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  1. #1
    Join Date
    Jun 2018
    Location
    Central NJ
    Posts
    4

    Default On the Process when and After I Reach MMI

    Hello Folks!

    08/2017 I was at work and a metal stair collapsed under me. Fortunately I was able to stop myself from falling all the way through the stairs, I really don't want to think how much worse it could have been. I was sent later that day to a walkin medical center through workman's comp with cuts and gouges on my right arm and increasing lower back pain. Their doctors gave me a prescription for 550mg alieve tablets and some real weak muscle relaxants. I told them I had a prior back injury (L5 spinal fusion) close to 30 some years ago right in the area where I was hurting now. They seemed more interested with the cuts on my arm then my back and only wrote me out for 2 days from work because of the open wounds.

    It took 3 weeks before the insurance company approved an MRI. When the first Dr saw the MRI he told me I would be needing surgery(this is when I was finally given a prescription for a weak painkiller (tramadol)). Workman's comp immediately stopped me from seeing him and transferred me to a different series of doctors. They had me doing physical therapy for 3 months even though it was giving me more pain. My job wasn't honouring the Workman's Comp Doctor's request for light duty...in fact they added to my workload 3 times(actually taking work from a coworker and adding it to my load). I hired a Lawyer, he had to twice write letters to the WC Insurance company to Honour your Doctors request. Finally I got tired of it and wrote my boss a 2 page letter of bullet points pointing things out (and I guess they realized it wouldn't look good if this went to trial) and they made a decent change to my work assignment (I really think they were trying to get me to quit and I know better then that.)

    The results from the MRI were:Posterior ridging and underlying bulge compressing th thecal sac without focal herniation, Lateral spurring asymmetric to the left with impingement of both L5 nerve roots, greater on the left. Bulge with bilateral foraminal components asymmetrically impinging the L4 nerve roots to the right at L4-5 Mild facet degeneration. Asymmetric bulge to the right at L3-4 with mass effect on the right L4 nerve root. Bulge and central herniation at T12-L1 Disc Bulges at T11-12 and L2-3. Grade a anterior spondylolisthesis on L4 and L5 and L5 on S1 on a degenerative basis.

    WC sent me to a pain management doctor who had tried a surgical injected cortisone shot which I guess I reacted to and for 5 days I was nauseous and stayed close to the toilet. Felt some pain relief for a day and then was gone. So they scheduled me for discotamy/discogram to figure where exactly the pain was originating from. That was the most painful procedure I have been through because they put you in twilight till they find the spot and wake you up to see how you respond to the pain. Well the WC Doctor told me my spinal fusion from 30 years ago (I was in the military and fell down a flight of stairs. I never received any sort of payout..they just used it to get me out of the military and my father's health insurance paid for the fusion I was 19) was all that was holding my back together, that the disc was crushed.

    WC finally after much deliberating approved the surgery, had it done in 02/2018 and have gone through 3 months of physical therapy and a month of Occupational therapy. The WC Doctor told me my back is a mess and I am probably going to be 100% disabled. I live in constant pain. (Years of martial arts help me keep the pain a little more in check, or at least when you look at me it isn't obvious until i try to sit, sit for more than 15 minutes (I squirm because I am in pain)) Heavy pain sitting and getting up from sitting, constant back pain, I can walk, but standing still for more than 15 minutes starts to hurt a lot. I used to be above average strong, well a month ago my combination printer scanner while under warranty crapped out, they sent me a replacement. The box weighs 21lbs shipping weight. Carrying it from the door to my computer no biggie. Taking the old one out to my truck not a big deal. When I went to the place to ship the old one back I ended up being forced to park almost 2 blocks away...well 21 pounds became a big deal. At my last job, myself and a coworker weekly had to carry a 210lb cart down 2 flights of stairs... now 21lbs is too much.

    The WC Doctor told me I would be on Tramadol for life. When I contacted my case worker that I needed approval for a prescription refill she got nasty with me on the phone that "We didn't pay for surgery for you to be on painkillers you need to get off them". I told her that their Doctor told me I would be on them for life and she (supposedly is an RN) is not the decision maker and do I need to call my lawyer because you are withholding my pain meds?" Prescriptions have been getting filled. I am guessing she must have been keeping up with the Dr's reports because when I spoke to her 2 weeks ago I could hear the tone difference in her voice "So your still in a lot of pain?"

    Friday 07/13/18, I go for my Functional Capacity Evaluation, and 07/17/18 is my final appointment with the WC Doctor.

    I have my suspicions I am probably 100% disabled. The anxiety of it all is pretty high because of this whole "unknown".

    My lawyer told me their doctors determine how much of the injury is "prior injury" Which doctor determines that, the one that operated on me or the ones doing the FCE? I never received any sort of payout for the injury.

    If I am found 100% disabled, I understand I have to apply for SSDI, but what about immediate money coming in? Apply for unemployment/temp disability?

    Thanks in Advance!

    Roland Deschain

  2. #2
    Join Date
    May 2010
    Posts
    588

    Default Re: On the Process when and After I Reach MMI

    If you have a lawyer why are you contacting the WC case worker?

    100% disabled means your a vegetable, you seem better than that...

    You need to file with SS, it will take months.....You sound like you could have a 3rd party lawsuit, but that will take many years as they will fight you tooth and nail.

    And REMOVE YOUR NAME !

  3. #3
    Join Date
    Jun 2018
    Location
    Central NJ
    Posts
    4

    Default Re: On the Process when and After I Reach MMI

    Quote Quoting airdale View Post

    And REMOVE YOUR NAME !
    It's not my name, it is a literary figure...google it. I had to contact the caseworker for them to approve paying for the prescription...every month.

  4. #4
    Join Date
    Jun 2018
    Location
    Central NJ
    Posts
    4

    Default Re: On the Process when and After I Reach MMI

    Well did the FCE, which was a painful test to do and I hurt for the weekend. Saw my WC Surgeon for the last appointment. I got a copy of my case file. Got a call from my WC nurse coordinator on friday that "workman's comp will no longer be paying for my pain meds that I will have to use my health insurance for that". Haven't heard back from my job but with the fairly heavy restrictions I don't see them taking me back.

    I called my lawyer office, who was in court. Spoke with his secretary who took all the information down and said he will call me monday but if they have to file a judgement it could take 2 to 3 months.

    I also got a letter from WC, effective 08/10/2018 the above referenced employee is no longer entitled to salary continuation benefits pursuant to title 18A. We will continue to pay temporary total disability benefits directly to the employee in accordance with the NJ Worker's compensation act for the remainder of the disability.

    Without pain meds I am not going to be able to do much...are they trying to force me onto SSDI? What do they mean pay my" NJ Workers Comp for the remainder of the disability"? How long are they going to pay me for?

    Any advice would be appreciated.

  5. #5
    Join Date
    Oct 1971
    Posts
    5,051

    Default Re: On the Process when and After I Reach MMI

    Roland Deschain
    I had a prior back injury (L5 spinal fusion) close to 30 some years
    The carrier will be entitled to an apportionment of loss - they can deduct the percentage of disability assigned this previous injury from your final rating.

    How long are they going to pay me for
    Depends on your final rating.
    These are questions you need to discus with your attorney, he knows the facts of your claim.

    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.

  6. #6
    Join Date
    Jun 2018
    Location
    Central NJ
    Posts
    4

    Default Re: On the Process when and After I Reach MMI

    Thank you Tony! I wasn't expecting to get cutoff from pain medications... i asked my lawyer about it months ago and he said they(WC) would be liable depending on the settlement how it is worked out but I am no where near that point. Just going to get real rough being in constant pain. His secretary said sometimes a letter from the lawyer kicks them in the ass to stay on track if not he has to file a judgement...all new things to me.

    The injury happened when I went into the army... they got me out on an entry level separation so never received anything from it 30 years ago...My lawyer said he has to wait 6 months after I have finished treatments till he could send me to his Dr to have me evaluated for a rating...so I don't expect a settlement till 2020 with the way the legal system plods along.

    thanks again

    RD

    Well I contacted the insurance company to ask the question of how far out they are going to pay me if the job doesn't take me back...and she said oh I got an email today that they can't keep me there because of my job restrictions... and the last day they are paying me till is july 17th.... Oh and when I asked about what is my level of disability according to them? She said in the next few weeks I will get a letter from them to go for a permanency rating... I know my lawyer said he typically sends his clients to it after 6 months since last treatments.



    I reached out to my union rep about sick and vacation time. Guess I am calling my lawyer... I am 3 years shy of qualifying for a pension. Not a happy camper today...it's a lot of money i am losing if I can't find another state job with my limitations.

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