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Opioids crisis fall out

   It's been several months since I've been active on this board. I had alot of personal things going on. A cancer scare with my daughter. I've only mentioned a few times that my husband died of colon cancer first dx when he was 38. When my daughter age 36 started bleeding it was like history repeating itself. Ends up it's not cancer but she does have a congenital condition venus malformation and I am also dealing with mounting stress from worker comp .

   First off..I'm not looking for sympathy..I guess it more or less a warning for all those yet affected by the opioid crisis about the destruction of many innocent people lives as well as their health.

  Unless you've been affected the true volume of what they are doing cant be felt only imagine. I know from seeing post I'm not the only one..but I am about to share a little of how its affecting me personally. 

  I've spoken to a few on this forum about my struggles..some have been very supportive even though deep down I'm sure their thinking good god... I myself have tried to be supportive even when I really had very little strength to do so... 

  My nightmare started in June of 2017. I had been seeing my ex PM for 14 years.  I was always compliant and I fully trusted him ( LESSON LEARNED) never put your full trust in any doctor. When push come to shove you will be the one that loses...at that appointment I was told I had to wean down due to the insurance company request as well as the CDC guidelines. So we weaned month by month..and as that happened my pain went higher and higher. Ofcourse for awhile they told me it was just a reaction to being lower . Back in April my ex PM closed down so I had to find new ones..first thing they did is lower my meds even more. I also had recently moved so had to find a new primary care doctor so basically starting over with all of them  and we are all still learning to trust each other. In today's environment that wasnt good.

   I'll admit I've grown timid scared to speak up ..I've been trying to let both my new PMS ( there's 2 of them) and my primary know I'm not doing well pain wise and other wise only to be repeatedly told sorry nothing we can do our hands are tied ( LIE)..I have fought months and months with my wc insurance company to be seen by my spine specialist..they kept refusing..why cause in their eyes I was just trying to get more pain meds..their exact words..do you know how hard it is to be treated like that ? And still manage to hold your head high ? So what did they do..cut my PM off..I finally got the approval to see my spine specialist..the insurance company allowed it cause they thought it would show nothing and prove I really didnt need pm... wrong..it proved I do have major issues and surgery is recommended to extend my c4-7 fusion two more levels making it c3-t1..I'm still fighting them though to reinstate my pm..how they are handling it is so outrageous and childish.  They aren't acknowledging request by not returning call or emails. (Shaking my head) so right now the cost of my PM for my wc injury ( neck ) and medication are on me because it is wc so my health insurance wont pay..so the nightmare continues .this is a old wc case so yes I have a lawyer who are all but useless..its all about $$$ since it's a old case the lawyer wont make much so that spells wont do much..really I just wish a Medicare set a side would happen..they can go their happy way and I'll go mine.

  Now along with that is how hard it is to get my new primary to listen which doesn't help that I now feel I need to be so careful what I say in fear again being labeled a drug seeker..

   During the time all this colon issue was going on with my daughter in Nov/dec I started have extreme lack of appetite. I figured stress ofcourse was causing it. Right after xmas I notice a strange bump on the top of my shoulder. Right were your clavicle meets your shoulder joint. I knew my shoulder had been bothering but I figured it was being caused by my neck issues. So the bump was something new so I went to my primary to figure out what it maybe..right off the bat they remind me  I wouldn't be given any pain meds..hello duh I know that..I was told oh it's a bone spur put ice and heat on it..so I've been calling it my unicorn horn this past month.  Yesterday I had a follow up with 1 of my pms..she the one that caring for my non wc problems of si joint dysfunction. So I thought Id show her it..hoping maybe I could get a cortisone injection to help with the discomfort. She was sitting across the room when I pulled my arm/shoulder out to show her. She jumped up..came over took her hand turned sideways on the top of my shoulder and said..that little bump your feeling is only part of the tumor that's growing there..and she took my hand showing me from were her hand was going towards my neck that it was larger then I thought. Tumor ?..so now I have to see a orthopedic surgeon for a biopsy  and even more fun was this pass week my legs broke out in red blotches so I showed her those...oh she says your platelet are low...wth... so now Tues I have a appointment to see my primary for bloodwork..

   What I'm mainly getting at is..since this so called opioids crisis my healthcare has all but gone to crap..I cant seem to get proper health care everything always goes back to me seeking or wanting more drug which I've never done or even asked for  but that doesn't matter...when I went to my primary about the shoulder thats all the pa focus on..not properly dxing my shoulder..I should get the same care when presenting myself to a doctor then anyone else..my money is the same as other that aren't chronic pain suffers.. My daughter told me something that made sense of all of this...chronic pain suffer are now considered a liability and a threat to doctors and their practices..see what our lovely government has done..doctors fear us..they dont want us around in fear of getting in trouble...



  • L4_L5LL4_L5 Posts: 1,421
    edited 02/02/2019 - 6:32 PM

    I see a worker’s comp. doctor every month who prescribes opioids and other medications for me and worker’s comp. pays 100% for these medications.

    Worker’s comp. also pays 100% for my monthly office visits to the WC doctor.

    Are you saying WC is not paying for your office visits or medications?

    That’s something I would take up with your lawyer.

    You may need to get more aggressive with your lawyer if things aren’t getting done properly.

    Don’t be shy. The lawyer is working for you.

  • nutcase007nnutcase007 United StatesPosts: 877

    @L4_L5 - Count yourself lucky that you are in a state that defends the case for the wc victim.  Many states treat wc patients worse than private insurance companies.  I've been lucky that my case could not be classified as wc, because it was so old that statute of limitations had long run out.    

    Do your due diligence, trust you know your body and question everything if it does not fit.  Advocate for yourself and you will be surprised what will be revealed trusting your body and instinct.

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  • MikethepikeMMikethepike MIchiganPosts: 654

    Boo how much medication were you on? 

  • L4/5

      Up until 2017 I was just like you. I never had issues everything was smooth.

      Yes l4/5 I meant both medication and office visits.

      I have message a couple time with emt (kevin) on this board we both have the same insurance company handling our worker comp. 

      I  have a lawyer for what good they are is another thing...I had a really good one from 2002-2008 then she retired. I went without one from 2008- 2013 it wasnt until I went out on ssdi that I got another one...they are less motivated to help because of $$$$. The big money already been made during my 2006 rating...if I could find a another one that would be great but all the ones I've spoken too aren't interested again $$$$ atleast they are honest and tell me up front the reason. Each new lawyer that gets involved has to split what they receive with any past lawyer so on and so forth...believe me I never thought I'd be in this nightmare. 

      I threw my hands up this past week and said uncle..I handed everything over to my son in law to handle for me I'm at my breaking point. He works as a adjuster for a large insurance company so he deals with lawyer and other adjuster everyday...hes even referred some of his questions to his friends at work that do worker comp claims . I'm having him deal with my lawyers that cant seem to give a straight answer.  First they said yes the insurance company can cut me off..now they are saying they cant...I want him around to protect me..


  • L4_L5LL4_L5 Posts: 1,421
    edited 02/03/2019 - 8:58 PM

    Have you had any gaps in treatment?

    It’s my understanding that as long as you go once a month to the WC doctor they’ll keep paying the bills as long as there’s evidence you have a chronic condition.

    My only guess as to why what happened happened is due to a lapse or gap in treatment.

    The WC doctor tells me not to miss any appointments as long as I’m still struggling and in pain. 

    So far I haven’t missed any appmts.

    Is your impairment rating pretty high? Like over 25%?

    I’m just asking because you mentioned something about a rating in 2006. I’m assuming you mean some type of PPD or lump sum settlement but I could be wrong.

    My first WC doctor was not good. I wasn’t getting anywhere. It wasn’t until I contacted a lawyer and the lawyer gave me the name and number of my current WC doctor.

    When I called the number the lawyer gave me the girl on the other end of the phone line said with an incredulous voice “where did you hear about us?” 

    She seemed very surprised I knew they even existed. This just shows you that the lawyers know where all the best doctors for WC patients are.

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  • Teresa your absence has been noticed. I pray you get the best care you can and this ends up positive for you.  You seem very strong at heart and that is where it matters.  Hope you keep us updated and that the pm/pcp/insurance bozos come around and see your health is more important than anything else that’s driving them.  Isn’t that what medical professionals are supposed to do, provide care to those that truly need it, with whatever means they can? Those should be strong enough to know when opiates help and when they don’t.  I can’t believe your care givers are so lame, but don’t give up, keep searching there is an advocate for you in your near future.   I have made some albeit expensive out of pocket progress with MM (MC) in the past few months.  It’s not perfect, it’s not regular, but it’s getting more reliable than at first when we talked about it and you had some negative experiences.    Stay positive and it will help.   ;)

    L3-S1 ALIF Feb 2018 and 

    L3-S1 PLIF Laminectomy and Fusion March 2018

  • L4

         No gaps in treatment.  I've been seen by either my ex or new PM monthly since 2005 so no extended gaps.

     Yes l4 I had my ppd hearing in 2006 and given 68% and lifetime medical . Like I said everything was smooth till ...the first hint something was up was fall of 2016 when I got a notice for my first ime in 10 yrs..then in June 2017 everything exploded.

       Joel thank you...I'm glad to hear your adventures with mm are doing better...Delaware program still sucks. MM has been rather hard to get as of lately..they seem only to carry now 1 or 2 night time blends. Still no edibles To me Delaware really needs to get their act together.


  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 330

    The US government provides the funding for the Legal Services Corporation (LSC) and it gives grants to legal aid organizations throughout the USA. These organizations provide qualified individuals with pro bono civil law support -  I don't know if that includes WC. From your writing, you sound like you might qualify for their assistance. Look for a legal aid society or group near you. If you cannot locate one near you can do an internet search for LSC in Washington, DC. Hopefully they can help you with your WC. Good luck!

  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 330

    boo, I sent you a PM with more info.

  • Thank you Jerome 

       I finally got reinstated yesterday to see my pm I have a appointment now on Feb 22... I've not been allowed to see him since early dec.

      Reasons I was given yesterday were..Jan was denied because of a pending hearing which never happened  they decided to allow me to see my spine specialist 1 day before the hearing..Feb was denied because everyone was waiting on his report. I had  a appointment on the 6th I had to cancel  to see my pm. Now that the reports in everyone is scrambling 

       When I first posted this I knew some on here would be confused so I've tried to explain the best I can.

      Thank God I am a strong cookie though I am wearing down some... I know alot of people that haven't been affected dont fully understand why or how all this is happening...All I can say to everyone that's not been affected...count your blessing but prepare for the worse...in time you too could be hit ...prepare by accepting the fact that the use of opioids are slowly going away...explore alternative option with a open mind...Which I have done but with no success because of ongoing spine issues that need surgical treatment. Years from now when people look back to these times they will see the injustice. 

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