Florida Worker's Compensation - Help For Injured Florida Workers

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  1. #1
    Join Date
    Dec 2009
    Posts
    25

    Default Refusal of Additional Surgery

    What happens if I refuse surgery? This would be my 3rd in 6 months.

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

    Default Re: Refusal of Additional Surgery

    When/if you refuse treatment intended to "cure and/or relieve from the effects of your injury/illness" you are basically declaring yourself MMI. Benefits will stop and your claim move to some type of resolution. Doesn't mean further medical won't be provided... but weekly TD benefits won't be paid while you make up your mind to treat.

    WC is intended to a restoration of functional capacity, and return to gainful employment. Doesn't matter whether it's pre injury employer, or condition, or job duties.

  3. #3
    Join Date
    Dec 2009
    Posts
    25

    Default Re: Refusal of Additional Surgery

    Thank you. I was returned to work after my first surgery, that's when I received an additional injury. It didn't interfere with the second surgery, but to correct the problem caused by the additional injury, the doctor is recommending another surgery. I was returned to work on light duty shortly after my second surgery so WC are not paying me. If I declare myself at MMI, who determines if I have an impairment rating?

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Refusal of Additional Surgery

    Your treating physician will determine the disability/impairment rating. Taking into consideration you have refused treatment. I'm not suggesting this is your intent, but lots of IW's have the idea they can refuse/delay treatment, get a higher PD rating, settle the claim and move on.

    While there is no way of course to tell what your PD % might be post op, there are red flags waving when an IW refuses recommended treatment that is intended to get you back to work sooner than later.
    The ER/IC arguement is, you are claiming injury that is cause for you not working your job. Refusing treatment/surgery would give rise to think you are not as ''disabled'' as you claim.
    While you may be/are TTD/100% disabled, with out the surgery, it's difficult to say you are 30% or 50% PD for rating purposes now.
    You can see where the delima is with the IC... they'd like to provide benefits, get you back to work, and settle the claim. Naturally settle with as little money as possible. If they paid you at 50%PD, but post surgery you may be 20%, they overpaid you.

    Point is, you should be prepared for resistance to settle the claim without completing a recommended treatment plan. They can just leave the claim/medical open and see what you do down the line. If you don't seek treatment within the Statute Of Limitations, the medical will close. You'd be 'SOL" for future treatment.

  5. #5
    Join Date
    Dec 2009
    Posts
    25

    Default Re: Refusal of Additional Surgery

    Thank you again for your response. I wanted to wait until after I saw the doctor to respond. Yesterday, he made it official, he is recommending another surgery. I understand the point you made about the ER/IC argument. But my point is I sustained this injury between my first two surgeries. After each surgery, I was returned to work on light duty as soon as my stitches were removed, with no regards for ADLs. Iím providing as much service to my employer as I can, but I canít groom my own hair or prepare meals let alone clean my house. Iím just not sure if I want to hit the reset button and start this process all over again. I apologize for sounding so weepy; Iím just frustrated because I donít see an end in sight. My first surgery site is becoming irritated and Iím about to have a third surgery.

  6. #6
    Join Date
    May 2009
    Posts
    158

    Default Re: Refusal of Additional Surgery

    shai1, unfortunately the above is true. if your treating doctor thinks this
    surgery will or can correct the problem WITHOUT risk of complications or
    possible worsening of your prior impairment...

    did your doc ever say to you there could be problems you may have after
    this surgery...? or because of.......

    of course the carrier at this point may assume this procedure will fix the
    problem its still your choice to have it...
    if you like your doc and trust the opinion that may be enough so best wishes
    to you.......................and a shout out to the mighty B..............

  7. #7
    Join Date
    Dec 2009
    Posts
    25

    Default Re: Refusal of Additional Surgery

    If Iíve reached MMI and the doctor orders an ergonomic study to prevent reoccurrence or aggravation of the injury, who is responsible for getting the study? My employer, the insurance carrier or is it my responsibility. If its either my employer or the carrier, what is a reasonable amount of time to have one done. Two maybe three months?

  8. #8
    Join Date
    May 2009
    Posts
    158

    Default Re: Refusal of Additional Surgery

    no employee should have to pay for an ergo study.....
    employer is responsible for keeping a safe work environment...

    if your doc thinks this study should be done then he must believe the job
    is unsafe for you and your co-workers and he may obligated to blow the
    whistle........

    no employee should have to pay for an ergo study.....
    employer is responsible for keeping a safe work environment...

    if your doc thinks this study should be done then he must believe the job
    is unsafe for you and your co-workers and he may obligated to blow the
    whistle........

  9. #9
    Join Date
    Dec 2009
    Posts
    25

    Default Re: Refusal of Additional Surgery

    Thanks. I now have two doctors requesting the study. Its been almost 3 months since the first doctor requested it, hopefully it won't take another 3 months to get it.

  10. #10
    Join Date
    May 2009
    Posts
    158

    Default Re: Refusal of Additional Surgery

    dont know what your occupation is and i'm not asking here but,two docs
    now inquiring? something aint right at that job....

    do you have an attorney/maybe you should talk to one....
    perhaps we can ask bvia to come back and read thru some of this again
    and enlighten us both on this subject of ergonomic studies hows/whens and
    more of the whys...

    not telling you what to do here, but maybe a consultation with an attorney
    EE's need professionals to guide/handle their claims because things can
    get complicated and its your health/future we are talkin about here.......pv

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