California Worker's Compensation - Help For Injured California Workers

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  1. #1
    Join Date
    Nov 2008
    Posts
    162

    Default I Don't Want Surgery

    I had my consult with nuero after 8 months of waiting and popping pills and here's what he said on the consult report regarding my physical examination by the nuero..

    Nuerological examination: Mental status and limited cranial nerve evaluation revealed normal findings. Motor testing revealed impairment of toe standing and ankle dorsiflexion on the right, both or which were thought to be 4/5. There was more severe 3/5 weakness of dorsiflexion of the great toe on the right. Motor function was normal in the distal left lower extremity. Touch and pain were diminished in the dorsum of the right foot as was temperature. On the sole of the right foot there was also significant impairment of pain perception. The toes were downgoing to plantar stimulation, although the response was minimal on the right. The patella and Achilles tendon reflexes were 2+ bilaterally.

    Treatment recommendations: I have informed Mr. Doe that the severity of his persistent pain, weakness, and numbness is such that it would be in his best interests to proceed with surgery, laminectomy and inververtebral discectomy in the near future.
    he also requested another MRI, which i had today and it's worse than it was on the injury onset 9 months ago.

    MY QUESTION: can someone lay this out to me in regular terms.. as far as how bad i'm hurt?

    i don't want surgery and they are almost forcing it on me.. will my claim settlement amount be affected if I deny surgery? the surgery/s have already been aproved by WC for $117,000+ $25,000 a day in the hospital at 3 days.. I really don't want the surgery..

    and honestly I want the C and R as big as possible..

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Advice = I Don't Want Surgery

    While no one can force a surgery on you... IF you decline treatment that is determined to 'cure and/or relieve from the effects of your injury'... you will be declared MMI, and a evaluation of your condition...taking into consideration your denial of treatment, and you will be rated for PD/WPI...

    If you accept a C&R to your claim, ALL treatment in the future you may need will be out of YOUR pocket... and you won't be getting near enough money to pay for the anticipated surgery that is being recommended to your injury.
    the surgery/s have already been aproved by WC for $117,000+ $25,000 a day in the hospital at 3 days.. I really don't want the surgery..

    and honestly I want the C and R as big as possible..
    Who told you it costs 25K to stay in any hospital... that isn't true. Even ICU is only around $6500/day... besides that, you are NOT going to see that amount of money in a settlement agreement.

    And, whatever amount you were to receive for FMT... you would have to deposit that money in an interest bearing account and use it for treatment to THIS injury. When you become Medicare eligible, regardless of your current age, you will have to prove to Medicare that you have exhausted ALL of that money for treatment before CMS/Medicare will provide benefits.

    Treatment recommendations: I have informed Mr. Doe that the severity of his persistent pain, weakness, and numbness is such that it would be in his best interests to proceed with surgery, laminectomy and inververtebral discectomy in the near future.

    MY QUESTION: can someone lay this out to me in regular terms.. as far as how bad i'm hurt?
    You don't know what your pain levels are, and you have more than one doctor recommending a surgercial procedure to treat your injury...?

    I want the C and R as big as possible..
    There is no negotiating here... your award/settlement is based on your rating, and the SWAG on the FMT... which won't cover treatment you might need. The IC doesn't pop money for treatment you 'might' use in the future. Statistics show that IW once settling their claims, don't access near the medical they would prior to settlement.

    Take the report to your PTP is you need further 'english' translation... and get the treatment... you're heading in the wrong direction here if you are making this claim about the money. When you decline treatment when surgery is anticipated... you are basically saying ''I'm not as disabled as I said I was''....there are red flags all over these statements.

  3. #3
    Join Date
    Nov 2008
    Posts
    162

    Default Re: I Don't Want Surgery

    I'm not really trying to send any red flags to anyone, just trying to make sure that if I decide to do the surgery later that I can afford it.. I'm honestly just really scared of the surgery, ie getting cut open , etc.. and then I worry about the possible screw ups or whatever.. what is involved in a discetomy and laminectomy? I was just hoping that I could get through this on my own, and I'm about to lose my house, vehicles, and everything and I'm freaking out. I used to think everyone that complained about back aches were full of crap until it happened to me and I see now that it's a real deal.

    can someone else please tell me what the nuerosurgeion stuff means since the last guy obviously is too far above me to help me out?

    thanks!

  4. #4
    Join Date
    Dec 2007
    Posts
    91

    Default Re: I Don't Want Surgery

    Quote Quoting xroadsgrad View Post
    I'm not really trying to send any red flags to anyone, just trying to make sure that if I decide to do the surgery later that I can afford it.. I'm honestly just really scared of the surgery, ie getting cut open , etc.. and then I worry about the possible screw ups or whatever.. what is involved in a discetomy and laminectomy? I was just hoping that I could get through this on my own, and I'm about to lose my house, vehicles, and everything and I'm freaking out. I used to think everyone that complained about back aches were full of crap until it happened to me and I see now that it's a real deal.

    can someone else please tell me what the nuerosurgeion stuff means since the last guy obviously is too far above me to help me out?

    thanks!
    discetomy and laminectomy what that means is that the Dr. wants to go in from your back by cuting through one of the vertabrate and remove the part of the disc the is pushing on the nerve and causing the pain

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: I Don't Want Surgery

    just trying to make sure that if I decide to do the surgery later that I can afford it
    What I'm trying to impress upon you is that you are NOT going to receive enough money to have the surgery at a later time. It just doesn't work that way.
    and I'm about to lose my house, vehicles, and everything and I'm freaking out
    IF you decide later on to go ahead, and you don't have the money, another IC, nor Medicare is going to step in and pay the bills.

    If you can reconsider/rethink these issues, and still decide not the have the surgery now, but take a Stipulation w/award...you can retain the abillity to re-open your claim within 5 years of the org. DOI, AND, there could be the possibility of 'new and further' disability. The rating you receive now, due to declining surgery is not going to actually cover the amount of the potential PD you may suffer.
    I'm honestly just really scared of the surgery, ie getting cut open , etc.. and then I worry about the possible screw ups or whatever
    Your concerns are the same as those of anyone facing a surgical procedure, and where you possibly have never undergone any major medical treatment, your fears are understandable. But, the longer you prolong the treatment, you could see a worsening in your condition, possibly something that cannot be 'undone' later on.

    I'm not really trying to send any red flags to anyone,
    Of course you're not, no IW wants 'red flags' to be waving above their head...you are waving that flag to give reason for the CA to assign a PI on you to get some sub rosa films...when you deny treatment as determined by your PTP as necessary to treat your injury, and provide a speedy RTW, you are damaging your creditabilty severly.
    And, IF you deny treatment, your TTD stops, how are you going to justify your going back to work when you are claiming you can't work, due to the injury...
    since the last guy obviously is too far above me to help me out?
    "Too far above you''...? I'm trying to point out the pitfalls here, as you are not understanding the conceipts behind Workers Compensation, as well as possibly compromising your case.

    laminectomy and intervertebral discectomy
    http://en.wikipedia.org/w/index.php?...ns0=1&redirs=0

    The Intervertebral DiskThe intervertebral disk is a little cushion that sits between the pairs of vertebrae.

    Because the spine can go in many directions, strong forces act upon it during movement and activity. The intervertebral disk absorbes the shock from spinal movement. It protects both the vertebrae and spinal cord from trauma.

    How does the disk do this?
    On the outside strong fibers are woven together to form an area called the annulus fibrosis. The annulous fibrosis contains and protects a softer, more squishy substance in the middle called the nucleus pulposus. The nucleus pulposis is responsible for yielding and giving during spinal movement. In this way, the disk acts as a shock absorber.
    More information on your concerns is here...http://backandneck.about.com/od/body...rtebdisk_2.htm

  6. #6
    Join Date
    Jan 2008
    Location
    New Oxford, Pa. USA
    Posts
    430

    Default Re: I Don't Want Surgery

    Other side effects are the lose of bladder control, loosing use of your legs to partial or full paralyis.

    Check out your Neuro, I am not sure if in Ca. they have a sight on the grading of dr's as far as malpractice etc. you might ask BiVA if she kows of any, ask other paitents while waiting in the waiting room about the success of their operation with this neuro. Look at his credentials, allot of hosp. has a brief bio on doctors that work out of their hospitals. I would rather have a neuro than an ortho do anything on my spine again. So I highly recommend a neurosurgeon.

    Hope this helps,
    Nipper

  7. #7
    Join Date
    Dec 2007
    Posts
    91

    Default Re: I Don't Want Surgery

    BVIA, WHAT you fail to tell the injured worker is the % of failed back surgerys. the IC deny and deny and delay of medical care till you have run out of TD benifits. you have no option but to have the surgery for FMT.
    In my case, it was three years of delay untill an AME stated I needed surgery, By then If I would go through with surgery I would be on the streets with a back fusion and my family. In my case is it a red flag?

  8. #8
    Join Date
    Jan 2007
    Posts
    428

    Default Re: I Don't Want Surgery

    The system forced me into surgery like they're doing to you.
    I hesitated because of fear etc and after 3 Weeks where I just wanted one more chance to try and get better and go back to work, the IC cut off my TD benefits and scheduled me to see their Dr for MMI.
    They where so quick to sweep me under the Rug it made my Head spin.

    I went ahead with surgery and it helped a little but not good enough.
    My pain never left and after a Year it's getting worse.
    I had a Diskectomy of the L5/S1.

    When the Surgeon wasn't getting his atta boy from me he threw me to the Dogs, put me at MMI and had the audacity to get mad at me and ask the question "what do you want me to do about it" when I told him that the pain was still there and wasn't getting any better.

    All I can tell you is that if you don;t have the surgery the system acts like you're faking and if you do have the surgery the system says you'll get better and be able to return to the work force, weather you get better or not.

    This system is geared for all involved to get rich at the expense of the IW.
    If we get better we're touted as the poster children and made the benchmark for everyone else.
    If we don;t get better then where swept under the Rug and hidden away as a shameful failure they don't want to look at.
    Everyone involved including the Layers on the IW's side make a killing and in some ways the IC is a victim as well because they are forced to pay huge amounts of money for treatments like Physical Therapy that in most cases does nothing and actually makes the condition worse, like in my case.
    My Surgeon made $8k, my Lawyer made $13k, the physical therapy place made Thousands as well, not to mention the pain management clinic that charged $1800.00 for Nerve Root block shots that caused the right side of my left foot to be permanently numb.

    Even though my case has settled, my pain hasn't so you need to prepare yourself for a long road ahead.
    Your surgery might help you, it might make it worse or it could just do nothing, no one knows, not even the Surgeon.
    If you decide not to have the surgery then like BVia stated, make sure your case is left open so that in the future the IC will have to pay for the surgery if you decide to have it.
    If you can't work and are in pain but don;t want to have the surgery then you'll be put at MMI and run through the system at whatever rating they come up with.
    You'll get a settlement and that's that.

    In the mean time you need to apply for SSI and SSDI but aother than that there's not allot you can do to fight this un-fair system.

    Just don't give up.
    After my case settled it allowed me to purchase a small home and at least have the security that my family has a roof over their heads.
    When this mess for you settles make sure you use the Money wisely because even though it may be allot, your life will never be the same and you'll never be able to make a living like before.

  9. #9
    Join Date
    Jan 2007
    Posts
    428

    Default Re: I Don't Want Surgery

    Quote Quoting nipper123 View Post
    Other side effects are the lose of bladder control, loosing use of your legs to partial or full paralyis.

    Check out your Neuro, I am not sure if in Ca. they have a sight on the grading of dr's as far as malpractice etc. you might ask BiVA if she kows of any, ask other paitents while waiting in the waiting room about the success of their operation with this neuro. Look at his credentials, allot of hosp. has a brief bio on doctors that work out of their hospitals. I would rather have a neuro than an ortho do anything on my spine again. So I highly recommend a neurosurgeon.

    Hope this helps,
    Nipper
    I second that Nipper.
    I had an ortho and his Jock attitude was something else...
    He's a very highly rated surgeon here and does allot of the surgeries on College sports teams etc.
    He might be great at Knee Joint replacement but I was just a quickie that he didn't put in 100%.
    When I have the next surgery and I say when and not if because I can feel things are getting worse not better, it'll be with a Neuro, not an Ortho.

  10. #10
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,898

    Default Re: I Don't Want Surgery

    I think the response from BvIA was very informative, as to what can happen if you accept a C&R. Medicare and private insurance will not pay for the surgery later, and the amount of the C&R will not cover the cost of spinal surgery.

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