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WORK COMP/independent exam help ASAP!!!

CapsdadCapsdad Posts: 92
edited 12/10/2013 - 10:26 AM in Health Insurance Issues
I'm worried and need some help. I just found out work comp gave me a case worker. Now this case worker is setting up an independent medical exam. I don't like this. I've heard all the bad stuff. She has read all my files and knows I still need a disc fusion. She wants me to find a new doc completely. I've expressed all my concerns to her. What does this mean for my work comp case and does this affect a possible settlement in any way?
Left side MicroD l5-s1 2/7/13. Re herniated immediately
Revision bilateral MicroD and posterior lumbar decompression 9/9/13. Failed. L5-S1 fusion on 3/6/14.
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Comments

  • No one knows anything about IME?
    Left side MicroD l5-s1 2/7/13. Re herniated immediately
    Revision bilateral MicroD and posterior lumbar decompression 9/9/13. Failed. L5-S1 fusion on 3/6/14.
  • Is an independant medical examiner- one who is supposed to review your records, exam you and make conclusions based on your history, his exam, any testing done, and recommend further treatment or not.
    It is not something to worry about if all of your tests confirm what you have told them and their exam of you, your records, and treatments are all in agreement.
    If there is stuff in your records that doesn't correlate with their findings, then it can impact a settlement, but if things are as you have said here, then you shouldn't have a problem. It is a relatively standard procedure.
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  • LTee43LTee43 Posts: 431
    edited 01/22/2014 - 4:45 AM
    Being that your case worker knows you need surgery, I wouldn't worry. Most of the IMEs I've had (car accident case) were tailored to discontinue me from a specific treatment. It seems that your exam might just be a formality.

    You'll still wind up with a settlement, later than sooner. WC claims are notoriously slow to settle.

    LT
    Diagnosis: Thoracic facet syndrome & cervical and thoracic radiculopathy from car accident trauma.
  • CapsdadCapsdad Posts: 92
    edited 01/31/2014 - 12:08 PM
    My IME is on the 30th. The problem is with all this time they're EDIT me out of it by making me wait, my pain is getting worse and now it's in both legs and I'm getting new pains. I'm a scared to death of a fusion but I can't take this pain anymore. It's ruining my life


    Post Edited for Inappropriate Language by Sandi.
    Please see the link below-The Spine-Health Moderator Team

    http://www.spine-health.com/forum/announcements/spine-health-announcements/inappropriate-language

    Left side MicroD l5-s1 2/7/13. Re herniated immediately
    Revision bilateral MicroD and posterior lumbar decompression 9/9/13. Failed. L5-S1 fusion on 3/6/14.
  • If you feel they are doing something illegal or unethically, consult an attorney to see what can be done. WC varies so much between all the States that it makes giving advice kind of hard.

    Keith
    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
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  • EMS Guy said:
    If you feel they are doing something illegal or unethically, consult an attorney to see what can be done. WC varies so much between all the States that it makes giving advice kind of hard.

    Keith
    It never hurts to have a WC lawyer. In NY, they get paid a flat fee and not by a percentage like other lawyers. So their case loads are huge. Mine made sure I got paid on a regular basis and fought to get me certain procedures and out of pocket expenses paid back to me.

    LT
    Diagnosis: Thoracic facet syndrome & cervical and thoracic radiculopathy from car accident trauma.
  • Yes my mom was forced to sell step dads retirement and go ahead and pay out of pocket for cervical fusion that WC said no need for. That surgury allowed her to return to work and still working today. But her pain tolerance could not outlast WC dragging feet. She eventaully got settlement and it equalled about what she had spent for surgury. Not a fan of WC, get a lawyer because its the lesser of two evils.
    Herniated T6-7, multiple herniations in cervical, tears in T5-T8. Stenois at levels and smorls nodes from thoracic thru lumbar
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