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  #1  
Old 10-17-2009, 09:07 PM
rocker00 rocker00 is offline
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Question Where to Go from Here

My injury took place in the state of Colorado.

I was injured at my job about a year and was laid off about 3 weeks after my injury. And for the record now i am still to this day unemployed, and unable to physically work. At first my injury was diagnosed as a strained lumbar and i was put into physical therapy for several months and was firmly reassured i would recover quickly. Time went by and my condition worsened. After seeing my normal injury doctor for many checkups between my therapy, I was sent to a delayed recovery specialist and then referred get an MRI done to see what was actually going on.

The results showed moderate facet hypertrophy at l4-5 and mild disc bulge, partial loss of the normal T2 signal within disc at L5S1 with mild disc bulge with superimposed central and slight right para central disc extrusion.


All copies of the medical reports i have received say that every doctor who has seen me notes that i have appeared to be in no immediate distress or pain and can sit comfortably with ease during my checkups. Unfortunately, this has never actually been the case because i always walk slow and sit funny to keep my back from bothering me! Why can they lie!?

I have also had a EMG done because i get numbness and tingling sensations randomly in both of my legs. The EMG turned up negative for nerve loss. My "specialist" informed me VERBALLY my condition was a result from my work injury.... From there i was offered the choice to do cortisone injections, see a chiropractor, or be released.

I got some information about the injections, and was told they were very "promising" to show improvement or a full recovery. Then did another followup with the specialist accompanied by someone from the insurance company, and there with my specialist and was informed VERBALLY my injury was a result from having a bad back from birth and being hereditary. Not what he had said the first time i seen him!!!! I followed through with the injections and waited a month to see results and still had no improvement at all in my condition.... with the insurance company nipping at my toes every week waiting to hear some positive results.

Now i am at the cross roads of being put back into physical therapy (which will hurt me!!!), being released (because i refuse the pt) or have the nerves disabled in my back.

I am sick to death of being treated as a liar and faker, and not as an injured human being!!! Can I request to see a different specialist? Should i seek legal council because this may be a life long injury and i appear to be at the end of my ropes? Will the insurance company offer me a settlement if i cannot be treated or refuse having my nerves disabled?? Should I request to see a different doctor for another opinion??

Thank you everyone so much for your time and advice!!!!
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  #2  
Old 10-18-2009, 08:19 AM
BvIA BvIA is offline
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Default Re: Where to Go from Here

This site provides some great info on spine treatment ans surgical approach.
http://understandingspinesurgery.com...ns.asp?d=bray&
Quote:
The results showed moderate facet hypertrophy at l4-5 and mild disc bulge, partial loss of the normal T2 signal within disc at L5S1 with mild disc bulge with superimposed central and slight right para central disc extrusion.
There are 1000's of people all over America that suffer 'soft tissue' injury such as you are describing. Surgery is generally not the recommended approach/treatment. Many/most of these resolve on their own over time. Painful... sure. Exactly what you are describing.

What is it you would like your doctor to do...? And that is a fair question. Conservative intervention should be your first approach. Appears that is what you are being offered here. Sometimes there is no ''treatment'' for your type of injury.
Do you want surgery ?
PT can be painful...though you should not be pushed to do something that would cause further injury.

If you decline treatment/PT you could/will jeapordize your benefits. Your ER is not liable to continue wage loss benefits while you rest at home. If you are capable of performing ANY type of gainful employment, that is what is expected.

WC benefits are limited, treatment is not the same as you might expect under your personal health insurance.
Functional restoration, and a return to gainful employment as soon as practical, whether pre injury job, or ER doesn't matter.

What the state considers appropriate medical treatment for your injury is found here http://www.coworkforce.com/dwc/Medical_Treatment.asp

Including an assessment for chronic pain http://www.coworkforce.com/dwc/Medic...nic%20pain.pdf

Other FAQ's are here http://www.coworkforce.com/dwc/Quick...uredWorker.asp, including a dispute resolution process. ( which would include your request for another opinion)

If you are being denied benefits, yes you should consult with an attorney. WC is not generally a "DIY" project.
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  #3  
Old 10-18-2009, 06:47 PM
rocker00 rocker00 is offline
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Default Re: Where to Go from Here

I want my doctor to treat my injury... and to return back to the same state I was in clean and clear. But i know what i want and what will happen are two different realities.

My doctor isn't reccomending the surgury and personally i do not look forward to getting the surgery done. But from what they are saying thats about all that can be done for me.... and i am at the end of my ropes.

I don't feel confident enough to return to the workforce because of the constant pain I endure. I am certain it will effect my ability to complete job tasks... and interfer with my resonsibilities. But my benifits aren't covering the bills and i am slowly drowing.

I don't understand how I can be released after I am still injured and even IF there is nothing they can do for me. And further more how can i "trust" my doctors Impairment rating when it comes to it when every visit they have put into my notes i have appeared fine and in normal condition when it wasn't true. I would think having a biased physician would be pushing the limits on some state laws....?
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  #4  
Old 10-19-2009, 10:04 AM
BvIA BvIA is offline
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Default Re: Where to Go from Here

Quote:
I want my doctor to treat my injury... and to return back to the same state I was in clean and clear.

i was offered the choice to do cortisone injections, see a chiropractor, or be released.
Sounds like you are being offered treatment that is necessary to ''cure and/or relieve from the effects of your injury''. That is what WC medical treatment is intended to do.
I'm not trying to argue with you... maybe point out that medical in comp is not programed, under the law, to return you to a pre injury condition. So you are right in saying...But i know what i want and what will happen are two different realities. Medical is provided until you have reached a stable condition... MMI. If there is treatment offered, you decline, benefits will likely stop. The ER/IC is liable for treatment, and wage loss, until you are MMI. That doesnt' mean additional treatment won't be provided...just that you are not expected to see any change better/worse in the next 12 months or so. With or without further treatment.
Quote:
I don't feel confident enough to return to the workforce because of the constant pain I endure.
Unfortunately in WC that is a medical determination, your treating physican will determine whether you will have restrictions to your job duties, you and your ER will decide if there is a modified, or alternate position you can fill at your pre injury ER.

When you say you were referred to a 'delayed recovery specialist', that would seem to mean you were sent to the IC's IME/Independant Medical Evaluator... those are doctors who evaluate you and opine on your condition that day. Many IME's are prone to be more ER/IC 'friendly' vs to the IW.
Quote:
I don't understand how I can be released after I am still injured and even IF there is nothing they can do for me.
Well, in WC...unless you are determined to be 100% PD/disabled, under comp rules, you are not going to be provided with a 'pension'. At some point, generally when you are determined to have reached MMI... your TD stops, and changes to PD/PPD indemnity based on your rating. Even if you are ''reduced'' to a minimum wage job, that may be the extent of what comp benefits are paid. Sad...unfair... yup. Illegal...? No.
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  #5  
Old 10-20-2009, 11:28 PM
rocker00 rocker00 is offline
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Default Re: Where to Go from Here

Quote:
Quoting BvIA View Post
I'm not trying to argue with you... maybe point out that medical in comp is not programed, under the law, to return you to a pre injury condition.
Sorry if i am coming off as hostile, I very much appreciate your time and input/information because Ive never been through this before and Its all new to me... step by step... and I'm not sure what the next step will always be. Just want to be prepared and still somewhat freaked out.

Quote:
Quoting BvIA View Post
Unfortunately in WC that is a medical determination, your treating physican will determine whether you will have restrictions to your job duties, you and your ER will decide if there is a modified, or alternate position you can fill at your pre injury ER.
I checked out a link that was provided earlier, and It didn't exactly answer my question.... so sorry to be repetitious but what do I do if I would like another doctors opinion? So far I'm learning the ropes with the Insurance company, but would like to know my options. I'm not "content" with my current delayed recovery specialist... which maybe i wasn't clear before but that's my current active doctor. I see no one else.

Quote:
Quoting BvIA View Post
At some point, generally when you are determined to have reached MMI... your TD stops, and changes to PD/PPD indemnity based on your rating. Even if you are ''reduced'' to a minimum wage job, that may be the extent of what comp benefits are paid. Sad...unfair... yup. Illegal...? No.
So when it comes, and If I disapprove with my "rating", what can i do to take counter measures against it?
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  #6  
Old 10-21-2009, 06:12 AM
Sherry Lou Sherry Lou is offline
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Default Re: Where to Go from Here

All I can say is I had "slights," "milds" and "moderates" in my MRIs after the panel WC doctor misdiagnosed and delayed the first MRI and subsequent surgery for months. Thanks to this delay I developed secondary disabling conditions. Thankfully, the surgery went OK and most likely in and of itself wouldn't have permanently kept me from work if that greedy SOB first-line panel physician had been professionally competent. His negligence was protected. My future ability to work was cut down forever.

Soft tissue injury can probably survive "conservative treatment" attention, BUT, can the rest of a whole body? Thanks to high quantities of numerous unneccessary and misdiagnosis drugs delicate hormonal and digestive systems can be chemically poisoned, unrelieved pain can lead to sleep deprivation -- and THAT will tear a body's health apart like nothing else. It takes whole body health to recover from trauma...

Just remember, established corporate medicine treats symptoms and has little interest (and knowledge) of causes to illness and especially how to monitor the progress and effectiveness of recovery from injury and illness under treatment. The IW's injury is/is not determined to be "caused" in an accident on the job and goes from there -- all about the money for the treatment of...pain, symptoms, fixing covered "broken" parts. Any additional damage done by treatment or insufficient/wrong treatment is just the IW's personal poor ability to recover... very easy to cover up/ignore when the insured medical focus is on a body part and not on the effects of the entire body involved in the process. The wealthy can "buy" the best medical attention but WC medicals are going to pay the minimum without responsibility for the outcome.

For example, do we suppose some chronic damage to the cardiovascular system from, say, taking toxic drug chemicals prescribed for an acute soft tissue injury, would ever be "covered" by the insurance that covers the injury and its "treatment?" Say a heart condition developed starting with the time an IW was under treatment for injuries sustained in a fall and the medication s/he received has a small percentage of patients taking it who die of heart attack? Say, if my WC-covered injury led to my receiving an MRI with contrast and the contrast chemicals injected into my blood system "caused" my spinal cord covering to (painfully) adhere to my spinal canal a decade later, or, caused some heart damage that shows up later -- do we suppose that iatrogenic (doctor-caused/treatment-caused) injury would be covered and treated? Not if the job-injured-then-"treatment-injured" individual was RTW or settled or been shafted out to tax-payer programs... If an IW refused a treatment option feeling the risk was too high to accept is that a fair judgement of "compliance?"

When faced with prescription drugs, invasive tests, surgeries... most would repeat the litany -- there's some risk in any of these -- there's a "risk" to crossing the street comes up, too. Yes, but you can sue for compensation to that risk having occurred. You can't sue for getting hurt on the job and/or damaged by WC insurance control and doctor practices that cannot work up medical solutions that are permitted to consider the whole body response to injury and treatments. Similarly, the stress upon the IW in this process is anything but conducive to full and complete recovery -- after all, the focus of WC is all about return-to-work, with the most financial (not physical) efficiency.

The treating doctor is your best hope for having even close to a fair outcome following work injury. Careful differentiation here can make or break "survival" in your future -- physically, mentally, emotionally, spiritually, and financially. Finding a doctor who can actually consider and treat the patient as a whole patient, in spite of WC insurance constantly creating adversarialism and forcing financial controls on that physician's best effort to perform as a physician, is now probably due more to dumb luck than something you can intelligently expect.

Many many medical and insurance company "workers" are earning their livelihood off the need for sick and injureds to receive treatment and get back to making their livelihood from work. Many will be aware of the stresses inserted by the "rules" of compensation, and feel the stress of moral and professional compromise foisted on them in their jobs. Yet, keeping their own paycheck is enough to slowly reduce their work, everyone's work, to a number with a dollar sign. One on one, we get those verbal truths of what our caring providers think and believe yet their "learned opinions" and professional "actions" on paper or spoken/reported to the insurance bean-counters and their representatives shrug off the truth and tell it as the payers will coax and contrive it to be documented. Individuals can be mentally ill with neurotic and psychotic afflictions. It used to be such people would stick out, be visible. What if whole systems were intellectually afflicted with insanity and all the people (dys)functioning in the system were earning their livelihood constantly trying to be sane in a majority insane group? No one would stick out, be obviously insane.

WC legislation and insurance performance may very well have gone mad. And there's no remedy, legal or medical, for the damage from this insanity. The same people who dictate this system will be dictating the so-called universal health care madness. It could very well complete the ruination of the "health" of our working American society, economy, country.

Meanwhile, only the doctor on the case retains any power to help an IW recover. There are many Goliaths, and very very few Doctor Davids left. Contrary to the propaganda of the situation, Worker Compensation is an entitlement program for employers, lawyers, insurance business, medical system workers... for everyone, except for the Injured Worker. Possibly the best investment one can hopefully make is paying for an IME with a carefully researched reputable (to patients, not to insurance companies) doctor.
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  #7  
Old 10-21-2009, 07:53 AM
BvIA BvIA is offline
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Default Re: Where to Go from Here

"Regular'' doctors are no better than comp doctors... what about the woman who was sent home from the hospital yesterday... where her mother had to deliver her baby.
Don't tell me her 'symptoms' were not obvious... oh...maybe that was a 'comp doctor' in the er that day...
Quote:
Worker Compensation is an entitlement program ..
BS...WC is a law, nothing more.
Quote:
Possibly the best investment one can hopefully make is paying for an IME with a carefully researched reputable (to patients, not to insurance companies) doctor.
There are no 'gods' in medicine...only education, experience and the ability to keep a practice/business going based on those perameters. It would be a delusion to view medicine as anything else.
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  #8  
Old 10-21-2009, 01:31 PM
Sherry Lou Sherry Lou is offline
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Default Re: Where to Go from Here

Quote:
Quoting BvIA View Post
"Regular'' doctors are no better than comp doctors... what about the woman who was sent home from the hospital yesterday... where her mother had to deliver her baby.
Don't tell me her 'symptoms' were not obvious... oh...maybe that was a 'comp doctor' in the er that day...BS...WC is a law, nothing more.There are no 'gods' in medicine...only education, experience and the ability to keep a practice/business going based on those perameters. It would be a delusion to view medicine as anything else.
BvIA -- After I moved I called six "regular" doctors closer to my new home. Not one accepted Worker Comp "clients." As more and more professionals fall into payer networks, and payer control over their work product, the "regular" doctors might regularly cave in to the easy path in the mine field laid by corporate warlords against The (Working) People. The few "regulars" who hold out, or leave the profession, will be the minority, and no longer actually "regular."

The professional "education" system controls what the professional knows. The third-party payer system controls the trained doctor's "experience." When one will not stand up, or read his/her moral compass, at the proper time one may be doomed to live and "succeed" financially in all areas of life with the "ability" of mind-controlled, programmed robots, rather than as human beings with the spark of gods within...

Dollars and compassionate human integrity in life and work, livelihood and cultural participation, are not meant to be mutually exclusive. If WC laws are nothing more than law then all laws are more of the same nothing --especially if they have nothing to do with justice and fairness toward those subjected to the law...WC is law, and very bad law as twisted and practiced by payers allowing no feasible remedy or access to remedy for the vicitmized IW. On paper WC law reads fairly well. In the non-delusional reality the attack on the value and meaning of the law has left it biased and abusive of too many IWs. It's the absence of willing accountability and moral conduct becoming responsible, lawful payers that cause it to have become bad law. Those who profit to excess will not voluntarily make it work like good law. They will continue to divide and conquer the systematized and robotized "clients" and "providers" until we are all so many livestock corralled and herded through a maze of ramps to an individual brain-terminating jolt. Now, that's efficient purpose to, system development from, and use, of "law!" Law that does not equally apply to and justly affect all parties is not, by definition, reasonable law. Just as human beings have spirit, there is a Spirit of the Law, as well as the letters of law littered with mean-spirited failure of integrity...

The delusion would appear to be in the deeply installed lock on ability to think outside the box, to stop mindlessly referring to complicated insider routines when the business is overarched by sheer evil, to rest from enslavement to bad ideas which enslavement leaves no energy to brainstorm creative solutions, to rise above this or that minor competition of critiques, and, to turn around the mental and spiritual violence of what is wholesale debasement of humanity, in this case working humans, and basic human rights. What's human rights up against greed and dollars to a few empowered (by bad law) profiteers? Must be an entitlement program or something. Where to go from here is to raise conscious awareness that little old WC issues are the same pattern and essence of everything that is going/gone so very wrong for We The People.
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