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Rehab Therapist who works for Insurance company coming over

charryccharry Posts: 5,657
edited 06/11/2012 - 8:34 AM in Health Insurance Issues
The Rehab Therapist who works for the Insurance company is coming over next week as they were concerned my Dr. said I may never be able to work again. Has this ever happened to someone? Where the Rehab Therapist comes over to assess your abilities at home. Thanks if you can help. Charry
DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN


  • Of course, they don't want to have to keep paying you. They want you to work, whether it is counting paperclips or stuffing envelopes. They dont care how bad off you are, you are costing them money. I hope you dont take this as scarastic, because it is not meant to be that way. Wish you the best, and stick to your guns, and listen to YOUR DOC.
  • hi charry
    ive read lots of your posts.
    if this is workmans comp do you have a lawyer?
    if so i'd get some advice
    also schedule it for time of day you are worst

  • It's not WC it's Insurance through my work benefits Long term disability. Thanks Needneckfixed. I know they want to get me back to work by February at which it's been 2 years and I lose my job. Maybe they're going to try some rehab excercises. I can't barely stand for 3 minutes or walk too far without the walker or cane without resting. My back hurts 24/7 I can't imagine how I'll get back to work not being able to sit stand walk or lift. I love my job but can't go back with narcotics and I'm due for another MRI for more pain futher up my back. I'll let you know how it goes. Thanks. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Is it an actual licensed therapist or a nurse case manager? I would never let a nurse case manager in my home.

    I agree with Pete, you might want a free atty consult. Lots of atty's do free initial consults for whatever problem.

    In my opinion, it is important to be consistent in your efforts and show that you are trying to cooperate. Don't "suck it up" and just do the tests, do what you can and let them know it hurts, if it makes you cry, don't try to hide it. If they try to make you do something that is beyond your abilities, tell them your dr has not authorized you to do that task. Show them what accommodations you have had to make in your home(i.e. if you have to sleep in first floor instead of 2nd, if you sleep on couch with heating pad, leave it out, if you use a reacher/grabber tool use it, don't clean your house for them, they need to see how it usually is and get the real picture.)

    I know these are all common sense things and you are a smart cookie, but these are things in my personal opinion people should make sure they show. Some folks come into dr appts complaining of pain but hair is fixed, make-up perfect, high heels, etc. I know some feel that a professional is seeing them and they are trying to look professional, but is that what they are able to do on a daily basis? They need a real picture of what your life is like. I'm not saying exaggerate anything, but some folks clean up for company because they're embarrassed of what their house looks like-she needs to see what your house really looks like.

    Also, I would get her number and call her the next day to let her know how you feel the next day after the exercises or whatever you have to do. She might include that in her report. And by all means, if she "threatens" to cut off your benefits because you say a particular test is out of your restrictions, report her. If you are pressured into doing something and it causes a flare-up, PLEASE see your doc as soon as possible(even if ER) to make sure you OK and to document.

    Would like to hear how this turns out.
  • dilaurodilauro ConnecticutPosts: 9,846
    I've heard about this many times. Working for IBM, all I needed for Short Term Disability was for my doctor to complete a form, indicating my current situation, including medications and a recommendation in terms of work force.
    STD is maxed at 90 days, and if you need more time, another form from the doctor would be required.
    In the past 4 years I have been on 7 STDs.
    After the last one, the HR department requested that I apply for Long Term Disability. During the STD time period, I am still considered a full time employee, earning vacation days, etc. Plus from the business side
    in terms of benefits, headcount, etc it doesnt matter.
    BUT in reality, the group that you work with has more work put on their shoulders.
    Now in Long Term Disability. I would be removed from the department headcount (so they could hire a new person). So the Department wants the LTD, since its the benefits package that is paying you.

    One of the requirements for an approved LTD is having several examinations determined by the business. So you really have to oblige. They are looking to determine if you could still perform your tasks given your medical situation. Two examinations would come from a traveling Nurse.
    I was quite surprised at what these traveling nurses can do at your house. The home exam combined the tests that they perform and the information you provide them.

    I would be totally cooperative and not try to set something up to make your situation look worse.
    Thats only because you will normally have to go for additional examinations.

    Good luck next week

    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Hi Ron, good info. Can you expand upon the tests that the nurses conducted at your home?


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