Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Worker comp Insurance, is it really ment to help us or make our lives a living hell??

bailey1bbailey1 Posts: 25
edited 06/11/2012 - 8:33 AM in Health Insurance Issues

Where to start, Well I injured myself back in 2006. Then the nightmare began. I never would have though in all my life I would have ended up in this situation. After I hurt myself with the company I was with for almost 4 years being one of the best employes they ever had. they treated me like I was scum of the earth. after about 3 months of trying to contact my work comp adjuster, I finally got the answer I was waiting for.. they are denying my case.. well I had to call a lawyer at that time and the rest is more or less history to me. but I did want to let those of u know if u have just hurt yourself on the job be ready for a world of stress and anxiety if u have never experienced depression before be ready for that as well.Sense this ordeal I had had to to to court about 6 times.. first was for back pay and to make them start paying that's a given.. second was to just see a neurosurgeon. third was to get approval just for stupid therapy fourth was for pay again because they decided they didn't want to pay me anymore out of the blue.. fifth was for medication because they felt, that because I had a history of depression back in 2001 they should be liable for my new depression problems. but little did they know I was on depression medication then due to my mom passing at the time boy did they feel like idiots when I mentioned that one.. u should have seen there lawyers face..Well the judge sided with me and said that I'm to young for this and they must approve my medication.. And now here is the recent one.. I'm trying to get approval for a psych eval to see if I am able to have the SCS-Spinal Cord Stimulator trial period and such.. after 2 weeks of my pm doc calling and calling my adjuster she finally talked to her and there telling her it could take over a month or so just to get approval.. And lets not forget all the times I didn't have to go to court because they will wait until a day or so before the hearing and approve simple stuff..WHY IS THIS??? I want to know why companies pay worker comp if all they do is cause more problems than good??? Why should we as employees suffer while work comp fills there pockets with the money our employer pays them each month. and all they wanna do is deny deny deny. There should be laws against such events to take place. as long as a person with no history of back issues injured themselves on the job causing major damage and an MRI shows that. and everyone knows that the job u had was very on hands where u had to do heavy lifting bending all day for 4 years with no problems how could they try to deny? I know I'm venting but I just want to give those of u a heads up on what to be expecting. The will try to settle first.. NEVER NEVER SETTLE until a Doctor says there is nothing more he/she can do for u. if ur like me I'm not in it for money I want my back fixed so I am able to return to work some day.. I could care less about money.. money doesn't last a life time it comes and goes. But just take my word if ur willing to go the entire distance like I am.. be ready for a fight.. it's up to u to stay on top of your lawyers and make sure they are working hard for u so ur not left in the cold. If anyone of u that reads this has any more questions please feel free to ask.. I'm no expect on work comp laws in all the states.. but I know enough to get by on. and in most states they are close to the same.. so please feel free to ask questions..

L2-L3 L3-L4 2mm bulge
L4-L5 Spinal fusion March 2008
Continued pain in low back.. Burning sensation into my buttock and down my right leg..
Sever depression, anxiety, stress brought on by life changing event.. common.. grrrr


  • I hear u ! Work Comp sucks ! The one comment or question I have is.. I live in CA and it seems that lawyers do not want to talk to u until after QME is this true for folks out there ? Where before when wife was on comp before law changes she retained lawyer from the very start of her claim... Anyway I was a SUPERSTAR with top company now since injury I have been moved around lost bonus pay of 10,000 yr. etc, and the list goes on... docs,family,work, RXs ... I dug reading your post as I can totally relate !
    Take - Care !
  • In most cases Lawyers actualy want to u try and see if u can get by without them. there only to help if work comp is trying to deny ur injury.I'm not to sure about the bonus thing. as long as they didn't cut your normal pay nothing much can be done. as Bonus is just that.. bonus! But if u start having trouble with work comp and they are being an ass u might wanna get a lawyer. I know for me I waited abotu 3 months. but by then nothing had been done period. they gave me the run around the entire time. I guess taking time to dig up any dirt and see if u have had any previous injury. Hope this helps...

    O a quick recap.. lawyers might be wanting to wait until u have had maybe an MRI CT done to see if ur injury might need surgery.. cause once that happens then the fight is on in most cases.. they will try to settle quick.. but time for lawyer as soon as they start giving problems. they wouldn't want to waste there time if u just have simple strain or something..

    good luck with your case if it goes that far... just remember never settle until ur happy or the doc releases u 100% or says ur disabled. those quick payouts wont cover medical cost long. and if u have to have surgery then ur screwed.
  • I assume you are from US but not necessary as some insurance companies are more ethical and reasonable than others and with global businesses enough said.

    Sounds like the 1997 Film "The Rainmaker" (based book by John Grisham) where the insurance company denied every claim. Maybe you should rent it (but if had not won already may have taken the insurance companies accusation to the claimant that they must be "Stupid, Stupid, Stupid" if expect to be paid as well as the conclusion may be demoralizing) and look on the bright side (you didn't die before winning).

    I read an article from Harvard Business School that an estimated 40% (think that was it from memory) of medical costs in US are due to legal and admin costs instead of providing the service (you may have just validated that estimate to be realistic for me).

    Glad you got justice (but doubt it covered the true costs to your health from slowing diagnostic and recovery). Did you just get the bills paid or were they also fined and damages awarded or no penalty (hide the legal costs as a cost of business) and no lesson learned (i.e. do same to next poor person)?

    Kind Regards
  • ok u had me lost there for a moment... was having hard time understanding ur post... please forgive me as my medications make my brain slow to reading.. had to read several times before I understood some of that.I get what ur saying now... all my medical bills are being paid for by work comp I haven't paid anything.. I have recieved a few bills but I sent in to my lawyer for them to take care of.

    No settlement just yet.. I still have lots of back pain and im not going to settle until I can get my back fixed to where I can go back to work some how.

    and no, no amount of money will cover the pain depression and stress I have gone through while dealing with this company.. my life has changed so much i can't begin to describe how I feel and what it has done to my life. I wouldn't wish this on anyone no matter what...
  • I don't know if I was predisposed to contracting RSD, But, when I got surgery, six months after I!!! knew I needed it, it crashed my symp. nerv, sys.
    Now, instead of work, I dream of an amputation.
    In fact, Wa WC just accepted RSD after fighting on my own for over two years. Got a lawyer, and my conditionss,sss are covered now. Labor and Ind., apperantly had no established protocol for RSD, until atty. suggested they adopt one.
    I have heard from plumbers, mainly, that if they deny a lot of people in the summer, ALOT of them go back to work...in pain...for X-mas!
    I think I am as bad off as can be, and all due to not being listened to. Frustrating\/
    My settlement will never make me better; yet, it may improve my "dirt poor in pure pain" position.
    Would settle for only hell, if it had a nicer view!!!
    Good luck all.
  • What hurt's people with legitimate claims are the people who stub their toe and sue for millions. When I was going through rehab after my fusion, there was a lady going through for knee pain. She continually moaned and groaned that she was unhappy with her employer because they wanted her back to work. Everytime the PT touched her knee she put on a good show. I say that because I saw her later in the day running around jumping in and out of her jeep having a big time. Can't imagine why her boss wanted her back at work?!?!

    Each state is a little different (or a lot). In my state, I found out if you learn the law yourself, go to all your appointments and comply with all the treatment, WC didn't throw up any roadblocks.

    Also, if you are having problems with WC, see if your state has a Department of Labor Ombudsman who can advise you of what the law really means. They can't represent you in court, but they can tell you what to watch for. The rules are a little different if you have already hired an attorney. Thankfully, I was able to get through the entire claim process and settlement without having to hire a lawyer. I got a pretty good settlement amount plus they are on the hook for the rest of my life for medical treatment.

    I'm still able to work, so I haven't had to get into the whole SSD process. I hope that I'm able to keep working so that I don't have to do that. But I do have to say it sucks going to work in pain. I guess only time will tell...
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • I agree. Those few fakers have ruined the system for everyone else. And what work comp pays out to hassle us probably is more money than if they just paid for our treatment in the first place.
  • I so agree that the fakers have put a might wrench in the system and it is locked. I actually feel the work comp system is set up in most cases to handle minor injuries and it more than likely works. However, should you have a injury that is going to require say major medical and lasting medical most aren't going to be able to wait the system out. In the state I live the state web site as set it up saying you don't need a attorney and how you can get through on you own. If you have a serious injury the Judges themselves will recommend seeking legal advice. In fact the initial paper work that is sent out on certain claims a neck or head injury it tells you to seek legal advice as well. Not sure of the rational of that, but I would suspect it is so you get the proper medical attention.

    In my state you aren't at liberty to seek your own doctors. You must use their doctors and if you choose not to, loose your rights to any and all benefits. You have the right to change doctors once and if you pick wrong, your in trouble. That is more than likely the most important thing to know about work comp. The money and or settlement amount is arbitrary when you are speaking in terms of the rest of your life. Depending on your end result following surgery, not sure if I would gamble with that.

    At my age realistically and statistically I have more good years behind me than in front of me. So what I am loosing at this point is crucial to the success of securing my future. So If you have lost your employment due to your injury, as I have(perfectly legal in my state), the statistics of you making back up that ground are very low. Certainly no one can say what the future holds for anyone, but you have to have a basis to work from and trends and statistics are the only facts that can be used. I guess my point is you have to look at the big picture and no little amount of money is going to undo what has been done, depending on what your medical situation is with relationship to being able to work.
  • I am currently on workers comp and my adjuster has been AWESOME!!! She keeps the ball rolling for me and gets things approved in a timely manner. I fell on 3/19/09 seen the WC doctor on 3/24 (due to the weekend) had an MRI done right away, sent to NS, had ESI, requested a second opinion- Approve in less then 30 minutes- had a nerve block and was sent to the BEST PT in OKC, I have a top notch NS who was choosen by my adjuster. Yes sometimes I am impatient but reading a lot of threads on here, I can count myself blessed that I have an adjuster who cares and NS who has my best interest in mind. Best of luck to all of you who are on a WC roller coaster hell ride!

  • I have been going through W/c for two years know, I had a continous injury which I filed with a Lawyer, Thank God I got a Lawyer when I did. I filed for W/c and two days later they fired me, so for me getting a Lawyer saved me.
    What is funny is last year 2008 march I had L4/5 fusion and things started out ok, but within months some pain gradually, and eventually more pain, and Know I am in between either MRI, Surgery or Bone Stimulater if there is no new injury.

    My Question though is they have scheduled me for an Exam with AME all the sudden, I didn't know if anyone knew what they do in these exams, as I have to go to California for it and then I am leaving to head home right after. I was just wondering what they do, is it long apointment or is each Dr. just different. I imagine I will not get anything but my meds until they the Insurance get the Results from the AME, maybe MRI but probably no surgery or stimulater.
Sign In or Register to comment.