Now what do i do?
 

:confused: Now i am having even more trouble! The W/C carrier hired a case manager, who is also a nurse, to tag along to the doc visits and schedule the tests. According to her, the only way to tell if i truly have RSD/CRPS is if the stellate ganglion block completely takes my pain away? Does this sound right? Especially since the doc already diagnosed me? I read on the RSD foundation site, as well as several personal stories on here that some people get several of these procedures done with no relief. So this tells me that she is wrong about that, but i may be wrong. The list of symptoms i have are swelling and discoloration of the hand with numbness/tingliness, painful stiff joints, loss of muscle tone in arm, burning pain through up past shoulder and into neck, somewhat sensitive to touch, cold, etc. Someone maybe let me know if this is it, and what i should do about this case man. Thanks

Hi Steve,
 

A lot of those symptoms go with Thoracic Outlet Syndrome. Have they considered that. RSD can come with it if you have surgery but I believe I had the RSD along with the TOS even before the surgery.

We have a Thoracic Oultet site also. You might want to go over there and read some of the stories on it to see if that might be your problem or at least part of it.

Ada

I know it can be VERY frustrating dealing with WC. I do not believe she is correct as I don't believe there is any procedure out there that can 100% diagnose RSD...but they should rule out everything else first. Which isn't a bad thing because if it turns out to be something that can be treated then that's a GOOD thing.

But as for the case manager...I had one of those. The best advice that I was given was to not worry about the things that are not in your control and just do what you need to do that IS in your control to get correct treatment. The case manager is NOT a doctor...if the DOCTORS say you have RSD and that you need certain treatments that THAT is what matters. She/He can say whatever they want as a case manager...but what matters is what the doctors say. Don't let them twist you up...that's what they do. Just stay focused on the doctors and your treatment and ignore the case manager.

I've had WC people try to diagnose me over the phone and it's just garbage. One even had the nerve recently to say that my symptoms sounded like I was PREGNANT! They will do/say anything to get you twisted up...so just realize that's their game. They are not doctors. When it comes to a judge in court...they're going to look at what the doctors say and ignore the "theories" of nurse case managers.

So take it easy and try not to stress too much. Focus on what IS in your control and go with the flow on the stuff out of your control because it's not worth stressing over. WC is just awful (in my experience anyway)...don't let them get to you. Focus on your health and your treatment.

Did you get a laywer yet?????

Hi Steve, Remember that she is doing what she is paid to do, work for the insurance company and not for you. Refrain from any casual conversation with her as anything you say can and will be held against you. It is kind of like an IME where the docs say what they are paid to say. Fortunately WC knows this and your own doctor's report and findings will carry more weight if you have to go to hearing. You don't say what state you are from, but I have been having the fun filled WC adventure for over 8.5 years. Stay cool and be your own best advocate.SandyRI is right, find an attorney soon, the system is too difficult for a person to navigate on their own. My son is an attorney and he won't touch my case because he knows that he does not have the specialized training to negotiate the system ( so glad I paid for college!). Be cool and good luck, Lisa

I did hire one
 

To answer your question, yes i did hire an attorney. He is experienced in handling RSD/CRPS cases, along with W/C. Also, I went a couple of days ago and had the stellate ganglion block. When I awoke from the procedure, my pain actually was almost gone. The doc said this was the numbing medication that he injected prior to the steroid. Unfortunately, I woke up the very next morning in more pain than I had to begin with. I called the anesthesiologist and he said this wasn't uncommon, and also agreed with the referring doc that I have every symptom of RSD, and gave me the official diagnosis. The case manager seemed very p.o.'d about this, and even tried to say that she still wasn't convinced. I had to remind her that she was a nurse and not even close to being a doctor, and her input wasn't worth the two cents she chipped in(HA HA!). If she wants to be like this, I will make her hate to come to my appointments, and even to speak to me. I am not a rude person, but it is so fun to treat the case mgr. and the insurance co. just as bad if not worse than they are treating me. So I do have another question, the case mgr. nurse says that there is no limit to the amount of blocks that they can give me, but the anes. doc. says he would try a couple more before he would stop. Does this sound right?

A doctor should ONLY perform a procedure if he thinks that it is medically necessary. They can make you see other doctors for other opinions...what they like to call INDEPENDENT medical evaluations...but what it really is is them shopping around for a doctor who will say what they want. The problem is that if your doctor thinks you need to do them then they may be able to say you need to do them. But if it increased your pain I am surprised that the doc would say he would do more. It's one thing if it does nothing...but another entirely if it made it WORSE.

I am so sorry that you have to go through this. Dealing with my own share of difficulties from work comp at the moment after complications after my lumbar sympathetic block. The funny (or ridiculous) part about when they make it seem like I am off for something not related to the initial injury is that as an executive manager I have 180 days of short term disability where they would pay me my FULL salary if it wasn't work related. Since I am paying my own medical bills at the moment through my own insurance...wtf? But until I know it's NOT related I'm not filling out any forms saying that it's a seperate thing.

Sorry... I have a tendency to go off on tangents. Just know you are not alone in this. You can post any time on this board and we will be here to support you. The sad truth is that the work comp comanies seem to see our pain as an advantage for them because it can make us make mistakes and get frustrated and just give up (some companies...not all). Hang in there and be careful with that case manager. It's easy to have your words twisted when it comes to something you said in anger. I just ignored mine and only answered direct questions. But yours may be trying to instigate something. Hang in there. I hope that the doctors are able to help you in this and take care of your pain.

Steve, as Lisa mentioned above, once you have a lawyer you shouldn't be speaking to anyone at WC at all...

didn't your lawyer tell you that?

From my experience, I only had a series of 3 nerve blocks. I too felt great right after the nerve block, but the pain always returned within 48hours so we only did a series to 3. Reason being was because it's effects were so short-term that the risks out weighed the benefits. After the nerve blocks I tried ketamine. I would look into that if the series of 3 dont work out for you.
I hope you get some long-term relief soon.
Sarah

From what I understand (not 100% sure) is that you can ask the doctor to make case mgr. wait outside the exam room for you to have privacy with doctor. I had a nurse case mgr. for my hands (bilateral everything is easier to say), she showed up once for the whole visit, which I did not care about, BUT she came for a second visit and get this, while waiting for the doctor to come in she tries chit chatting with me and then all of a sudden she goes completely pale and starts digging through her purse. this is how the rest of our chit chat went:

Nurse mgr: O my god, i forgot that i was supposed to call for jury duty today.

me: wow, well call them and explain your position and see if they can reschedule it for you. I believe we are allowed one reschedule w/in 6 months. (NYS)

Nurse mgr: do you think i should do that? or do you think i should lie and make up some excuse?

me: UUUMMM, honesty is the best policy.........

she ran out and i never saw or heard from her again!!! WTH!!