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  1. #1
    Join Date
    Mar 2012
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    il
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    11

    Default Doctor Declares Worker at MMI, but No New Examination Performed

    My workers compensation claim was made in the State of: IL

    The IC told my lawyer that the the doctor they sent me to five months ago, who ruled me TTD now says I am MMI. I have not seen this doctor again, how does he know I am MMI. The said all my payments will be suspended until I go to a place for two days that will put me through a ton of agility test. There is no way I will be able to do any of the test I read about, I am 50% worse than I was five months ago, the injury is my right shoulder, arm, neck, and the nerves running down every part of my body. When I lift the milk from the refrigerator it causes my arm and hand to swell, and the worst pain imaginable. my left shoulder is starting to be effected too.

    Why would my payments be suspended until after the test to see if I can perform my job or another job are finished. UGH, this is the worst time for this, my husband left last month ( jerk, could not take the fact that I could not care for her anymore) and my only income is 1000.00 a month from child support.

    This whole process has been a nightmare, whoever thinks living off of workers comp is worth it, never lived off of workers comp.

    any information would be appreciated. I was a school bus driver, attacked by a special needs student, he slammed my head and right side of my body into the wall and steering wheel, yanked and pulled at my neck and bashed the left side of my head for almost five minutes until a teacher was able to get him off me.

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    doctors ofter review medical records and form opinions based on them.
    you can object to your MMI finding.
    your tests should support your contention that you are getting worse and are not MMI.

  3. #3
    Join Date
    May 2010
    Posts
    412

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    They are sending you to a Functional capacity evaluation (FCE) most likely. It is usually a 2 day test to evaluate your recovery and physical capacity now. The IC is probably who is sending you, and they are threatening you with the "cutting of benefits", which they will do if you do not go, but the doctor has not declared you MMI, I am sure, they are hoping he will after this report. Go to the FCE and try to do what you can and be honest. Let them know when you are in to much pain to conitue but don't be difficult. The doctor will probably want to see you again as well before declaring you MMI. You need to know your rights under your state about choice of doctors, some states allow you to pick your own. I would say, that if you have not consulted with an attorney at this point, you need to do so right away. Consulting is free, and they will be able to explain everything that is going on and advise you on your rights, benefits, and options, and if you have a case they maybe able to help you with or not. Don't do anything stupid like refuse to go to the FCE, you will find yourself cut off and then need an attorney for sure.

    - - - Updated - - -

    I now see you are in Illinios, so you have a right to make 3 doctor choices. I would be doing so right away. I am confused if you have a lawyer already why he didn't explain this to you when he informed you about what the Insurance Company said? A good lawyer would have told them that he would see the doctor in court if he was declaring any patient MMI without an examination! That just seems that their is missing information here! I am sure you have your own doctor correct? I cannot see why your attorney would allow you to only be examined by a IC doctor? Is your lawyer a workman's comp attorney, or a personal injury attorney? It seems that you are not being advised correctly here or information is missing. I would advise you to contact your lawyer about this again, and find out why your lawyer has not advised you to see your own doctor as is your right, who would clearly want to see you, and should be the one to order an FCE, when he feels it is time. If you do not have a lawyer, and have just been talking to a lawyer working for the IC then get one right away. You might need to find a new attorney anyway, as you seem to be being lead around by the IC and not by a doctor of your choosing which is your right. Furthermore, if you are on TTD (temporary total disability) in Illinios, you should be receiving 66.6% of your gross salary (for the last 12 months) which should be pretty close to what you were making before injury, So again, I am confused about you case, and missing information. How can you only income be child support?
    Last edited by ladyvol; 08-02-2012 at 09:53 PM.

  4. #4
    Join Date
    Mar 2012
    Location
    il
    Posts
    11

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    Yes, I have a lawyer, he has been great up to this part.I also used the doctors. the clinic my work sent me on Jan 18, 2012 for the injuries that happen less than 10 hours earlier. after seeing them until February 5, 2012, I was getting bad that they just kept me coming and saying come back in a week. I got a lawyer that week. He told me I could go to the doctor that had been caring for me for over 12 years, I was pretty mad because the IC said it was nor allowed, I could only see there doctors. I went to my doctor, and had the clinic refer me to my neck surgeon ( I had disc surgery two years prior.)

    My doctor is pissed. he knows me and knows how much pain I am in, and the idea that they are messing with me is eating him up inside. He just ordered me a week before this to start taking morphine 30 (2x a day) for the pain, but the morphine only covers the baseline pain, not the pain caused my the nerves, so I in a lot of pain still, next appointment in a few days.

    He was out of town the week all the happen, and only left me an email with the IC doctor letter to the IC, saying I am at my MMI and feels I could drive a school bus, I wonder if that includes his children. I barley if at all drive my own car because I can't turn my neck to see left or right. My daughter is the one who drives. I have to have someone shop with me because I cannot pick stuff up.

    The only medical papers he could be seeing is from my doctor, who is trying to get the IC to look farther than the neck, because of the pain from my left shoulder, arm, hands and now going down my back. I am just dumbfounded on how he could determine this without a second look, he said in april that my injuries would prevent me from driving the bus and taking care of special needs children, now he has done a 180, why are my funds on hold until after I finish this FCE? If I start something during the test, and fins it is too painful, d0 I stop or push pass the pain. Anyone ever have to do this and have any advice ?

    TTD (temporary total disability) in Illinios, you should be receiving 66.6% of your gross salary (for the last 12 months) which should be pretty close to what you were making before injury, So again, I am confused about you case, and missing information. How can you only income be child support?
    They have neen paying me since January 1012, but there letter said since doctor says I am MMI no farther payments will be given until the (FCE) report. Sedgwick is good at prolonging things that enhance a claim, they would go sometimes three weeks without paying me and make my lawer work two times harder to get it to me.


    p.s yes the docrtor did say I was MMI, and my injuries would not inter-fear in my job of driving a school bus, lifting 70# children from seat to wheelchair, strapping wheel chair, opening the heavy door with my injurer shoulder, driving and not being able to turn my neck more than 10 degrees left or right, every degree test this doctor performed on me left me in tears and showed I had very low movement-ability in upper body and some in lower body.
    Last edited by Injuredonthejob; 08-03-2012 at 07:01 AM. Reason: wrong color0

  5. #5
    Join Date
    May 2010
    Posts
    412

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    Your doctor calls the medical shots not the IC doctor. Your doctor would be the one to put you at MMI, not the IC doctor. I understand at TTD payment, it was just completely different then what you orginally wrote (only receiving child support). If your doctor is giving you morphine for pain, they are not going to allow you to drive a bus! Your lawyer needs to explain this to you, there is confusion here and I believe miscommunication as well. I would e-mail him and have him explain what is happening, who is calling these shots and why. Certainly the IC is paying for the morphine you are taking so they know you are on it. Again, the FCE will be so that doctors can make a better evaluation of your capcity, and that would make perfect sense if they felt you have improved, but it would be grossly unprofessional and seriously legally dangerous for a doctor who has not examined you to make a decision that you have reached medical max. improvement, and certainly, enlight of the fact that your own doctor is treating you with morphine, and obviously trying to get further test done and approved by the IC. Your lawyer needs to do so big explaining here.
    Last edited by ladyvol; 08-03-2012 at 07:46 AM.

  6. #6
    Join Date
    Apr 2012
    Location
    Oregon
    Posts
    350

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    I know how Sedgwick is and they are terrible. You may be having symptoms of CRPS, google it. Sedgwick is giving you the bum's rush in order to try and avoid paying for treatment. Often a surgery like yours will set CRPS off. You need to get your lawyer on board with this it will result in a better fee for him so he should do it and I know you're trying to see your doctor. Believe me if you have resulting problems with CRPS then you will need treatment.

  7. #7
    Join Date
    Mar 2012
    Location
    il
    Posts
    11

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    The IC IME said something in his report about suffering mylophthy something it sounds like CRPS, what the IME states is damage to the muscle in the shoulder and maybe the neck area, this will cause other muscle to die. Personally I feel like I could have both, no medication has been able to take care of both types of pain, pain meds take care of a certain layer of pain, but left the other open to a heaviness and shooting pain. I do not like the morphine at all, it take away the top layer of pain, but makes me very drowsy, and leaves the rest of my body feeling like a big bruise. I will be asking for a change next week.

  8. #8
    Join Date
    Jul 2012
    Posts
    62

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    You have a DOT physical, they cant put you back on a school bus until you meet the needs of the DOT physical. You can report the doctor to the DOT, and explain the situation, and they're supposed to pull his medical license pending a full review. Should legally nullify any work status documents that he prepared for a little while.

  9. #9
    Join Date
    Mar 2012
    Location
    il
    Posts
    11

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    And I have a DOT physical due next week, If I don't pass it, by school permit will be removed. Funny the DOT doctors are the people who refused to move forward with any treatment until I contacted a lawyer, and not they be the people that get to tell this other doctor off for me.

    - - - Updated - - -

    Sorry for typo's my fingers don't type right anymore, but my handwriting is worse right now, all jumbled together.
    Last edited by Injuredonthejob; 08-04-2012 at 03:47 PM.

  10. #10
    Join Date
    Mar 2012
    Location
    il
    Posts
    11

    Default Re: How Can a Doctor Say I Am Mmi, when He Has Not Seen Me in Five Months

    I had my appointment with DOT doctor and was not given my DOT because of the medications I am on, one is Morphine ER,three are for nerve pain, 1 for anxiety, 1 for sleep, I for Crohns and the last is for sleepiness. The doctor wants a written summary of every medications affect on my ability to drive a school bus, and what affect the combination of all the medications could have on my ability to drive a school bus. I was very angry when my lawyer and the Workers comp adjuster who told me to just try driving the bus for a little while and see how I feel, that my medications should keep me pain free for the duration Of my job and I should be able to drive without any restrictions ~~~~ I have been a school bus driver for 12 years and know with 100 % fact that it is illegal to have more than 0% of alcohol or and other drugs in your system while driving, prescribed or not. If I was in an accident I would be arrested ! I think my lawyer is too mush of a wus to take this to trial, he should have insisted on it the minute they took my checks away based on a IME who has not seen me in five months, one who has no idea what medications I am on, and what my improvements are if any. The insurance adjuster played him, and I Hope he gets what's coming to him for not following up before signing the release. The insurance adjuster sent him a fax on July 16,2012 asking him is he felt I have had enough time to heal, he replied that he would like to see a FCE done first, the adjuster followed up with a fax that was not included in the paper work, the doctor then followed up, that yes, he thinks I may be at MMI, and suggests a FCE, the adjuster sent another fax that is not available to me, the IME replied that yes, I now believe her neck and ARM pain is subjestiveand (it is my shoulder, and nobody will give me a script to have it looked at) after reading your description of the patients job and her job duties, I do agree she is at MMI and could return back to work without restrictions, But I suggest a FCE be given. The next day my lawyer was sent a fax with bits and pieces of the fax from the IME, letting him know there will be no more medical payments for me and all checks will be ended as of July 17,2012. I received the information from my lawyer until August 1, 2012 in an email !! ( he says he was out of town) and he refused to return my calls until August 8, 2012 telling mew sometimes things go wrong ..... I started applying for SS soon after the accident because I know deep down my injuries are not going away soon, and they seem to be heading in my direction. What do I do ? I have been released from Workers comp from there IME, DOT refused to give me permission to drive, work says if I do not get the medications approved soon (Even when the sheet says 90 days ) it will be a refusal to work. I cannot within my scope of morals put children and other people's lives in jeopardy by driving on this much medication. the DOT doctor said a person who needs this much medications to perform a job should not be working... as usual he was too much of a chicken to put that in writing. Why are doctors so afraid to stick up for patients ? but are willing to face what happens if caught lying for a insurance adjuster. How can he say that a person with a ROM of the neck 10 on left, 20 on right ( norm is in the 90's) safely drive a school bus? or has a ROM in shoulders and arms that is extremely low, and failed sensitivity testing, I am so confused right now. I asked my lawyer what is he going to do and he said " what do you want me to do " I said YOUR JOB !~!!!!

    - - - Updated - - -

    Mat0174,

    I was not given my DOT card to drive, because of the medications I am on, one is Morphine ER,three are for nerve pain, 1 for anxiety, 1 for sleep, I for Crohns and the last is for sleepiness. The doctor wants a written summary of every medications affect on my ability to drive a school bus, and what affect the combination of all the medications could have on my ability to drive a school bus. They did not even know I was there as a return to work from workers Comp, The paper work suggested it was a re-certification. I was the one who told them I was coming back after eight months from a work injury, and he never asked about the IME who released me, did not even ask for release papers because he thought it was a yearly re-certification. The only thing that stopped him in his tracks was the bag ful of medications, I took them all out and left them on the counter for him and asked him if it okay to drive a school bus while on these medications... he looked at me with horror and said I will be right back.... he gave me the paper work asking for the above information and said nobody who needs that much medications to relieve pain to work, should be working ...

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