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  1. #1
    Join Date
    Sep 2014
    Posts
    4

    Arrow IME Doctor Recomments Return to Work, Treating Doctor Disagrees

    Yesterday...
    So an "independent" doctor, hired by my workmans comp insurance company, who hasn't even seen my MRI or the medical records from two attending physicians or my current doctor, is sending me back to work. Not only that, he has recommended that I be taken off pain medicine, sent to physical therapy 2xwk (again), stop seeing chiropractor and to cancel my appt for an epidural injection. I have a 7mm herniated disk and a smaller one in my thorasic and five bulging in my lumbar. Seeing my doctor tomorrow morning to discuss. I have an attorney and my pre-trial with wc is Oct. 27. I plan on telling my doctor that I can and will continue my current course of treatment with him. The ica told me they won't pay for anything outside what their ime recommends. However... I'm fairly certain that the judge will order them to.

    Today...
    Just returned from my doctor and spoke with my attorneys office. Both of them told me, if you are still in pain, DO NOT RETURN TO WORK. So that is that...

    My doctor took me off work for another month and I just turned it in to HR at work. I don't know if I will be fired, but I've read that they cannot fire me before I have reached MMI. I do know the insurance company is going to stop paying my lost wages, but they will owe me back pay and resume payments after my hearing on Oct. 27th if all goes well. Both my Doctor and Attorney think we have a VERY strong case.
    That's the plan anyway from my medical and legal team. Before I forget, I'm going ahead with the epidural injections. Doctor said the insurance company WILL pay for it. Doctor says they are just bullying me into not having the procedure done because the judge will order them to pay for all my medical expenses at the pre-trial.

  2. #2
    Join Date
    Oct 1971
    Posts
    5,193

    Default Re: From Injury to Pre-Trial

    Good for you, finally - we have someone with a real attorney and doctor!
    This is what I've been preaching for years, follow your doctors' and attorneys' instructions.

    That quack is hired by the carrier to give a biased opinion, he is not your PTP, he doesn't have the authority to deny or approve anything.
    The purpose of an IME is to give an alternate opinion exclusive of your PTP's opinion, that's it.
    Always follow your doctors instructions, never let an IME quack govern or control your treatment.
    It doesn't matter if you follow the quacks instructions or not, that carrier is going to cut benefits anyway - you might as well protect your interest.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Sep 2014
    Posts
    4

    Default Re: From Injury to Pre-Trial

    Thank you,

    Yes, I hired an attorney four months after the injury and a second MRI ordered by my second physiatrist showed that my herniated disk had enlarged another millimeter while on restrictions. My second doctor gave up and decided to refer me to yet another doctor. I told him I would get another opinion from the VA first. When I called him back to get the name of that referral his office would not return my calls.
    My attorney sent me to my current doctor and for once I'm getting the treatment that is actually helping me. My Doctor scoffed at the IME's opinion and pointed out that he is triple certified, whereas the IME has only one certification in physical medicine and rehab. He started writing the rebuttal to the IME's recommendations before I even left the examination room. I have a call recorder on my cellphone and I have the ica on tape telling me that the IME still doesn't have my MRI's or medical records. If I had not challenged her on that, she probably would not have divulged that the IME didn't have all the necessary background info to make a competent decision to send me back to work.
    I will resume my visits to the chiropractor when I get the greenlight after the pre-trial. Money is going to be tight for six weeks while I'm waiting for the pre-trial. Without money from wage loss I can't afford gas to get back and forth twice a week to see him right now.
    Anyway... Always get as many doctor referrals as you can, try to work as long as you can and if your injury has not improved (or in my case worsened) after the second referral is done with you, hire an attorney immediately...

  4. #4
    Join Date
    Sep 2014
    Posts
    4

    Default Re: From Injury to Pre-Trial

    My employer sent me what basically amounts to a welcome back letter. This was dated the day after I dropped off my doctors note taking me off work for another four weeks and it was delivered to me on the Saturday before I was to return to work. HR reminded me that it is to everyone's advantage that a worker who alleges a work-related injury to return to work as soon as possible. Again they are going by the IME recommendations, not my doctor's. How soon they forget that I did return to restricted work/hours for over five months after my injury and my condition continually deteriorated to where I am at now. At one point, soon after I was put on restrictions, they ignored my doctor's orders and put me in a position that violated those restrictions. The result was another injury to my lower back. Also... I returned to work after my injury for less than 100 weeks.

    I have a couple letters from my employer that mentions that I am on [FMLA]leave at the moment, which, btw, I did not agree to, sign off on or were formally notified of. If I am on FMLA however, it should run until November 15th. That date is over two weeks after my pre-trial and even though I will be let go at that time, my eligibility for wage loss will continue.
    Section 301(5)-(9) indicates:
    (9) If disability and wage loss are established, entitlement to weekly wage loss benefits shall be determined as applicable pursuant to this section and as follows:
    (e) If the employee, after having been employed pursuant to this subsection loses his or her job through no fault of the employee and the employee is still disabled, the employee shall receive compensation under this act as follows:
    (i) If the employee was employed for less than 100 weeks, the employee shall receive compensation based upon his or her average weekly wage at the time of the original injury.

    Another thing I want to make mention of. Whether or not you know if you will be able to return to work at sometime in the future. File a Preservation of Unused Benefit Entitlement with the Michigan Unemployment Office.
    https://www.google.com/url?sa=t&rct=...Cw2rHYVRZMvFtQ
    No one told me about this and I just found it myself. I know someone who didn't do this and lost her right to file for unemployment benefits when she was declared MMI and was not totally disabled.

  5. #5
    Join Date
    Sep 2014
    Posts
    4

    Default Re: IME Doctor Recomments Return to Work, Treating Doctor Disagrees

    Short update. My doctor confirmed that I also have carpal tunnel. Not diabetic nerve pain that the IME and other doctors had misdiagnosed. Assuming this will be added to my w/c claim soon. Faxed diagnostic report and diagnosis to attorney. Attorney had conference on Dec 23rd. Said we should make some headway. No info yet on how it went. Still not getting lost wages, but they are paying my medical bills under duress.
    They are claiming my treatment is unnecessary.

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