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Having medico-legal assessments



  • It's too bad you can't pick your Doctor when they're doing a claim. I taped my meeting with the Insurance who came to my house just in case because there's no witnesses. That must be difficult to go back there but know he's wrong in his first assessment as your Heart Specialist is just that. It's good your husband is going with you. I hope everything goes well this time. Seding positive thoughts this will be in your favor. 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
  • I am glad hubby will be there. It will also be good for him to see a bit of what hoops i'm made to jump through with this claim. I can't guarantee that he won't rip the doctors head off his shoulders though :)
  • SpineAZSpineAZ WiscPosts: 1,084
    What type of insurance company is doing this? Health Insurance? Disability Insurance?

    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • it's called Compulsory Third Party insurace. I injured my back from a car accident, the insurance company insists that my problems were pre-existing and have not paid for a cent of my medical bills. The whole problem is that I had a sacro-iliac/neurological problem before the accident but my GP had just written lower back in his notes. He didn't know that he would have to differentiate between two separate areas at the time. So the Insurance company have latched onto that and it's been absolute hell trying to get them to understand that ever since.
    Any way that's my whinge for the day :)
    The appts went ok, I was having an extremely bad day with pain that day, so they definitely saw me at good time. As alway they could not elicit any reflex my my knees.
    won't know what they think for a few months so it's just a waiting game now.
  • SpineAZSpineAZ WiscPosts: 1,084
    Yep, that is tough. I have a private disability policy to supplement the one from my employer. They excluded my lower spine since I had L4-S1 problems prior so they'd be pre-ex. If only I'd had them specify levels then this current L3-L4 treatment might not be pre-existing in their eyes.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • they'd probably still fight it though.
    what level of the spine seems irrelevant to them. My other issue wasn't even part of the spine, but it makes no difference.
    We'll see.
    That's a bummer that your not covered though, it must be tough on you financially.
  • I was told by my insurance company to write a letter if I feel a doctor is lying in his report or being unprofessional. My first independant exam took place two weeks after my rotator cuff surgery. When I got there it was a store front with a few partitions for examining rooms. Walls didn't even go to the ceiling so everyone in the place heard what the doc was saying about me. He spent 20 minutes yelling at his secretary about what he was getting paid to do this exam and what he would and would not do for the money. Then he did a quick exam, wrote down the pain I was feeling and recommended that I stop seeing the surgeon who just did surgery! go figure! Two weeks later he sent a revised report saying I should have PT for a few weeks and follow up with surgeon.

    When I mentioned this to the adjuster he asked me to write a letter. He said they don't know about these problems unless someone says something. Of course when you are worried about losing benefits you are afraid to put anything in writing.
  • For this doctors first report, I wrote all over a copy of his report in red ink, correcting all his mistakes and inaccuracies, then my sol wrote a very long detailed report with all of what I had reported and sent it to the Insurance Co.'s sols.
    I believe that is why his format changed to everything being recorded and filmed.
    thanks for the advice though :)))
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