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  1. #1
    Join Date
    May 2012

    Default Abandoned in the Bush

    I posted this is the medical questions section before I saw there was a state by state forum, so posting here also. I live in a bush town.

    I injured my back at work in November of 2011. I have been seeing a chiropractor and his massage therapist. We began with 3x a week therapy and progressed very slowly, but there was progress. The chiropractor wanted me to stop working. I was concerned about financial responsibilities, my work responsibilities, and the effect of staying home during "the dark" would have on my mental health. He said he understood my position, and although he thought it would be best for me not to work, he respected my decision. There continued to be progress, although slow, and I remained working.

    In early March things looked promising. I could feel the inflammation in my back was less, the pain was less, and we reduced my visits to once a week or so. I also started some light physical therapy exercises prescribed by the chiropractor. Somewhere in early April something happened, I'm not sure what it was, and things got worse in a big way. For a couple of weeks my feet were tingling, I had terrible spasms, etc. I reduced my time at work and increased my visits to the doc. It improved some, but not a lot. At that time I began to ask about a higher level of care. I am in a bush town and he is the only chiropractor here. He hadn't taken x-rays or done a CT or anything and I started to worry. His response to that was to call WC and ask to have an IME scheduled in Anchorage(I didn't know what an IME was, I thought he was requesting a higher level of care.) A few weeks went by while he worked on this, and he again urged me to stop working. Thinking the higher level of care would be soon, I told him I would decide once I talked to that doctor.

    A couple of weeks ago I had a bad weekend. The pain was awful and after 24 hours of intense pain I went to the emergency room. I complained again of the feeling of terrible swelling in my back. The medical doc put me on a five day course of prednisone and gave me a non-opioid pain shot. The prednisone worked amazingly. Although I still had/have the pain, the swelling was greatly reduced and my comfort level has improved from that alone.

    When I saw the chiro a couple days later and told him I had gone to the ER he flipped out. He ranted that he wouldn't treat me while I was "taking all those drugs" and told me that I had threatened my WC case by seeing a different doctor. He then yelled at me for not having called him instead, and again ranted about me not taking time off from work. At first I was shocked, but finally stood up for myself and said I did not have to defend myself for going to the emergency room, that my pain was 9/10, that I believe in the proper medications for the proper illness and that prednisone was not masking my pain. He said he would close out my case if I wanted to see an MD from now on. I told him that was not my preference. He again started yelling about whose "fault" this was. I told him I was offended that he "blames" me when it is no one's fault. He yelled, "Oh, I guess it is all MY fault." and he slammed my chart down on the counter and told the secretary that he was discharging my case.

    I had always let him be in contact with WC, so I got the information for the case worker from HR and called her. She said he had called her twice that day already, told her he had discharged my case and that I had refused to follow his plan of care. She said that the reason they allow three tx's a week is so one can continue to work while getting treated. She also said I had done nothing wrong by going to the ER and that she wondered why the doctor wanted an IME so early, that they usually don't worry about doing an IME until the case has gone for 9-12 months.

    So I've been doing some research. It seems to me that the last thing I want to do is go for an IME. What do I do? There are no other chiropractors or massage therapists here, so I don't have a provider now. Is the case manager my advocate? Who can I talk to about what is best for me? The only treatment available to me now, in the bush town, is seeing a physical therapist. Without the massage and the chiropractic I don't think there is an way I can work. If I can't work here, the cost of living is outrageous, and while I sit here going broke I can't get care??

    What the heck do I do??

    And that's the final straw in my story. I intended to resign my position and move back to the lower 48 by the end of June, because, here, we have to move in the summer when the barges can get into port to ship your belongings out. So if I resign my position, what happens with the WC case?

    I'd be so grateful for advice and suggestions.

  2. #2
    Join Date
    Feb 2007

    Default Re: Abandoned in the Bush

    Who can I talk to about what is best for me?
    A WC atty. Any atty in the state can represent you.

    You are not likely to receive ongoing chrio/PT or massage therapy... there must be a stated goal of functional improvement for this to continue, or it's considered pallative.

    The IME is a Dr selected by the carrier to determine your current status, whether you have reached a MMI/Max Medical Improvement status, that MMI does not mean pre injury condition, but your ability to perform gainful employment, whether that is pre injury work or other sedative work.

    If you voluntarily remove yourself from the open labor market, your wage replacement benefits may be suspended... quitting shows you are not suffering wage loss...the medical portion of your claim remains open.
    Much of this depends on the statutes.

    You need to discuss your options with a WC atty before making any decisions.

  3. #3
    Join Date
    Feb 2007
    831 East Morehead St., Ste 355, Charlotte, NC 28202

    Default Re: Abandoned in the Bush

    There are legitimate reasons why chiropractors are not favored as treating docs in most state work comp systems.

    Based on your symptoms, you need to find out whether you have a disk injury or not. An MRI or maybe a CT scan could identify that. An xray will not. You may just be suffering from muscle spasms, since the massage was helping, but seeing an orthopedist or neurologist or neurosurgeon is probably a good idea for you at this point, to rule out a potentially more serious disk injury.

    You probably need a comp lawyer too. Do your homework and pick the best one you can. and are helpful sites to research lawyers.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney and Board Certified Specialist in NC Workers' Compensation Law

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