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  1. #1
    Join Date
    Oct 2010
    Posts
    1

    Default Depressed and Fighting the System

    Injured my neck on the job,was denied comp because 1) I reported the accident over a week later (actually went to my primary doctor 4 days after the accident because i had lower neck and shoulder pain and thought i just pulled a muscle,but found out i have herniated discs with one that is bulging due to a lifting accident at work.) 2)was told i was deceitful about divulging information on my artheritic knee condition. Was off work for 3 weeks with severe neck pain with no pain med prescribed,sent to a neurosurgeon who said my condition wasnt severe,sent back to my primary doc with these results and sent back to work on light duty with severe neck pain. I have been eating the doctor bills myself, waiting to talk to a lawyer to appeal the comp decision,working with terrible pain in my neck and today reinjured my neck at work. (which i went right away this time to my supervisor and reported the injury but was told to go home and "take care of it")....I have a family to support and need to be home letting my neck heal,yet i cant afford to be off work............Dont know where to turn at this point...........ugh!!!

  2. #2
    Join Date
    Oct 2006
    Posts
    9,073

    Default Re: Depressed and Fighting the System

    discuss your emotional issues with your doctor; depression is a common complication and needs treatment.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Depressed and Fighting the System

    ............Dont know where to turn at this point...........ugh!!!
    Turn to the attorney.
    The dispute/denial of your claim will likely need to be determined by a WC judge. That can/will take some time, and no wage loss benefits would be due until the judge issues a decision.

    Depression due to 'pain', actually chronic pain, which is defined as pain lasting more than 90 days post injury is generally compensable, in that you would be referred to a pain management clinic.
    Depression due to the length of time the WC system takes or how you have been denied benefits isn't usually the responsibility or liability of your ER/IC.

  4. #4
    Join Date
    Sep 2010
    Posts
    19

    Default Re: Depressed and Fighting the System

    “Discuss your emotional issues with your doctor; depression is a common complication and needs treatment"
    How does one approach this issue? Through primary care physician or through your specialist like orthopedic surgeon who is treating me.
    Also have a question about medicine like Hydrocodone, after taking for over two years for pain it has effect on sexual activity. Does anyone have this issue and how to approach this issue with my doctor?
    Thanks

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Depressed and Fighting the System

    Also have a question about medicine like Hydrocodone, after taking for over two years for pain it has effect on sexual activity. Does anyone have this issue and how to approach this issue with my doctor?
    Just tell your treating physician, the WC doctor, of the problem you are experiencing.
    It's not at all uncommon, and there is HRT/Hormone Replacement Therapy available to counter the symptom.
    Your Dr will have to supply medical reasoning for the treatment, and get the prior authorization from the CA/Claims Adj, but there are peer reviewed studies available to support the request. Testosterone patches...Endroderm is the norm.

    As to the depression due to chronic pain issue, talk to your WC Dr about your symptoms. Just describe how you pain is affecting your daily living activities. Don't talk about how the system has abused you.

    Your personal/PCP doesn't have anything to do with the WC claim, unless that is the way your state allows treatment.

  6. #6
    Join Date
    Sep 2010
    Posts
    19

    Default Re: Depressed and Fighting the System

    Thanks so much. I was little shy and embarrass to talk about this to my orthopedic surgeon.
    I had rotator cup tear. It was repaired. Had one MRI before surgery and two MRI after but discomfort and pain didn’t go away. Had 4th MRI in three dimensions. Report says “there are abnormalities of superior labrum constituent with chronic injury which can be associated with internal impingement” My dr. wants me to see other dr. for second opinion. Have to wait for approval.
    Show this report to my primary dr. and he explains to me what it is, and I may need a surgery to solve it.
    Long delay in getting approval from IC is the reason this is going on for over two year. Orthopedic surgeon is the best in our area and for me I worship him like a god for helping me.
    About my lawyer-he said to me what is taking so long to be MMI? Let’s get MMI and I will get you good chunk of money.
    I told my lawyer I am not interested in money. I need to solve pain and discomfort and weakness issue in my shoulder.
    With all these issue with me I am little worried to mention “depression and HRT/Hormone Replacement Therapy” with my WC doctor (orthopedic surgeon)
    And my TTD is going to end soon

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Depressed and Fighting the System

    If your TTD ends, you are statutorily MMI, and will be rated for PPD, the indemnity will be determined, and those payments begin. Once the indemnity is gone, there is no more money to be paid.

    That's likely the reason your atty is asking about MMI at this point.
    Dont know what a "good chunk" of money is.
    The indemnity, or number of weeks are due is pretty much predetermined by law. Section 23 1044 defines payment for scheduled loss.
    The AZ WC Act is here http://www.helplinelaw.com/usa-statu...20COMPENSATION

  8. #8
    Join Date
    Oct 2006
    Posts
    9,073

    Default Re: Depressed and Fighting the System

    unfortunately for some, attys and the comp system generally avoid long haul cases; they want to close out the claim and move on to the next case.
    It's a volume business.
    delivering extensive treatment is not something the system does well. the longer you are in the comp system the more the financial losses can pile up.

  9. #9
    Join Date
    Sep 2010
    Posts
    19

    Default Re: Depressed and Fighting the System

    It is IC that is taking too long. Three month after injury they approve MRI and after three month they approve surgery. Everything gets approve after more than three month.
    For prescription, I go to CVS and it is not approve. I will call express scrip from there and will give all information again, rep at express scrip will talk with CVS and then I get prescription. Whole thing will take over an hour and that is very time I go for prescription.
    My state is very small and very few people are posting from my state. So, I don’t want to post from my state. My lawyer gave me this web address to study and get use to it. So he knows and reads this forum.

  10. #10
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,938

    Default Re: Depressed and Fighting the System

    My state is very small and very few people are posting from my state. So, I don’t want to post from my state.
    That's fine, but WC laws are state specific. You're posting in AZ, these laws are not specific to your claim, actually not at all.

    If your state has a UR/Utilization Review process in place, we don't know. IF there is, then there are likely timeframes for a Dr request for treatment to be authorized. It would not be 3 months. If the CA is taking that long, there is a dispute resolution process in place...but, again, don't know because you have not provided your state.
    For prescription, I go to CVS and it is not approve. I will call express scrip from there and will give all information again, rep at express scrip will talk with CVS and then I get prescription. Whole thing will take over an hour and that is very time I go for prescription.
    It takes so long as Express Scripts is a TPA/Third Party Administrator, they cannot authorize any Rx. They don't take you/IW word for anything either. Nor do they contact the CA for the pharmacist.
    You're lucky you're getting the Rx filled if there isn't a prior authorization.
    Your Dr should be writing the Rx + refills as needed, get the prior authorization and you won't have this problem. I use Express Script too... they are "difficult" to deal with at times. But lots of ER/IC use them for contracted cost medications.

    Anyway... what ever response you receive or have read in this thread in not likely relative to your situation. Best to begin your own thread...in your state. If you want to use a general forum, at least provide your state.
    Info and/or advice on your claim should come from your attorney.

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