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Just need to vent

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:31 AM in Health Insurance Issues
Request for pain management consult was denied.

Change in injury code from contusion of shoulder to Cervical spondylosis with myelopathy denied until an IME is done.

I live in Ohio and have a Self-Insured Employer.

Currently they are not doing any type of treatment at all other than 800 mg of Motrin and some darvocet if I choose to take them (which I really don't like to do). I can feel that things are starting to get worse. My neck hurts more, I am stumbling a bit, and right arm is weaker (I am right handed). What does a person have to do to get the treatment that is needed so they can return to work? How long can this drag on? I am only 46 and have two kids to raise. I did not put the crack in the parking lot and raise the cement 3 inches just so I could trip over it. Heck they have me on camera and I have a slew of witnesses. What more do they want from me?

Thanks for letting me vent. I am sure I will be posting in the depression forum soon as this is really wearing on me.



  • I don't have a lot of experience with workmen's comp but can understand your frustration. I always believe that they are not out to serve the employees, they're just out to penny pinch, deny claims, and cover their asses. All I can do is offer my support to you and hope that things go your way. Do you have a lawyer? You need to have one especially if they are hindering your access to treatment.
  • I totally agree with meydey. You must have an attorney. It is a real shame that it boils down to having a good attorney but it is extremely important in order to make sure that you receive proper treatment. Good luck and please keep us posted.
  • Although this is not the right way to do it. Have you requested that the insurer put in writing they are refusing you help. I am not sure what state you live in, however most states with that letter you can proceed with help under your private policy. You don't want to seek help under your private policy without stating that it is a work comp case. In most states once you say it is work comp a doctor won't treat you without the rejection letter or a approval from work comp. Also if the pain get to bad and you can't take it seek out the ER. I don't like telling people to go to the ER but if you are in myelopathy, a doctor needs to be monitoring you as well. Sounds as though your carrier wants the oppurtunity to pull your medical records for the previous 5 years to insure that you have had no treatment on the effected areas. Hippa doesn't apply to work comp. I went through a similar situation and hiring a lawyer put a end to all the bs. I gave them 6 months to do the right thing and it was clear that it wasn't going to happen. Within a week of me hiring a attorney I was on my way to surgery. Unfortunately, during the time frame incurred some additional damage that is permanent. Good luck and I hope the IME is sooner than later.
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