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  1. #1
    Join Date
    Oct 2011
    Location
    north dakota
    Posts
    43

    Angry Not Responsible for Degenerative Disease

    i was hurt on a temp job , twisting knee and ankle and slamming right side of body knee ecetra into concrete was a serious fall , to make a long story short i had surgery and now have 2 inche of atrophhy and knee is no better , dr says i need a knee replace ment sever chondro malacia , and knee is grinding and not tracking properly have to walk with cane and brace , but becasue it shows degenerative disease , they say there not responsible for this , i was totaly fine running when i got hurt and now cant stand for mor than 10 minutes , cant kneel on my knee , ecetera , and dr says need a knee replacement ,
    how are they not responsible for this condition.
    i tried to get help with an attorney but there is only 2 in the whole state , they can only help you with medical denials and want like 2500 up front to pay for fees witch im only getting 500 a month cause they didnt consider what ive done for 10 years just this temp job
    help please
    if i still didnt hurt so much id give up
    they also i hired a crocked ime dr witch i can prove and he did nothing but lie i have 3 other doctors that do not agree with his report .
    why is it if you are an injured worker people automaticly think your a scam or a fraud , i loved being a hairdresser and a massagetheraprist , now im nothing , some people have more pride and like going to work not all of us think of an award

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Not Responsible for Degenerative Disease

    If you had not been injured, of course the ER would not be liable for treatment to the degenerative disease... that's is an underlying condition, not cause of injury.
    The ER/IC is liable to treat your injured body part... denial based on the DD is not valid, and probably will need to go in front of a WC judge.
    they also i hired a crocked ime dr witch i can prove and he did nothing but lie i have 3 other doctors that do not agree with his report .
    IME is a Dr of the defense choice, not your treating physician. The report is an opinion... lies to you because the Dr disagrees...your Dr's are opinions as well, Ok to you, because they agree with you. The judge is the ultimate trier of fact.
    why is it if you are an injured worker people automaticly think your a scam or a fraud
    Don't know that that's always the case...many injuries are not readily visable to the lay person.
    WC is not health insurance, nor is the employee the insured party.
    The IC covers the liability of the employer.

    You need to get this in front of a judge to resolve the dispute.

  3. #3
    Join Date
    Jun 2011
    Posts
    203

    Default Re: Not Responsible for Degenerative Disease

    I think the degenerative disease HOPEANDPRAYER is talking about was due to the accident so there for should be covered by WC

  4. #4
    Join Date
    Apr 2012
    Location
    Oregon
    Posts
    347

    Default Re: Not Responsible for Degenerative Disease

    I concur with purple puppy, you now the bias in ol


    I agree with purplepuppy the degenerative condition hopenprayer is referring to is not the reason for treating the injury and shouldn't be the reason for denial. Chondromalacia, reportedly has no consensus on how to best treat some say ICE and rest and surgery won't work. IME medical opinions are biased and structured for denials. IWs here report some IME doctors use other patients records and some IME providers do not even have acess to x-rays or MRI reecords when they make their reports (mine included)

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