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  1. #1
    Join Date
    Jun 2018

    Default Medication Denials by the Utilization Committee

    My workers compensation claim was made in the State of: Ca

    I have terrible nerve pain in my feet and legs due to a spinal injury from work with the State of Ca.
    Although I have lifetime medical, they are denying my Gabapentin. The reason they say is that Gabapentin should be denied is that 'studies are not supportive of lumbar pain' and yet what I take it for is radiculopathy from my L4/5 injury. Although I am going to fight it, I get so tired of fighting all the denials and torment. I fear the nerve pain and I fear the suicidal thoughts I had before I started taking the Gabapentin and was in so much pain. There is a huge lack of compassion and decency in that utilization team. Who are they, does anyone know?

    I am breaking my pills in half to prolong them as I don't know how long this fight will take or if it will be successful.

  2. #2
    Join Date
    Dec 2013

    Default Re: Medication Denials by the Utilization Committee

    The only thing I can say is that you are not alone. I think most of us have problems with UR denials for medications which we know would be approved if we were not in the work comp system. One thing you might want to try is asking your Dr. to prescribe a different medication for nerve pain. For example I use to take Lyrica, that was denied that I so I switched to gabapentin then when that was denied I switch to Topamax also Cymbalta. Maybe you can find a new medication to help with nerve pain that they will approve.

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