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Work Comp IME.....confused and very upset!

CMatthewCCMatthew Posts: 49
edited 06/11/2012 - 8:36 AM in Health Insurance Issues
I had an IME on the 18th of August and just got the results back today on the 28th of September. I am confused and upset and in almost disbelief on this outcome. I was injured in a work accident on June 5th,2008. I have not worked since and haven't had much help. I had two fractured vertabrae along w/ a couple herniated discs and DDD on top of all of that which doesn't pertain to the accident, but diagnosed w/ peripheral neuropathy along with the others because of the accident. Surgery I am not a candidate for and have been in extreme pain in my right leg and lower back ever since the accident. Now i was told that I was not able to continue my treatments at the pain clinic the minute i have my IME until the report comes back. That took about 6 weeks and I feel like any progress made (which wasn't much)there was lost,due to the fact that six weeks went by with no help. I was only allowed to pick up my meds from them. Well now I got my IME back and the DR stated that I have sustained some nerve damage and I have a permanent 24lb. weight limit, and am not a candidate for surgery so I should be weened off my pain meds and put back in an office job that I am allowed to sit for 6hrs and get up and walk around as needed. Now the problem with all of this is that I am in as much pain if not more than when my accident happened and nothing has been done with a positive feedback on my recovery. I have done concrete work my whole life and am expected to find an office job that pays as much. I can't even walk a block yet or do much of anything. I guess I'm writing this because I do not understand how someone can write that I be taken back from my pain meds and thrown into job search asap when nothing has been done. How can he write that he thinks I should get back to work when I can barely get out of bed says i have nerve damage and cant lift over 24lbs but can get off my meds and get back to work. sorry i basically repeated myself but I feel like they are trying to throw in the towel. And what gets me more upset is that my case worker wrote on the report to my pain clinic DR." His last appt at the pain clinic was on Aug. 6th. Has he been discharged from therapy, if so please provide a date. It appears his only treatment consists of taking oxycontin daily" Are you kidding me!!!!! She said I ws not allowed to go there once I had my IME which was on the 18th and the week before my DR was out of town. She is trying to make it look like I was the one who asked for any of this. I did not ask to be injured and I did not ask to be put on these meds and I did not just stop going she told me too until the report comes back. She is making me look like a prescription abuser and that, that is all I show up for. I can not believe this lady or State Farm for that fact, I have not missed one appt. the year and a half I've been out of work and have gone above and beyond doing everything possible to get me back to everyday life for me and my wife and two girls who I need to be there for. I want nothing more than to get back to a job so i can get back to supporting my family and actually have a life and see some of my friends again. I have no social life and the financial part of my wife haveing to carry the load is so depressing for me as a husband and a father not to be able to do. i have never been so depressed in my life. I just want to be able to play at the park with my kids and enjoy everything we used to do. Sorry this is extremely long and i don't know if I've gotten the message out of how cruel and rude work comp can be after things go on longer than they anticipate. It makes it harder that my company closed its doors three months after i was injured so "I JUST DON'T KNOW WHAT TO DO ANYMORE, I FEEL LOST AND HOPELESS"I need help. Thanks for anyone listening to this. I Love Everyone!


  • So sorry you are depressed and I can certainly see why. I am new here and I have a"newby" question. What is IME? Perhaps you need an attorney to rep you. If nothing else someone from legal aid. I don't know... I will be praying for you. I have been in chronic pain for 8 years with sciatica. I worked full time for 4 years with it and the last 4 yrs I am working part time with it in my own business. I could not make it without my meds. I just had an MRI last week and got the reading today. all kinds of terms I don't understand but basically there are several place when disks and such are causing moderate to severe spinal and central canal stenosis, plus some other stuff like cervical spondylosis whatever that is, and end plate hypertrophy -no idea what that is... but DR says I need surgery to correct it and it should take care of the sciatica plus the numbness and tingling in my left arm! I don't even have WC to fall back on. Don't give up. I will be saying some prayers for you and that precious little one in your picture. GOD is BIGGER than any problem we can have.

  • jlrfryejjlrfrye ohioPosts: 1,111
    My advise to you is get a lawyer NOW!!!!!! IMO you will get no further without one.
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  • Cmathew,

    I can certainly appreciate your frustrations and confusions when it comes to work comp. The FCE they put you through was not to provide you with more medical care, but rather to find your permanent restrictions and release you from their care, therby making you MMI(maximum medical improvement). Now you have several options at this point and time. First do you have the records from the doctors who have treated you? If so you need to review them and see if any doctor has suggested that you have a issue with addiction to the drugs, also you need to look and see if someone has suggested that you will need continuing care for this problem. Not sure if you have insurance or not, if you do, get a letter from work comp stating they are no longer caring for you and go seek treatment with the doctor of your choosing.

    I strongly urge you at this point and time to get a attorney. If you are against that, you can file a hearing with work comp in your state and you will have to prove why medically, you need additional medical help. Telling them you are still in pain, isn't going to prove that you are in need of additional medical treatment, remember pain is a subjective complaint. While I believe you are in pain, and can understand the need for additional care, the court system weights the evidence as a whole.

    Most attorney's will offer a session at no cost, so as you can see if they are the right fit for you. Just because you speak to one doesn't mean you have to hire that one. You have the choice to sign on the line also remember fees are negotiable as well. They will take their payment out of what is recovered in your physical loss.

    Whatever you decide, just make a decision and go with it. Don't wait to see how it plays out, it is your spine and need to take some action soon, very soon. The longer you go untreated, one the longer you suffer and two it bides well for them proving you weren't in need of more medical care. Take care and let keep us posted on how it works out.
  • Get a lawyer like tamtam said. My friend had to also of course his is different they were nice for the first year then suddenly turned vicious and didnt want to do anything more for him. Once he got his lawyer their attitude changed. Of course every case is different and yours may not go this way but it is definately an option for you to think about. Im sorry for how they are treating you it would be very upsetting. I cannot be of any help with this other than to agree with getting a lawyer. I dont have wc to deal with so i dont know their rules or how they deal with situations when they arise.

    I am dealing with short term disability through my company and they do enjoy stopping my checks when the doctor doesnt get the paper work done on time. I just got mine started back so thats one stress off me and now im focusing on my ssdi. Hopefully they wont stop my payments again but if they do i will go through the same process i did this time and deal with the doctor and call them daily until i can get things going again.

    You should definately think about all your options and then decide what is best for you.
  • Thank you everyone for your advice. I just don't understand how they act like they want you to only get back to work and fixing you is no longer a concern when there DR says thatI pretty much can't be fixed. He's the only DR that has said or had a problem with my pain meds and the only DR out of 6 that has said I am able to work at a desk job with very limited restrictions. With the economy who is going to want me compared to other people who don't have restrictions and need a job. Man I feel like I got the short end of the stick, but I will not give up and say to myself that may pain and nerve issues cannot be resolved. I feel like I haven't seen the right DR yet. There is one out there that can help me I know it. And I have spoke with a lawyer up until my IME and haven't gotten one formally yet but definitely will. Thank you everyone for your advice.
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  • jlrfrye said:
    My advise to you is get a lawyer NOW!!!!!! IMO you will get no further without one.
    I got a lawyer first off he deals with state farm insurance for me in all matters I have never even had to talk to anyone in or with the insurance. Even the bill for my lawyer is paid by my insurance! All medical bills have been paid in full fast and I have recieved no complaints from my insurance company for doing so. Please look into getting a lawyer to help you with these kind of problems. GOOK LUCK!
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