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  1. #1
    Join Date
    Aug 2009
    Posts
    20

    Unhappy Not Understanding

    So I had my day in court, and they ended up throwing out the Dr. report that said the pain was all in my head being they sent me to two pyscologist who said the pain was real. Well now they have decided to allow me to have the dicogram done again because they need more validation. Do you think they are just playing games or do you think that I am headed in the right direction.It's been almost a year since injury I have had no meds or medical treatment since July when that Dr. made me out to be crazy
    I guess it is what it is and hopefully I can get this fixed so I can go back to a somewhat normal life!

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Not Understanding

    Well now they have decided to allow me to have the dicogram done again because they need more validation.
    Why/who is requesting a discogram ?

    Discograms are performed prior to surgery...they are tools used to pinpoint the exact location the pain is generating from...discograms are not ''diagnostic' tools... and aren't used to 'validate' a claim.

    If you are being recommended for surgery... IMHO I'd decline this procedure... they are painful, and many times used to discourage an IW from proceeding with the claim.

  3. #3
    Join Date
    Aug 2009
    Posts
    20

    Default Re: Not Understanding

    I had a dicgogram done back in May the verdict was surgery WC sent me to another doctor for a "2nd opinon" IME who said I was fine nothing was wrong with me and that I had an underlying pysch problem haha so after a deposition they sent me for another IME who then said he thought the pain may be pychosamatic and he was unsure of the findings on the first Discogram which showed a large annual tear at the s-1 l-5 and a moderate tear at the l-5 l-4 with leaking. Awful pain down the left side into my foot and side side to the knee several falls due to left leg. So we went to court they threw out the first IME and I was found to be in true pain so now the new IME doc wants the discogram redone, yes it hurts but i do need surgery and if I have to redo it to get it done then so be it! Other words I am just being suffeld around by an insurance company who doesnt wanna pay a proven valid claim...

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Not Understanding

    Other words I am just being suffeld around by an insurance company who doesnt wanna pay a proven valid claim...
    IT's not a matter whether the claim is valid or not... and WC is no fault. The IW however, through the medical evidence provided by the treating physician, or other evaluating Drs, to prove the entitlement of the benefits requested.

    It's not like your personal health coverage... the benefits are limited, and subject to litigation, as you have found. With your own ins coverage, there is a UR process, your Dr must show medical necessity for anything ordered... the difference is, you are paying the bills ...in comp, your ER/IC is paying. Big difference. When you pay, you can have whatever you can afford... in comp, you can have anything you can prove you're entitled to. Sometimes that requires going to court.

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