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  1. #1
    Join Date
    Jul 2008
    Posts
    141

    Default Disc Damage and Fibromyalgia California

    Hello

    I'm in almost constant pain despite taking a good amount of medication.
    I had a pre existing condition (cervial and lumbar disc damage) and then another motor vehicle crash took place when coming back from a business trip which resutled in additional damage... I was in a car for hire when coming back from the airport and was hit by two other vehicles. I don't have an attorney and have been trying to work with my employer. and the workers compensation insurance company. It has been six months with the workers compensation doctors and now they are saying I have fibromyalgia.
    I'm trying to get relief from the pain and want to find a good doctor in California that can help me get back to where I was... I have not lost any paid-time but have used some vacaition time. I'm falling asleep all the time but not feeling well-rested - I'm not sure if this is due to medication or the FM; I'm being told this is part of the condition. I bought some books to read up on the condition but just can't figure out what to do - if this is as good as it gets then I'm not going to be able to continue working - i'm just too exhausted and can't keep a high level of concentration - again, I don't know if this is due to the condition or the medication. I would really appreciate some suggestions. Thank you.

  2. #2
    Join Date
    May 2008
    Posts
    130

    Exclamation I would be very careful

    There are people here who can give you excellent legal advice.

    This is simply a comment from one sufferer to another: it has been my experience that in cases where there are complicated diagnostic issues, litigation, and a great deal of pain, diagnoses such as "pain syndrome" and "fibromyalgia" can be used to avoid diagnosis of real damage—or at least to muddy the issues, making proof of liability more difficult.

    For WC injuries that occur after the laws were changed, the insurance companies are no longer liable for providing treatment for "mere" pain.

    People are sent to pain clinics when there is nothing more to be medically done for them. If that is truly your situation, there is a great deal that a pain clinic could do to help you control your pain. BUT you don't want to accept that diagnosis until every medical possibility has been ruled out FIRST.

    I was repeatedly diagnosed with a "pain syndrome" when I had serious injuries which were subsequently successfully dealt with through surgery. But I had to push and push and push to get the correct diagnosis.

    There are a lot of conditions that can cause exhaustion—constant pain alone can do so. Not to mention anxiety in regard to your situation. For someone with pre-existing spine problems, getting rear-ended should set off alarms re SPINE.

    Last, YOU NEED AN ATTORNEY, and not just any attorney. Make sure you get a GOOD one. Because this is going to be a tough fight.
    Last edited by frazzled; 07-29-2008 at 03:33 AM. Reason: left something out

  3. #3
    Join Date
    Dec 2006
    Posts
    2,169

    Default Re: Disc Damage and Fibromyalgia California

    InPain, Frazzled has pointed out some of the many issues that you will be faced, with, and WITHOUT AN EXPERIENCED ATTORNEY, the IC/CA will take advantage of your unfmailiarity with WC AND your exhaustion!!! The CA, however "nice" themight be NOW, is NOT your "friend", and has no duty to help you litigate your case when these types of issues/disputes arise!''

    I would, however, clarify treatment for pain. An IW CAN be treated for pain under WC for their accepted conditions. BUT, the treatment and medications MUST be consistent with the ACOEM treatment Guidelines and a newer Pain treatment guideline (that I can't recall off the top of my head this early in the a.m., and/or "EBM" (Evidence Based Medicine).

    So, it is VERY IMPORTANT for your treating physicians when they are submitting treatment requests for authorization, that they SUPPORT their requests consistent with the "Treatment Guidelines" and EBM and whatever PEER-REVIEWED SCIENTIFIC ARTICLES and STUDIES that SUPPORT the treatment for your ACCEPTED cervical/spinal and Fibromyalgia conditions.

    Your CURRENT WC PTP can REFER you to a SPECIALIST, but the PTP must FIRST obtain authorization from the IC to do so. Many times, with chronic pain patients, when there really are no other TREATMENT OPTIONS for the UNDERLYING ORTHOPAEDIC conditions, like surgery, the PTP "TRANSFERS CARE" to the Pain Management specialist, who THEN becomes the PTP....

    As for finding a DIFFERENT PTP or SPECIALIST who CAN be your new PTP, it depends on if your Employer has a Medical Network Provider system (MNP), and IF they provided you the PROPER LEGAL NOTICE if they are demanding that you treat WITHIN their MNP.

    Sometimes, it is possible to treat OUTSIDE the MNP, but we would need more information from you, such as:

    1. Does your Employer have MNP, and if so, HOW were you NOTIFIED? If by letter, we would need to know EXACTLY what the IC/CA said in the letter to determine ADEQUACEY;

    2. How did you find your current WC PTP? Didi the IC "assign" him to you?

    3. So far, has the IC ACCEPTED your fibromyalgia claim?

    AND, so we have more information that might FURTHER potentially complicate your WC claim:

    4. Has the IC ACCEPTED you cervical/spinal injury claim, given your pre-existing history of spinal problems ? If so, then there will be issues regarding APPORTIONMENT when it comes time to determine residual impairment/PD....

    5. Have either YOU and/or the IC filed a "third party" claim or law suit against the two other drivers involved in you work-injury incident?

    6. Have you EVER filed a WC claim? If so, what body parts were involved, and HOW did the claim(s) RESOLVE?

    WE can provide more guidance when we get the answers to the above questions....

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Disc Damage and Fibromyalgia California

    Here are the new MUTS/Medical Utilization Treatment Standards...http://www.theacpa.org/documents/ACP...07%20Final.pdf

    This was adopted by the DWC/Medical Unit and is actually more to the benefit of the IW than to the ER/IC as were the ACOEM guides...

  5. #5
    Join Date
    May 2008
    Posts
    130

    Default and watch out for the drugs!

    This is what I wanted to add before, but couldn't figure out how to do it. (You'd never guess I was a computer professional!)

    You mention drugs—some of those pain drugs could put an elephant to sleep. Neurontin is one that many people can't handle, and oh, by the way, most people gain 50 pounds on it! There is actually a class action lawsuit by families of people who committed suicide after taking it.

    Treatment for pain is really, really difficult. Most places just throw drugs at you; and all of those drugs have side effects which usually no one will tell you about. The doctors know, however. So just keep this in mind: you don't have to take any of them. If some drug is making your life a living hell, go back and complain. (Some people do better than others on different drugs. They will usually try several on you.)

    It is very common for a pain drug to make it almost impossible for you to think or stay awake. Brain fog! And be careful of your stomach.

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Disc Damage and Fibromyalgia California

    All of the issues you mention are very accurate...and that is the reason for a ''comprehensive evaluation'' in a pain management facility, were a multi level approach is taken to handle your pain...

    Continued medication by opiates is not appropriate for pain management in the 'chronic stage'...

  7. #7
    Join Date
    Jul 2008
    Posts
    141

    Default Re: Disc Damage and Fibromyalgia California

    Hello and thank you all for the support.

    In reply to the following:
    1. Does your Employer have MNP, and if so, HOW were you NOTIFIED? If by letter, we would need to know EXACTLY what the IC/CA said in the letter to determine ADEQUACEY;

    IPIC Replys: I don't know what MNP stands for, but I don't recall seeing anything in the mail... maybe a letter from Liberty Mutual / many case workers (seems like they keep changing)

    2. How did you find your current WC PTP? Didi the IC "assign" him to you?

    IPIC Replys: My HR contact provided this one to me but the physician PTP was part of the WC so I think that the IC gave this to my HR person

    3. So far, has the IC ACCEPTED your fibromyalgia claim?

    AND, so we have more information that might FURTHER potentially complicate your WC claim:

    IPIC Replys: I'm not sure as yet. I'm still going to the primary physician but have an approval to see a pain management (anestheologist) in the coming days. I think the doctor / IC would prefer fibromyalgia over the additional disc damage. I was sent to an orthopedic surgeon and a general pain management doctor (trigger point guy) who said I had too may point aggravated to treat and that both ortho and trigger guy said my cervial is too damaged (multi level) that surgery would not be adviseable.

    4. Has the IC ACCEPTED you cervical/spinal injury claim, given your pre-existing history of spinal problems ? If so, then there will be issues regarding APPORTIONMENT when it comes time to determine residual impairment/PD....

    IPIC replys: I was very open with the WC physicians in providing medical records for comparison. I communicated the need to the IC for the MRI which were delayed for 5 months because a comparison was essential (in my opinion). I do not know if the IC "accepted" my cervial spine injury claim. I am not sure that I understand what is meant by accepted.

    5. Have either YOU and/or the IC filed a "third party" claim or law suit against the two other drivers involved in you work-injury incident?

    INIC replys: I have not filed a "third party" claim and I do not know if the WC folks filed one. I not sure if they could file a claim. Would the IC WC folks need my authorization - release of information to do so. Can I / Should I file a claim against the other party(s)?

    6. Have you EVER filed a WC claim? If so, what body parts were involved, and HOW did the claim(s) RESOLVE?

    INIC replys: Worked for the same company for the past 20 years and never filed a WC claim


    Regards,
    In Pain In Cali

  8. #8
    Join Date
    Jul 2008
    Posts
    141

    Default Re: Disc Damage and Fibromyalgia California

    Hello,

    How does one determine a good / experienced / ethical attorney in this arena?

    Bakersfield / Riverside California



    Regards,
    In Pain in Cali

  9. #9
    Join Date
    May 2008
    Posts
    130

    Default attorney search

    Be prepared for a lot of work! This is the single most important thing you will do in regard to your claim (except for fighting for treatment and finding a good doctor).

    You can get a list of attorneys in your area from the website of the California Applicant Attorneys Association.

    Put together the facts of your claim on a single piece of paper, which you are going to hold in your hand for reference while you begin calling. You will get a paralegal or someone similar, who will take this information and pass it on to an attorney. Then they will get back to you, if they want to deal with you.

    You will be turned down a lot; get ready for it. There are not enough WC attorneys for all the people who need them. Has nothing to do with the legitimacy of your claim. Your claim, like mine, will be seen as "difficult" and that will make it harder to find someone to take it on.

    I would advise NOT choosing a small or single attorney office. These guys will never, ever have the time for you. They will also have a tendency to look at the bottom line, push you to settlement so they can get their $$ and move on. Look for a bigger firm that has staff to do the scut work. A lot of attorney websites will have their ratings listed (if their ratings are something they're proud of!) On the website, there will be a list of attorneys and their backgrounds. Check them out!

    Eventually, you will meet with some of these people. Don't jump at the first one. Pay attention to how you are treated! Be ready with questions! THINK ABOUT IT! This is like choosing a marriage partner, with only TROUBLE involved. This person better have a good character.

  10. #10
    Join Date
    Jul 2008
    Posts
    141

    Default Re: Disc Damage and Fibromyalgia California

    frazzled,

    Thank you. I'm really frustrated with the pain and exhaustion... fortuanetly my spouse is supportive - he is handling this much better then I am handling things. I'm having a conflict with being employed for 20 years with this company and actively looking for an attorney. My IC hardly ever returns my calls and often, I do not get prompt attention. It seems that the doctors (WC) try to fight for me to get treatment but still, the time to get things through the insurance approvers is time consuming. I'm working sort of full time but often need to take breaks (an hour or two) to rest from the pain and fatigue. My body constantly jumps / twitches - think this contributes to the need to nap.

    Regards,

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