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workers comp ???

cherrybabyccherrybaby Posts: 49
edited 06/11/2012 - 7:19 AM in Back Surgery and Neck Surgery
I am still waiting on the approvle from workers comp. and i talked to my case worker and she told me that. my file sais that it is in review md. dose any one know what that means??? :?
I seen the sugeron on the 11 of june and was told that it should not take to long to be approved where it is a second oppinion. and here it is almost a month later and i do not know what is going on.
My surgen told me that it will take a week to two weeks for the sugery to be schedualed after the aprovel to go threw!!


  • sometimes it pays to call the case worker and ask why it is in review. i myself am fighting wc which stinks but that is another story. don't take that as a final answer
    good luck
  • I am too WC and it has taken over 2 months to get approval for a 2nd opinion and/or surgery.

    I know in Florida I just found out that WC only had 5 days to answer our Petition to change surgeons to get a 2nd opinion/surgery. Do you have an Atty? If so you can find out what the statutes of limitations are with how long it takes for them to respond to you. Or as Maria suggested call WC again and find out why they are taking so long.

    Good luck and let us know if we can you any further.

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  • My situation is a work related injury and work-comp. It was a nightmare!! I jumped through their hoops, that's for sure. About 9 months worth of crap!!. After having 4 cortisone injections and PT, I went to three of their surgeons. After viewing my MRI's and x-rays, all three agreed that I needed a three level fusion. Well work-comp wasn't happy with those reports, so they sent me to a forth surgeon. He said "surgery denied". Just what work-comp wanted to hear. After that I didn't hear a word, no folow-up visits, no cure, no nothing for 5 more months.

    I finally went into MY OWN insurance carrier through my husbands employment. I couldn't take the pain any more, and laying on the couch and bed 24-7. Took my MRI's and x-ray, told them the truth about my on the job injury. (didn't know if they would help me or not).

    Then it was like, "wham-bam-thankyou-mame". Badda, boom, badda, bing!!! Was referred immediately to one of the best Neurosurgeons in the Denver area. He reviewed them, couldn't believe what work-comp had put me through (or lack there-of) because of my MRI's. It was no more than 2 months, I was in the hospital getting my three level fusion done by MY SURGEON. Thank God!!!

    Thus, a HUGE lawsuit is in the works. I have an incredible attorney, we have all the proof, all reports from w/c doctors stating I needed the three level fusion. It's like my attorney says, "MRI's and x-rays don't lie".

    Now, my settlement is including the real cost of my surgery, (not my co-pays) all perscriptions, driving miles, future care, past wages for 16 months. So we're looking at a figure of upward of 250k. Frickin' idiots, it would of been cheaper for them to just fix me!!

    But I'm glad things turned out the way they did, cause at one point with work-comp I was set up for surgery with a work-comp orthopedic surgeon, (then slammed down) and I ended up with one of the best Neurosurgeons in Denver. Lord knows how I would be right now had the orthopedic surgeon did this work.

    So ya, YEAH ME!!!!! idiots!
  • I too had an injury at work and my surgery went flying through the hoops. had to do the 3 injections, which is a good thing. the independent review doc said she needs surgery if shots do not work. told case worker I could no longer stand the pain and she okayed everything and within a week i had the surgery.
    you guys have suffered through a nightmare and I cannot imagine the frustration level along with your physical pain.
    the place i work for deals with an individual insurer and not the state wc. Perhaps that is why this all went so well.
    i sure wish you all the best.
  • I too had to deal with the WC system. My surgery is 8 months TO THE DAY from my date of injury. Sadly, each state is so different that it can be challenging to give advice. In Ohio, almost every case that includes a surgery request goes under MD review. Typically, the BWC will then take themselves out of the picture and make a 3rd impartial party make the decision whether to allow/disallow a condition or procedure. This means months of waiting for hearings, etc. My recommendation is to get a WC lawyer if the MD review doesn't approve your surgery. It's a very tricky system and if you don't have all of your ducks in a row, or if you aren't hyper vigilant watching your case, you could miss something important and have your case suspended or thrown out.

    The whole system is a bureaucratic nightmare that very clearly assumes all cases are fraudulent and you have to PROVE yours isn't.

    Let me know if I can be of any further help! Good luck to you and KEEP FIGHTING THE GOOD FIGHT!!

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  • My injury was work-related and I found that the squeaky wheel gets the grease. It took 4 weeks from the time of injury to get my MRI which I felt was ludicrous. I got the names, emails and phone numbers of every bureaucrat involved and I started calling and emailing daily, often more than once a day. From the time of the MRI to the surgery was 2 more weeks, for a total of 6 weeks. When I got my appointment with the NR, the scheduler wanted to know who I was and why so many people were calling on my behalf to get in to see him. 6 days after my visit, I was in surgery.

    My advice is never underestimate the apathy of a mid or lower level office worker. You have to "make" them care about you by becoming a nuisance to them. They will get you through the system as fast as possible just to get you off their back. You just have to "motivate" them. Kill them with kindness coupled with unwavering persistence. That's how I did it, and I work for a government entity, so you know how tight they are with their money. Best of luck...SC
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