgot to tell you that, my surgery was denied. The insurance company thinks that spinal fusion surgery at my age (51) will mess up my back the rest of my life) Although I was told also that the spinal fusion surgery costs upward of 100k, and that's why it's not being approved. Can I get some sort of other job? Or do I have to accept what they are offering?

3. How hard would it be to get my work-comp benefits back until these idiots fix me? I have had two opinions (all through work-comp) that said I need this surgery, I have had 4 epidural cortisone injections, surgeons said "no physical therapy", due to it may injure me more, but my attorney made me do it anyway. Only three visits, and PT technicians said it was rediculas, that they could injure me more. So I have done all the "conservative" treatments.

4. I've been researching on the internet about a Spinal Laser Institute in Florida that is amazing, I have spoke to a surgeon there, and it is an invasive surgery under local anesthetic, pain gone within 5 days. Anyway it only costs around 45k. Is there anyway I could possibly get that surgery approved due to it being less expensive than the spinal fusion? And safer...

I live in Colorado.

[Mr. Knowitall]

1. If the worker's compensation doctor and your other doctors don't agree as to your restrictions, you need to try to get the doctors to work things out between themselves. Your lawyer may be able to help.

2. I don't know why your lawyer told you not to interview for the other job. Ask him.

3. Talk to your lawyer about how to get your benefits restored.

4. Ask your insurer.

[lynnsy]

I spoke to my private insurance carrier and they will take care of me! I am so excited, I only have to pay the co-pay.

And yes, I don't know why either why my attorney would tell me not to get that dream job that passed me by. (that's why I said "attorney giving me wrong advise) I'm still upset about that one getting away. I am now going to an interview today with another office, (forced to, due to finances. I'll be damned if I let all of these work-comp delay's let me lose everything. I don't care how bad it's going to hurt, I'll just have to deal with the pain as I have been for 6 months)

Now my question to you is, when I have my private insurance carrier do the surgery, will it be easy to receive my w/c benefits back during recovery and physical therapy? Or is it going to take forever as everything else does with w/c?

[aaron]

I'm still trying to figure out what your lawyer may have been thinking. Perhaps the lawyer was concerned that you would either disqualify yourself for certain benefits by demonstrating your ability to perform the new job, or that you would work long enough to reduce or end your wage loss benefits and then find yourself unable to perform. But only your lawyer can tell you what he was thinking.

If worker's compensation is disputing that the symptoms and need for surgery are work-related, unfortunately, having your health insurer step in won't change their minds. On the other hand, having covered the surgery, your health insurance may cover the physical therapy.

[deadlock]

Having experienced the WC system as a rehab consultant for the insurance companies I advise you to follow your attorney's advice.

You are going to lose the ability to negotiate a settlement if you indeed interview and obtain employment.

This is a chess game and you don't know the rules.
The company wants you off their wc payments.

Question #1 - The WC physicians work for the Bureau.
No. Your signature only represents that you received the notice.
You don't have to accept anything they propose.
When they cease your benefits you tell your attorney who knows exactly what they are doing (pressuring you to make a move).

Question #2- Stop with the dream job, it's past tense. (It only sounded like that anyway- if it was a dream it would not have been spelled (w-o-r-k)

Question #3- You will always have WC benefits, but this condition will always be considered a previous injury and will likely limit any benefits you might receive if there is extension of the injury in the future.

Question #4 - I agree with Mrknowitall.

[bugmann]

To not report a work injury would only disqualify you from benefits afforded you by the State WC law. If you should hurt yourself to the tune of total disability then your only recourse is SSDI if you have the credits or SSI. Even with WC on your side you still may need a total disability determination to persue total disability for the work injury in WC court, I would need to look up that specific under your states rules.

There is no way to say for sure you would be fixed if you avoided WC altogether, as back injuries are complicated, its not the fault of any insurance that your body has become stubborn and has not recovered.

Its clear to me that you have DDD and every patient will respond differently

The reason your employer has offered you part time work is to limit their liability in this pending claim. If you are working part time then you have a lessor claim when it comes to the permanent disability compensation part of your case, and their puppet Dr seems to say that you medically can do these tasks. Or wants to see if you can and the best way to tell if you can do these is try? You may also be able to challenge this Drs opinion with another recognized expert by WC court with a motion in WC court. I have not specially look up your states rules, but would if you were going to make a thread on this.

YES the WC Dr is within her rights as a Dr to treat you this way. There is no right to courtesy. She doesn't need to see the surgeons report to make a medical determination as to whether you can sit or stand. She is a MD or DO correct? You need to also understand that WC Drs are protected under WC law from any law suit that you may bring to her. That I am sure she is aware of.

I will need to look up your states rules but I imagine the treating WC DR needs to say you are eligible for WC Palliative care may not be covered in your state so if its not then any treatment that only treats the symptoms and not the underlining disease(DDD) is considered palliative and not covered.


Let me know if you need me to research what the law is in Colorado but I dont think you will be afforded A Florida treatment. All that is most likely the case is that you get reasonable care which to me sounds to be the case

bug

PS You may even have a bum for a lawyer there are many out there, however to know for sure we will need to thread this then I will get specifics on your states law hope to hear back??

First how I want to begin this. If I am hurt on the job again, I will never, ever again report the injury to my employer. I will go home, call my own Health insurance carrier, make an appointment, and lie that I did the injury at home. Had I done my injury at home last March, I would have already been fixed by now, on the road to recovery, and working. Live and learn..
OK, now for my questions. I'm going to try to simplify this. I have a sevear back injury. In L-3, L-4, L-5 and S-1, ruptured disc, cracked vertebrea, degenerative bone desease, one vertebrea has been pushed out of allignment with the others, one is twisted. I have been through the mill for the past 6 months, and still am.
1. At my last office visit to the work-comp physician, she wrote on her form, "patient can only sit for 5 minutes at a time, and can only lift 5 lbs." She could see that working was out of the question. The following day I had an appointment with the surgeon (that wants to do a spinal fusion) that I had already seen before. That day he wrote out his report on his recommendations for surgery. The work-comp physician did not receive his report for about 20 days. The third day after I saw the work-comp physician, she received a proposal from my employer. She signed off on it. In this proposal they offered me a part-time position, lowered my pay. (Keep in mind the last I saw on the work-comp physicians report, I could only sit for 5 minutes at a time.) On this proposal she wrote, "patient can sit for 30 minutes at a time, then stand up for 30 minutes, sit, stand and so on. (rediculas!) So before she even saw the Surgeons recommendations, and the last I saw was "sitting for only 5 minutes", she signed off on me working. She was aware that I was in need of this surgery.

My question is: Can she do this without for-warning me that she accepted their proposal? That I am to sit for 30, stand for 30? When last I saw (and knew), was I could only sit for 5 minutes at a time. Can she do this without seeing the report from the surgeon? And can they lower my wages and hours? My attorney told me (when this proposal arrived via certified mail) not to sign it, not to worry about it. Making me think if I signed it, I agreed to the working conditions. I only signed the certified mail card. Was that misconstrued as "my signature?" Because of this, they stopped my work-comp benefits, without a warning. And is it legal for the work-comp doctor to write something totally different on the insurance companies form than what I was advised?

2. I was offered another position (dream job) with a different office during the first 2 months of being injured. I called my attorney to see if I could go on the interview, discuss my situation with them, and see if anything could be worked out. He said absolutely not. Now, my husband and I are in dire straits financially. I cannot work for those insulting wages from my employer, to top it off only part time! I have got to do something until my surgery is approved. (oh I forgot to tell you that, my surgery was denied. The insurance company thinks that spinal fusion surgery at my age (51) will mess up my back the rest of my life) Although I was told also that the spinal fusion surgery costs upward of 100k, and that's why it's not being approved. Can I get some sort of other job? Or do I have to accept what they are offering?

3. How hard would it be to get my work-comp benefits back until these idiots fix me? I have had two opinions (all through work-comp) that said I need this surgery, I have had 4 epidural cortisone injections, surgeons said "no physical therapy", due to it may injure me more, but my attorney made me do it anyway. Only three visits, and PT technicians said it was rediculas, that they could injure me more. So I have done all the "conservative" treatments.

4. I've been researching on the internet about a Spinal Laser Institute in Florida that is amazing, I have spoke to a surgeon there, and it is an invasive surgery under local anesthetic, pain gone within 5 days. Anyway it only costs around 45k. Is there anyway I could possibly get that surgery approved due to it being less expensive than the spinal fusion? And safer...

I live in Colorado.

[lynnsy]

The work-comp doctor is only a "general practioner". She knows nothing about backs. When she first saw my MRI she freaked! The first words out of her mouth was "You broke your back". She also stated that I would need surgery but we're going to try conservative treatment first. She then referred me to an orthopedic surgeon. Then when he saw my MRI, he stated the same thing, that you really need surgery, but I will try epidural steroid injections first. He did four at the same appointment. After I saw him at a follow-up visit, (no improvement) he said he was going to refer me to another surgeon to see about surgery. Of course I had to go back to the WC general practioner to get this referral. I then went to one of the top orthopedic surgeons here in Denver (he is not WC) and he thought I would benefit greatly from "spinal fusion" surgery. I then had to go back to the WC doctor and tell her his findings and suggestion. She immediately set me up with a "pre-op" appointment. I went to the pre-op appointment at her office, and right in the middle of the physical pre-op, she came running in saying "we have to stop, this hasn't been approved by the insurance carrier yet". I couldn't believe it. That was the last time I saw her. So I jumped through the hoops, WC referral after referral, and all knowing I need surgery. Both orthopedic surgeons said "no physical therapy". My attorney told me to do atleast 2 anyway. I did three and it was horrible pain. The physical therapist (not work-comp but referred by WC) stated "I'm sure there's calcium building up on the crack by now, and there's not much I can do with you, I'm only going to injure you more". I got his report in writing and faxed it to my attorney. That was 2-1/2 weeks ago, and I haven't heard a word since.

Why wouldn't the insurance carrier approve my surgery? After two of their referred surgeons say it needs done. The excuse letter that I received stated, it would end up ruining me for life due to the vertebrea above, and the vertebrea below the fusion would get weak. (Surgeons want to perform a 3 vertebrea fusion) Problem is, I'm going to be in pain the rest of my life if they do absolutely nothing too!! I just don't understand...

The "general practitioner" WC doctor has put "anticipate permanant dissability" on each one of her forms to the wc insurance carrier. Then she writes on the very same forms that I can only sit for 5 minutes at a time. Then signs off on this work release to my x-employer just two days later and said I could sit for 30 minutes, stand 30 minutes. (no employer is going to put up with what I would of done, stand, sit, walk around, go home early due to pain, come in late due to pain, not be able to bend over to pick something up, etc...) I did not sign it, and did not agree with it. That's when my benefits were cut off.

I have now been 1-1/2 months without my wc benefit pay, and we are feeling it financially badly!!! I have to get a job doing something until there is a settlement, or will there be a settlement? They can't just leave me like this can they? Seems my attorney is dragging his feet. It has been 6-1/2 months now. How long will I have to wait for a settlement? Will there be enough in the settlement for me to go to Florida for this laser surgery and pay my attorney his 20%, and enough money for 6 months of re-cooperation time and physical therapy?

[lynnsy]

P.S. To Aaron; The work-comp insurance company is not disputing that this is a work related injury. I hurt my back before about 30 years ago at home, and my physician treated it with steroid pills. It was gone within a week. (They can't possibly go back 30 years can they?) Not to mention the injury was not this severe.

P.S. to Bugman; Thank you so much for clearing up what was really behind the proposal for me to work part-time and for lower wages. What a nasty game they play. It seems so wrong and should be against the law. Also I forgot to tell you that I did tell my insurance provider the truth about my injury, and they said they will take care of me regardless. I would imagine it is due to I have done all "conservative treatment", and am now at 6-1/2 months with no relief. My insurance carrier said "conservative treatment" consists of steroid injections, and PT within a 6 WEEK period. If that didn't work, then surgery.

[bugmann]

Hi Linsey, Yes some of the dirty tricks that employers and WC carries play should be against the law, but we will never see that happen. Over 35 years ago Congress voted to work on making the states laws more employee friendly. It was titled the Injured Workers Manifesto. Needless to say they have found other things to do and now in today's work climate American workers are being turned into 3rd world workers as American companies are moving their production overseas to avoid what liabilities we are to them now when we are injured at work. WC is very political.

You insurance company did give you the average scenario, but as I said earlier surgery may not be the answer, you need to work this out with a surgeon that you TRUST!!!

If I may comment on your reply to Aaron, WC is 3 fold 1) medical care for the work injury 2) TTD benefits while out of work on medical corrective care. 3) Compensation for the measurable amount of permanent disability that you are left with after all corrective care has been done. That's it!!! So you may have been injured 30 yrs ago but you were well enough to be hired and work for a length of time therefore if you are re-injured you are entitled to the WC benefits set forth by the state where you were hurt. OH yes your entire medical history is already on someone's desk, make no mistake about that 1.

I want to review Col rules and then I will reply to your lengthily post. Or if you wish we can IM and talk about this is detail either way I am comfortable?

BUG

P.S. To Aaron; The work-comp insurance company is not disputing that this is a work related injury. I hurt my back before about 30 years ago at home, and my physician treated it with steroid pills. It was gone within a week. (They can't possibly go back 30 years can they?) Not to mention the injury was not this severe.

P.S. to Bugman; Thank you so much for clearing up what was really behind the proposal for me to work part-time and for lower wages. What a nasty game they play. It seems so wrong and should be against the law. Also I forgot to tell you that I did tell my insurance provider the truth about my injury, and they said they will take care of me regardless. I would imagine it is due to I have done all "conservative treatment", and am now at 6-1/2 months with no relief. My insurance carrier said "conservative treatment" consists of steroid injections, and PT within a 6 WEEK period. If that didn't work, then surgery.

[lynnsy]

I will wait for your reply.

I do have another question for you. Due to my benefits being cut off, I am forced financially to find some sort of job. I have no other choice or I could lose my beautiful home up here in the mountains, or our vehicles, or our ATV's, or our Motorhome. I am so mad at my attorney advising me to "not sign the ridiculas proposal from my X-employer, to ignore it and everything is going to be alright". I wish he had told me my benefits were going to be cut off, that was over 2 months ago. I have been left in limbo land, not knowing what the heck is going on now. I mentioned it to my attorney about our financial situation, (we have to re-finance our home next month due to a 3 year ARM), this is really scarey stuff. I am not employed and not receiving benefits, what is this going to do to our debt to income ratio? He said to me "I don't know what to tell you". Jeez, now that made me feel better... Sorry Mr. Attorney, but I don't make 500K a year! I'm left with this pain every single day, can't pick up a pair of sox off the floor without me feeling a pain that lets me know my back is going to go out at any moment, can't stand for any length of time without shifting my weight constantly from one leg to the other, my sciatica pain shooting down each leg as I [B]try[B] to sleep. Depression and anxioty is getting worse and worse. And he says, "I don't know what to tell you?". Not to mention, "surgery denied"? I'm guessing he's working on a settlement. I don't have a clue. He doesn't communicate with me, and now he's on vacation again till next week. This makes about 3 since I hired him.

O.K. enough of that. The question is, can I get a job? I figured if it is some sort of receptionist job (not my career) I could stand up and sit down at will. Is he holding off like this and telling me not to get a job due to more money (at settlement) in his pocket? I really don't care about the settlement as long as it's enough to get me fixed and have money during recovery time. The only thing that matters to me is my health and happiness and my home. Life goes on while waiting this rediculas amount of time, I have got to move on and GET MY LIFE BACK!!! I MUST get a job!!! If my settlement is lowered due to my working, so be it. Atleast I won't lose all that matters to me.