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  1. #1
    Join Date
    Oct 2010
    Posts
    3

    Angry The Doctor Won't Do Anything Except Give Me Pain Pills

    I was injured at work in August of this year. I have been out of work since... I have no problems with the workers comp. company. THey have been great! My problem is that my doctor won't do anything! I demanded a MRI... Last Friday I got one, but it was for the wrong part of my body. My doctor ordered it wrong... Everytime I see him (once a week) he offers me more pain pills... I can't take the ones he has given me because they make my physically ill... I told him that, but he still offers me more pills. The doctor told me that there was nothing wrong with my spine (MRI results)... And I told him... Ummmm.... Duh... It's not my spine that hurts. It's my right buttox and hip. He then told me he couldn't help me anymore and that he was sending me to a spine specialist... SPINE??? What do I do now???

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    What body part are your claiming injury to?
    Often soft tissue injury to the back/spine is cause for pain in the buttock/hip/leg... if there is only mimimal bulging ie. 2mm...3mm it's not generally something surgery would be recommended for.

    You can change PTP at any time post 30 day into your claim. 3 PTP is max, you can then dispute the diagnosis or treatment plan by requesting a IME evaluation in the MPN your PTPs are in.

    What treatment are you supposing would be appropriate to your injury?

  3. #3
    Join Date
    Oct 2010
    Posts
    3

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    I am claiming injury to my right bottox/hip. I had a round of physical therapy and the physical therapist won't touch me anymore. They feel that they are doing more harm than good. They feel that I have an avulsion or tear of a tendon, ligament or muscle away from the pelvis. Needless to say I am in a lot of pain.

    I will look in to changing doctors... Thank you for the advice!

    Treatment? I don't know... I need to know what is wrong first and how far gone it is before I can find the right treatment.

  4. #4
    Join Date
    Aug 2010
    Posts
    70

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    Red,
    I had the same thoughts when my left buttock was in pain, turned out to be sciatica , which is related to the lumbar region of the spine, (i.e disk rupture/herniation or buldge pressing into the spinal cord...causing the sciatica and pain down the leg) they (the first treating doctor) said I was fine and offered plenty of pain killers at first also. It's been my experience, that the first treating doctors will take the conservative approach when diagnosing injuries.... don't know why,( i have my ideas) but they just do. I did the PT also, its all part of the conservative approach to treatment.

    He then told me he couldn't help me anymore and that he was sending me to a spine specialist... SPINE??? What do I do now???
    In my case, After 2.5 months with no signficant improvement the first treating physician had no choice but to request a specialist to address the spine issues. Your Dr. requested a spine specialist because your current Dr's are not qualified to treat your injury or qualified to comment on your MRI. Even if your Dr. saw an issue on your MRI He/She or they would not tell you...They will only refer your treatment/case to the "Higher Authority" ( the specialist). Because of my situation, I believe, in your case with the info you provided, your doctor did order the correct MRI. Now, a specialist will make the proper diagnosis based on the MRI results. I thought the same thing at first,.... "My Ass Hurts!" not my back or spine ...Turns out my particular pain in the Ass is directly linked to the issues of the spine ...research SCIATICA and the relation to the Lumbar spine. Bvia mentioned soft tissue injuries (sprains) can cause the same aches/pains..which is/was the first diagnosis in my case.

    Everytime I see him (once a week) he offers me more pain pills
    That's what they do. No exam's...just pills and follow up appointments..since your injury occured in August, and 2 months of "treatment" with no improvement, a refferal to an ortho/spine specialist most likely will be the next step for you. First treating Dr.'s may seem not to be overely interested/concerned and "Tightlipped" with facts about your injury and will almost certainly downplay / misdiagnose even the most obvious injury... its like that for a reason..Why?..So the next guy can have his slice of the pie?..then on to the next... don't know..but not impossible.

    BVIA said:
    You can change PTP at any time post 30 day into your claim. 3 PTP is max, you can then dispute the diagnosis or treatment plan by requesting a IME evaluation in the MPN your PTPs are in.
    .
    Best fact/suggestion or advice ever!!

    I have no problems with the workers comp. company. THey have been great!
    Also what I thought early on, Until they stop answering phone calls....and started denying and delaying treatments/liability. Hope it doesn't change for you.


    See the specialist, let him diagnose...(he'll keep your prescriptions full) don't expect a whole lot of treatment at this phase either, expect the "Specialist" to make another refferal to pain management....If you see no improvement.....

    Of course, everyone's injuries/situations are different. From what I've read (in these forums) and people I've spoken to..We are all on the same "Ride" and perhaps our experiences are more similar than different.

    Do not refuse to be seen by any Specialist/doctor....it certainly wouldn't help your claim.

    Just my 2 cents..
    Take Care, Keep us posted Red
    Last edited by I.W; 10-18-2010 at 05:24 PM.

  5. #5
    Join Date
    Oct 2010
    Posts
    3

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    Hi I.W. Thanks for the feedback... THe only thing I do know is that it is not siatica... The MRI showed my spine to be just fine...

    And, this morning I called the workers comp. company to request a different doctor... Let's just see if they call me back...

    TO me it just seems silly not to order tests as soon a possible to figure out what the problem is... I would think that it would benifit the Dr. and the workers comp. company to get me fixed and back to work as soon as possible... Don't you?

    I will keep you posted! Thanks!

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    And, this morning I called the workers comp. company to request a different doctor... Let's just see if they call me back...
    The CA is not responsible for you to change PTP.
    Just go to the MPN list, and choose a new Dr to be your PTP. Make an appt, notify the CA in writing of the Dr name, contact info etc. That's all that's necessary. As with most things, when you rely upon someone else to do something, it's either not done, takes longer than necessary, or not to your satisfaction. If you have resistance in this, contact an I&A officer.
    TO me it just seems silly not to order tests as soon a possible to figure out what the problem is... I would think that it would benifit the Dr. and the workers comp. company to get me fixed and back to work as soon as possible... Don't you?
    Don't try to "think" like an ER/IC. You'd be spinning your wheels.
    You didn't say what type of injury you suffered. Only the symptoms you presented with. It's not out of the ordinary for the Dr to take the steps he did in attempting to diagnose the root cause of your complaint. Now you know, through MRI, that you have not suffered any bulging/herniation to your spine/disk or damage to a vertebra.

    If you suffered a "slip 'n fall" type injury, falling/hurting your hip specifically, that is what the Dr would go after in developing a treatment plan.
    ... order tests as soon a possible to figure out what the problem is
    If you were paying the bills, you could have all the testing you could afford, or afford the copays/deductibles for.
    In WC, you present with specific symptom, describe the facts surrounding your claimed injury, and that's what the PTP is required to address. The ER/IC is not responsible for providing a full body MRI or like diagnostics to find the cause of your complaint from some other body part/s. Only address your specific complaint.
    Also, based on your symptoms, and type of injury claimed, there are treatment guides...MTUS/ACOEM for occupational/industrial medicine. Your PTP is required to treat within those adopted guidelines.
    That's just how WC is.

    More on the "Duties of the Primary Treating Physician" are here http://www.scif.com/pdf/TreatingMDguide.pdf, page 3

  7. #7
    Join Date
    Aug 2010
    Posts
    70

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    Red.
    Assuming the Workers Comp.company ..(AkA IC)does not return your call. Go to the IC's website and look at the list of Medical Provider Network (AkA MPN) doctors available. Select one close to home or work, whichever. Call the new doctor and schedule an appointment. Then handwrite and mail/fax a letter to your CA (claims adjuster) at the IC (AkA Insurance Carrier).
    Something like this: (as Bvia mentioned above)

    To whom it may concern at blah,blah,blah,

    As of (date here) I elect Dr. Blah, blah
    Address here
    Telephone #

    from the MPN list provided on your website as my first choice
    right to change my Primary Treating Physician from (date here)forward.
    My first scheduled appointment with Dr.Blah Blah is on (date) @ (time).

    Thank You
    Claim # 1234567890


    Bvia said:
    The CA is not responsible for you to change PTP.
    Don't hold your breath waiting for them to call you back or help you to find another Dr.

    If the WC Company's website has no MPN list, you can ask your employer or WC Company contact for one.

    ---------- Post added at 05:37 PM ---------- Previous post was at 04:04 PM ----------

    TO me it just seems silly not to order tests as soon a possible to figure out what the problem is... I would think that it would benifit the Dr. and the workers comp. company to get me fixed and back to work as soon as possible... Don't you?

    I Agree with you 100%.. However, I've learned the WC Process has 2 speeds...SLOW and REVERSE.
    Authorization for treatment changes and referrals to specialist can take time as it would have to be found medically reasonable and certified by the UR (Utilization review).
    (UR) is the process used by employers or claims administrators to review treatment to determine if it is medically necessary. All employers or their workers' compensation claims administrators are required by law to have a UR program. This program is used to decide whether or not to approve medical treatment recommended by a physician which must be based on the medical treatment guidelines.)...UR's have 2 speeds as well.

    Later
    Last edited by I.W; 10-19-2010 at 05:02 PM.

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: The Doctor Won't Do Anything Except Give Me Pain Pills

    Authorization for treatment changes and referrals to specialist can take time as it would have to be found medically reasonable and certified by the UR (Utilization review).
    The maximum time for UR is 14 days, from the date the request is made by the PTP.
    Unless there is reason for extension, and agreement by the parties. Not longer than 14 days... http://www.dir.ca.gov/t8/ch4_5sb1a5_5_1.html

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