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Worker`s Compensation/Permanent work status

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Question
I have been getting treatment for chronic low back pain for about 2 1/2 years now.  

I originally got injured at work and I never fully recovered.  My problem is that the doctor I have been getting treatment from finally told me that my chronic low back pain is now permanent because of the duration that I have been dealing with my problem.  The orthopedic surgeon that was treating me also said that my problem is now a chronic condition, but that he would not be able to place me on Permanent & Stationary because he was not a workmans comp doctor.

I was also sent for a Functional Capacity evaluation and I am going to list the problems that they pin pointed to me so, you can get a better idea of what I am dealing with.

Cervical Spine ROM:

Extension: Occiput 32, T1 12, Result 20, Normal 60

Lumbar Spine ROM:

Extension: T12 6, Sacrum 5, Result 1, Normal 25
Left Flexion: T12 26, Sacrum 11, Result 15, Normal 25

Shouders ROM:

Flexion: Right 164, Left 176, Normal 180
Abduction: Right 144, Left 176, Normal 160
Internal Rotation: Right 15, Left 55, Normal 90

Hips ROM:

Hip Extension: Right 15, Left 15, Normal 30




I have been treated by:

Chiropractors
acupuncture
Physical Therapy
electric stimulation
Pain management

Now, my employer recently contacted me and said that they need to send me to their doctors so that they can confirm what my treating doctor has already said.

So, at this point what happens? what is the possibilty that the workmans comp doctors rule against the orthopedic surgeon and treating doctor?

Answer
Hi Mark and thanks for writing,

I am sorry to read about your work-related injury, you’re wise to ask questions. I would consult with a Labor Lawyer; I always recommend people at least consult with a lawyer experienced in WC cases, even if you don't want them involved in the negotiations just to protect yourself and make sure you're aware of all your rights.

When you look at settling, the things you'll want to consider are:
-lost wages during your time off,
-any expenses you incurred due to the injury (Physician visits, Chiropractors, Physio Therapists, Transportation to/from any of the above; Medical Supplies like bandages, braces, crutches, pain medication including pills and ointments; Fees for filling out forms for you or from the doctors); Postage and/or Fax expenses,
-any lost benefits (Vacation Days, Stat Holidays or Stat Pay, Medical-Dental coverage, etc),
-any costs you may incur upon return to work (time off or cost of making up any education or in-services you may have missed; any training you may need to do prior to returning to work),
-if you will be doing a Graduated Return to Work Program [most people do this if they've been off more than 30 days and/or need to have restricted duties (ie: lifting, hours of work, etc)] then Workers Comp [WC] should pay for the difference. A very common scenario is: if you normally work 8-hrs/day, 5-days/wk, you could return doing 4-hrs/day, 3-days/wk x 1 week; then 4-hrs/day, 5-days/wk x 2 weeks; then 6-hrs/day, 5 days/wk x 2 weeks; then 8-hrs/day, 5-days/wk IF TOLERATED and WC will pay the difference until you are working F/T hours again,
-Pain & Suffering (although this may be harder to prove and may be impossible to get without a lawyer – this is usually reserved for severe injuries where the employer can be proved to be liable).

Unfortunately Worker's Comp is like all other Insurance Companies - it is in THEIR best interest to drag things out as long as possible, and usually they hold most of the cards and have the laws on their side. Sadly, this can cost people their jobs, and sometimes their families due to the stress associated with lingering pain and other disabilities; the financial and/or emotional drain can be too much for some people. 60 Minutes did a show a few years back where large insurance company executives admitted there is an unwritten rule to deny most claims initially as they know a good percentage will just give up and not fight the claim.

It is important to be sure you do everything correctly during your claim period and you don't want to miss out on any payments you may be entitled to now or in the future, so I advise that you consult with a lawyer who does WCB cases and find out exactly what your options are, and what you need to do in your state to cover yourself (WCB regulations do vary state to state).

Dealing with WC is one of the most frustrating things we have to do, like most big insurance companies, their number one interest is guarding their own money. I always find it's best to do a little brown-nosing when talking to those people and ask "how can we make this a win-win for both of us and how would you like me to proceed" etc...

Laws do vary state to state, so I always advise people to go online and talk to WC Helpline about what their rights are so you're informed of what you are and are not entitled to with coverage. As for them asking you to be seen by their doctors, that is normal procedure and hopefully the doctor you see will be professional and provide an honest report.

Most States have Lawyer Referral Services which will give you the name of a few local lawyers who specialize in your area of concern (Labor Law) and you can usually get an appointment to meet with them for 30 minutes for a nominal fee. You could go and ask some basic questions, exactly like you asked me and hopefully s/he can give you some advice and possibly some resources to help you.

I hope this helps, it may feel like you're constantly hitting a brick wall, but perseverance is necessary whenever you deal with them.

All the best,

Margot

Worker`s Compensation

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Margot RN BScN GNC

Expertise

Please feel free to ask anything, but the more specific you are, the easier it is for me. Please share as many details as you are comfortable doing. I do check my Emails daily Monday through Friday so you should receive an answer within 24 hours on most business days. Thanks.

Experience

I have 15 years experience as a Small Business Owner-Operator; I own a Nursing Agency so often deal with both employee and client injuries. I would be pleased to offer any assistance I can. If I can not answer your question I'll do my best to direct you to an appropriate resource. Thank you.
Experience in the area
20 years of Long Term Care and Community Nursing, specialising in Geriatrics, Gerontology and Palliative Care.

Education/Credentials
Registered Nurse , Certified Gerontological Nurse, Bachelor of Science in Nursing
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