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  1. #1
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    Jan 2010
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    Default Self Insured Companies

    My question is:

    I'm new to this site and have so many questions. I was hurt at work and I am getting paid w/c and my bills are being paid. I was hurt in 8/09 and I have only seen w/c doctors ortho,neuro and a pain specialist. I would love to see one of my own but they have told me I can't. They neuro said I have dystonia. They have told the w/c nurse of people they want me to see and what they want done and she drags her feet on them. I was told back before the holidays that I was supposed to see a movement disorder specialist and to date no appointment has been made. I was also told that I needed physical therapy and It took an act of God to get that started. I just feel like they are dragging there feet with my care. Now to top it off they are sending me to a board of specialist of the same quals as the ones noted above. They are calling it a IME. I don't know what that is either. If I am seeing all w/c doctors already why would a insurance company want a IME done too? Plus I just got a letter that they want me to have a sike eval. They said it's for my benefit to see how this has all effected me. I take sike evals every year because of the weapons I have to have at work. I am ok with all of these new doctors just wish they had experience with dystonia. They have not sent me to anyone who can tell me what to do to get better. I want to get back to work and I don't want to lose my job or go on SSI or get some sort of settlement. I just wanna get back to 100%. I make a great living and make a lot of money and want to keep it that way. When I got hurt I did the right thing. I reported the accident and even worked on light duty until the doctor said I was only making my injury worse. I now have knee pain, back pain, headache, stomach pain from meds and the list goes on and on. Is there a site that explains the rights a I/w has when getting care from a company that is self insured? I feel they have all the balls in there court and I am stuck in a boat with a hole in it and I am sinking more and more each day.

    Any help or incite would be great. I hope I am back out there protecting the country again,
    Puppet

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

    Default Re: the Self Insured Companies

    There may be some info here that will help you...http://www.ica.state.az.us/forms/wor...urance_FAQ.pdf numbers to call to the AZ WC commission.
    It would be a good idea for you to consult with an attorney or two who handle comp in AZ.
    It appears you are being delayed/denied benefits... the laws pertain to self insureds as well as employers who are covered by insurance company's.

    There are FAQ's here too http://www.ica.state.az.us/faqs/index.html

  3. #3
    Join Date
    Jan 2010
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    130

    Default Re: Self Insured Companies

    Thanks bvia,
    I went to the work ordered sike eval yesterday! I was told that it was for the doctors to see if I was having any sike side effects from the injury. I told the doctor when he mention having the MMPI that I already take these at work those 1001 questions. He assured me that it wasn't one of those tests. So I said OK. I am on neurontin, cymbalta, and nucynta. I just started the nucynta two weeks ago for pain and had that tweeked to every four hours. I have been getting really bad killer headache. This new nucynta had bad side effects for me. So when I woke up with the same headache pounding and the two hour drive I was in lots of pain. Not to mention I was on narcotics. How can a doctor eval a patient who is on narcotics and not in the right frame of mind? Then to be handed a clip board with a paper for me to sign. They wanted me to know they don't permit a tape recorder and I had to sign the paper saying I didn't have one. What is that all about? Why would they be worried about being taped? I didn't have one but wondered what would they be saying that they would have to have someone sign a paper? Then they took me into a small room and you guessed it I was given the test the one that they ask you 1001 question like: do you have sex with animals, do you hate your mother, do you hate your father, do you do drugs, do you wanna kill someone, would you want to be a florist, do you hear voices? They would put a question in every now and then about pain or about something realistic. Then half way threw she came in to give me a break from the test and started asking me the questions about my family,,, sisters and brothers there jobs how many kids. How I was in school? How my accident happened? She even had the balls to ask me if I had an attorney??? What does that have to do with anything? But really come on if you don't believe me or the WORKMENS COMPENSATION DOCTORS YOU ARE sending me to,,, release me!!! so I can go to my own doctors and get the care I need and go back to work then. I would rather be at work then jumping threw these hoops. I was just wondering if anyone else has gone threw this circus game! I find it unreal that a company says make sure you report all accidents no matter how small they are! If I would of known they would of put me threw all of this bull****. I would of never turned it in and went to my own doctors and got the proper care being on short term!
    Fed Up with this crap!
    Sorry for venting.
    Puppet

  4. #4
    Join Date
    Jul 2008
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    California
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    1,855

    Default Re: Self Insured Companies

    Quote Quoting Puppet to wc Doctors View Post
    My question is:

    I'm new to this site and have so many questions.

    Welcome to this site.

    I was hurt at work and I am getting paid w/c and my bills are being paid. I was hurt in 8/09 and I have only seen w/c doctors ortho,neuro and a pain specialist. I would love to see one of my own but they have told me I can't.

    That is not true. If you can afford to pay out of pocket for another opinion that would ease your mind, I say do it. They cannot prevent you from seeking treatment or second opinion...although they would like you to believe that.


    They neuro said I have dystonia. They have told the w/c nurse of people they want me to see and what they want done and she drags her feet on them. I was told back before the holidays that I was supposed to see a movement disorder specialist and to date no appointment has been made. I was also told that I needed physical therapy and It took an act of God to get that started. I just feel like they are dragging there feet with my care. Now to top it off they are sending me to a board of specialist of the same quals as the ones noted above. They are calling it a IME. I don't know what that is either.

    An IME is an Independant Medical Evaluator. Don't let the name independant fool you. They are hired guns working for the insurance company. I recommend you bring a witness with you to any of these exams.


    If I am seeing all w/c doctors already why would a insurance company want a IME done too?

    Usually because they want to limit the cost of your claim. These doctors are known for minumizing the injured workers injuries (not all of them are bad insurance company whores, but many of them are)


    Plus I just got a letter that they want me to have a sike eval. They said it's for my benefit to see how this has all effected me.

    Do you have an attorney? If not I recommend hireing one at this point.

    I am guessing a reason for the psych exam may be due to your Dystonia, which is a movement disorder. There are multiple forms of dystonia, and multiple causes of dystonia, from trauma, medications, and infection to mention a few. The majority of dystonias do not impact cognition, or intelligence. The main exception to this is dystonia that occurs as of another diosease or condition that cause such complications. Psychogenic dystonia, is dystonia that is secondary to psychological disturbances. Again, this may or may not be a reason for the psych eval.




    I take sike evals every year because of the weapons I have to have at work. I am ok with all of these new doctors just wish they had experience with dystonia. They have not sent me to anyone who can tell me what to do to get better.

    http://www.dystonia-foundation.org/p...sional/158.php

    The link above is a list of providers who treat dystonia. Just click in where you live.

    There is also a lot of information about the disease and treatment.

    I want to get back to work and I don't want to lose my job or go on SSI or get some sort of settlement. I just wanna get back to 100%. I make a great living and make a lot of money and want to keep it that way. When I got hurt I did the right thing. I reported the accident and even worked on light duty until the doctor said I was only making my injury worse. I now have knee pain, back pain, headache, stomach pain from meds and the list goes on and on. Is there a site that explains the rights a I/w has when getting care from a company that is self insured?

    They should have to follow the same laws as other work comp insurance carriers. I personnaly think dealing with self insured employers is the worst. http://www.expertlaw.com/library/com...e/Arizona.html



    I feel they have all the balls in there court and I am stuck in a boat with a hole in it and I am sinking more and more each day.

    Any help or incite would be great. I hope I am back out there protecting the country again,
    Puppet
    Again, if you have not hired one already, I recommend consulting with some work comp attorney's. This will even the playing field out a bit more (IMO).
    Last edited by kelly38; 01-19-2010 at 08:44 AM.

  5. #5
    Join Date
    Jan 2010
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    130

    Default Re: Self Insured Companies

    Thanks all for your responses. I have read a ton of posts and replies from almost all of the posts under Arizona. I have learned so much. I have contacted and attorney first. I have also sent in a request to get all of my medical records from all of the doctors. Today I am going to get a tape recorder to take with me. I have not got all of my records back yet and the ones I got just about blew me over!!!! Again my company is self insured. So I am forced to go to all of there doctors and when I am sitting in there office they say one thing and then report another. I went to the neuro on Monday and this fool is the one who asked me how are you since the last time you were here? So when I told him he seems to understand what I am saying. I told him I didn't get to the movement disorder specialist that he ordered before the holidays. However I did get to the so called sike eval and I just wanted him to know that I do not have sex with animals, my parents are still together, love my sisters and brothers, I don't hear voices, I don't hear voices that tell me to kill anyone. I found that a waste of time considering my ankle and knee is still screw up. He says I know that this is frustrating for you ((( This Ass has no idea how frustrated I am when he tells me one thing and I read another in his so called report!!))). I just find it odd it takes these self insured companies forever to get things going then puts the injured worker to the max payout for care. I am still not fixed and now face a panel of doctors and I am going to point out that these doctors have made suggestions on the care and the company found ways around it. I want to return to work. I have a really good job. My injury is not like a lot of folks on here I will be able to get back to work!! Thank god for that! It's just getting the care I need with out them dragging their feet. How is it fair that they can take months 4 of them in fact to get a movement disorder specialist lined up??? I called and asked if they were seeing new patients and the next appt. was three weeks away?? This site just bleeds of frightening stories about people losing there jobs and houses and cars... What is going on in Arizona that allows this to happen to people? Well off of this tangent I am on and off to get a recorder!!! I will be ready for the IME. Good Luck all and take care and keep fighting...
    Puppet

  6. #6
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    Feb 2007
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    Calif
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    Default Re: Self Insured Companies

    Arizona

    An individual must have the consent of at least one party to a conversation in order to legally intercept a wire or electronic communication, including wireless and cellular calls, in Arizona. Otherwise, this conduct is a felony. Ariz. Rev. Stat. Ann. § 13-3005. Utilizing a device to overhear a conversation while not present, without the consent of a party to that conversation, is also a felony.

    Under the statute, consent is not required for the taping of a non-electronic communication uttered by a person who does not have a reasonable expectation of privacy for that communication. See definition of “oral communication,” Ariz. Rev. Stat. Ann. § 13-3001.

    For example, a state appellate court has held that a criminal defendant’s contention that police officers violated this law by recording their interviews with him without his consent was meritless because the defendant had no reasonable expectation of privacy in a police interview room. Arizona v. Hauss, 688 P.2d 1051 (Ariz. Ct. App. 1984).

    It is unlawful in Arizona for an individual to photograph or film a person without consent while the person is in a restroom, locker room, bathroom or bedroom or is undressed or involved in sexual activity, unless the surveillance is for security purposes and notice is posted. Ariz. Rev. Stat. Ann. § 13-3019.
    http://www.rcfp.org/taping/states/arizona.html
    You are being treated by a ER doctor because your ER is legally self insured. As the ER is paying the bills, they are permitted to select the Dr to treat your injury.

    Even if you were seeing a Dr of your choice, and a IC was providing coverage, your Dr would have to approve a change, and/or the AZ comp commission. http://www.ica.state.az.us/docs/clai...ed_Workers.pdf

    WC comp takes time because it's all about liability. Treatment must be 'reasonable' to the injury, and requested by your treating physician prior to providing the service.
    What is going on in Arizona that allows this to happen to people?
    It's the same all over the country. The IC lobbies, including the Chamber of Commerce, as they represent the ER's, are writting the bills the legislature votes on, and the Gov signs into law. WC is a law, not a benefit. It's all about exposure to the financial cost of the injury/illness.
    WC treatment is geared to the minimum, and return to functional capacity. Whether that is pre injury condition or job, or ER, is not relative.

  7. #7
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    Jul 2008
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    California
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    Default Re: Self Insured Companies

    I would recommend you bring a witness with you to the IME exam.

    If you do decide to tape record the doctor, I also recommend you tell him you are tape recording the exam for your own records. Place the tape recorder in plain view. Just know... some doctor's get annoyed with this, and talk quiet. Every state has different laws on tape recording...and I do not know what your state laws are. You have the right to ask for a copy of any forms that you fill out at this appointment. Before you hand the forms back to the nurse, I recommend asking them politely for a copy, for your own records.

    There have been injured workers on this site who have had honest IME doctors. Not all IME doctor's are insurance company whores...but many are (IMO) from reading the stories on this site, and also was sent to a defense QME years ago (similar to an IME, whore).
    Last edited by kelly38; 01-22-2010 at 07:28 AM.

  8. #8
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    Jan 2010
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    130

    Default Re: Self Insured Companies

    Thanks guys for your replies,, Yes I would definitely tell them that I had it and would also ask if it was OK. It would be alright if they didn't want it too. I am looking for a fresh set of eyes for this. I will have 4 doctors that day and I sure hope one of them will see how all of the w/c doctors have suggested me to see specialists for months and to dated none of that has been done. Now these are there doctors so how can they not listen to there own doctors? I am lucky because I am paid to sit at home. But I don't want to be at home collecting money and no work is being done to get me back to work. I wanna be at work and they pay me to sit at home but don't send me to the care to get better? That don't make sense! I could see if it was one of my own doctors and they were not sure if they agreed with it or not. But come on how about me getting better. I feel they just let you sit there and collect until you hit the 4-6 month range and then get some set of quacks to say hmmm ya this i/w is at max. How about all of the things there doctors say needs done and isn't? This just seems like a game and they hold all of the pieces! Sorry just an opinion,
    Puppet

  9. #9
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    Default Re: Self Insured Companies

    I agree with the poster above....to consult with a few work comp attorney's "as they seem to be delaying/denying" medical treatment.

    BvIA also posted the laws in your state about tape recording. You can still bring a witness to the IME exam, which I recommend.

  10. #10
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    Jan 2010
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    Default Re: Self Insured Companies

    Thank you Kelly and Bvia ;o). I am going to take someone with me and a tape recorder. If they don't let either one in I will totally understand that too. I am just wanting care and I did get an attorney. I really do think there are some really crocked i/c doctors out there. The reason I say that is not because of the I/c It's because they just sit back and collect the money and keep making apt. and seeing you and not doing anything. My ortho doctors seen me 7 times and just keeps saying no weight bearing on my knee. When this all happened he was the same doctor who put me to work light duty and said I could walk and then after several weeks of pain they did a MRI and guess what lots of damage fracture, cyst, fluid and all kinda stuff I don't know what it is but now I'm stuck. Shouldn't they be responsible for that too! Seems weird that it didn't hurt when I took that tumble now it's all tore up.
    Puppet

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