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SSDI denials, WC Settlements and PSD

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:23 AM in Back Surgery and Neck Surgery
My husband was injured on the job May 2, 2005 in California.PHYSICAL INJURIES: shattered left patella, fractured L4, L5,went initially undiagnosed. First knee surgery, attempts were made to fuse back together the patella. After 4 weeks, patella separated again in a fall when my husbands knee gave out. New surgeon (1st 1 wasn't WC approved)new technique. 6 weeks later no fusion. After 4 more surgeries and techniques, one including a bone graft from illiac crest, (and a WC lawyer was hired), we saw a 3rd Ortho(lawyer approved) who removed the patella completely, ordered mri's of the spine, WC denied. Saw a AME Dr who ordered"the works" MRI, and neuro tests, which consisted of alot of carefully placed needles. (AME was also lawyer approved) L4 L5 fracture was discovered and WC was requested for approval of fusion. If, anyone has be work injured, you know how long it takes to hear back from WC. We did lots of waiting. Now it is June 2007. Thanks to Arnold's WC reform, after 24 months, last month May 2007 we received our last WC check! As many of you probably already know, its 66% of your income which was a devastating loss to start with. Surgery was done June 4 2007. Fusion with hardware. My husband thought long and hard at this decision. It is now Sept 2008 and my husbands pain has been different if not worse after surgery. We were finally approved for hardware removal Sep 29, 2008. My husband is looking forward to less pain. I am optimistic after reading others stories of their hardware removal making a huge difference in their pain level. FINANCIAL INJURIES: readers digest version, we lost our business, due to cut in pay i.e. WC. Fortunately for us SDI kicked in, and 9 months later ran out. We were in foreclosure then and ultimately lost our house. I discovered through my husbands employee handbook, he was covered under a LTTD plan. Which now kicked in but is nominal $$$. Better than $O. My husband found a little run down mobile home in a not so pretty park, for few $$ so we bought it and moved to Oregon. We live in a very small town and a job for me at minimum wage is a 59 mile round trip. Not to mention it snows here and I am a driving weather whimp! So I am not working here, however, I do income taxes in Ca every tax season. We are separated since our son goes to school here in Oregon. I stayed with my sons family in CA last year and cannot this year, will try to find cheap room. MENTAL INJURIES: Since my husband is already bi polar, the love for his job, he drove a cement mixer, was a replacement for drugs. He was happy and no longer needed medication. You guessed it, until this devastating injury.WC ordered him to a Psyc eval which declared him mentally unable to work. This will help our SSDI since we were denied. We do have SSDI lawyers, but I dont like them and may switch. I dont think they are updating Dr visits to SSDI.Which brings me to permanent and stationary disability.What on earth is my husband supposed to do for a living now? he will never be able to drive another truck. And no offense to him, he's not a rocket scientist. Anyone have trouble with SSDI? Or life after PSD? I would love any advice. Thanks for listening.


  • I am not sure what ssdi is-I have complete disability SSD and I get medical (FULL paid-NO copays even!) and monetary benefits. It took me 3 years of trying to get it-the declared me "disabled" the 2nd time I applied but argued that my "date of last insured" ran out BEFORE I became disabled. I was a stay at home mom. I hired an attorney and he proved by my records that I was disabled before that time period ran out-the court ruled in my favor and even went BACK 4 years-instead of just the 3 I had been waiting for. Your situation sounds pretty harsh-my heart goes out to you!! I will keep you in my prayers!
  • There's stuff that you can do after being denied in an appeal case to have a new case started or to improve your chances of winning the next case. If you don't like your lawyer, by all means, get a new one, there are good ones and bad ones out there. Research on the internet and learn about disability appeals and stuff like that. If you are informed about how to win an appeal then you'll know if your lawyer is a good one.

    If you've just been denied in an appeal hearing, you can request a copy of the tape of the hearing and if it's a bad copy or it's missing then they automatically have to redo the case, as there is no record of the original case and so there's no way for them to accurately judge if the case was valid or not. They talk about this over at disabilityappeal.com.

    If your lawyers have been poor ones then there's a good chance that if you find a good one you'll have a much stronger case. Good luck, I hope it works out and you guys get the benefits you need.
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