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  1. #1
    Join Date
    Aug 2012
    Posts
    2

    Default Working Under Restrictions

    Hello all, I went back 6 yrs on this forum...not much on restrictions. Sooo, mri showed the injury to be 2 bulging disks. Off work for into May but had trouble still with pain. Doc ordered 2 injectons with a 3rd if needed. After the 2nd injecton went on light duty and end of June I was back full strength. Here's where it goes south. Back started to act up last week in July, on the 31st in a.m. I called my CM (voice mail) asking how I go about getting the 3rd shot...no call back that day. Next day (wed.) I leave note at lunchtime for employer to ask same thing. Worked thursday getting worse...wake up friday a.m. can't put on a pair of socks cause of the pain. Called in and explained recent events. Monday the agent calls wanting to know what happened, she asks am I off on my own time and I said yes not realizing till later she wasnt going to restart TTD. 2 1/2 weeks later being off and unpaid I finally get appt with doc that gave me MMI in June. He says if he takes me off work he will have to give me perm restrictions which he says I will likely get let go or go to work with restrictions. Mind you I can't even bend over, so I get no bending or twisting and 15 lbs lifting. Employer has one job that I did and can still do according to restrictions...drive the municiple garbage truck. So friday I try it and have to stop 1 1/2 hrs in cause of pain. Try again monday same result. Supervisor tells me to stay home. Agent says I have to work within those restrictions or stay home on my own time. So I call the doc to tell him the problem, he alters restriction to include no sitting for more than hr w/o 15 min break. This will be hassle for employer so I dont think they'll want me there but at same time WC agent is not giving up the weekly benefits w/o a fight it seems. The last doctor visit he actually asked if I had a lawyer!! I dont see where a lawyer will make any money, but I was never offered an PPI so maybe there? Do I need a lawyer??? To me its crazy that I have to work while in pain and cant take pain relievers under CDL. Sorry so long, just trying to be accurate.

  2. #2
    Join Date
    Apr 2012
    Location
    Oregon
    Posts
    347

    Default Re: Working Under Restrictions

    Yes, you need an atty. WC atty. You are being taken advantage of and will need hearings before ALjudge. Get an atty now!

  3. #3
    Join Date
    Feb 2007
    Location
    831 East Morehead St., Ste 355, Charlotte, NC 28202
    Posts
    3,762

    Default Re: Working Under Restrictions

    When things get so bad that your doctor tells you that you need a lawyer, you need one big time. A workers' comp lawyer, not a personal injury lawyer. You have already made a serious mistake by telling the CM you were off on your own time, so you better get a lawyer very soon before you dig yourself an even deeper hole.

    Good luck.
    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

  4. #4
    Join Date
    Aug 2012
    Posts
    2

    Default Re: Working Under Restrictions

    Well its me again, guess it shouldn't be a suprise this didn't go away. So the update is after I tried to work and couldn't I called the doc and he altered my restrictions and with the company had no job so I finally got TTD benefits.
    I got the third injection which did little to help the pain when I bend over. Went back and told doc that he said I needed to decide if I want surgery, told wasn't interested in getting worse~! Case manager agreed to no suprise, I'm sure they don't want to spend that kind of dough. He said we just can't do nothing, all of the sudden he suggests "work conditioning". I call it glorified physical therapy, ha. We to first appt and by the time I left I could barely walk to my vehicle it hurt so much more. Called doc and told them what happened, they said stop going and come in 2 days later( this is this past friday).
    In this discussion no mention of surgery anymore, now he thinks something else is going on. Orders another CT mylogram?, but here in lies the newest problem. Case manager says on the spot they won't approve it. So he says I'll need to go thru my wifes works family insurance to get it done. This ain't gunna fly, just can't afford it. Same reason there's no lawyer. I've been making $80/week less since March and they killed any benefits in august with their delays.
    So there's where I'm at, CM said she would know for sure monday(so that means tues.) If I were to get CT and it does turn out to be the same problem with the S1/L5 disk then it would be work related and he said I would have to fight the agency to get it paid for, which I have zero confidence in that happening. If no ct than what will they do next? Sounds like surgery is off the table even if I wanted it. Oh, he mentioned that in my history when I had a minor bulge back in 1998 that there's preexisting, CM says once a bulge always a bulge like they're thinking there's something else in play here. To me I got hurt at work plain and simple, to them its like there's a conspiracy or some crap. What a nightmare.

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Working Under Restrictions

    Have you even consulted an atty to find out there is no cost to talk to one...?
    Have you found that atty fees are generally take from any benefits recovered for you? That you don't pay up front?
    Assuming things makes nothing happen. Now it's been months, and you have gotten no where....

    Just because a CA/Claims Administrator....(same as a CM) says something won't be covered, doesn't mean you can use your own health coverage... GHP/Group Health Plans expressly exempt work injuries.
    As such, you need an attorney to take this to the WC court/judge. Doubt that is something you can handle on your own... especially as the IC has highly skilled attys you'd be up against.
    Went back and told doc that he said I needed to decide if I want surgery, told wasn't interested in getting worse~! Case manager agreed to no suprise, I'm sure they don't want to spend that kind of dough.
    Stop trying to "think like" the IC... you are nothing more than a number of a case file... the cost of your claim has nothing to do with whether or not something is authorized.
    Treatment is based on medical necessity, on a industrial basis. That's different than using your own GHP.

    Talk to an attorney... as complwyr suggested, before you get deeper into this hole you've dug for yourself.

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