Really need your advice or suggestions
 

Very upset at the moment because I went to my pharmacy to fill my script for my Duragesic Patches 150mcg that I wear 24/7 for years now for CRPS in my left leg, and I haven't had a problem with Workers Comp for a while, until now. The pharmacist tech told me that when they went to process the request, they received a message for them to call for authorization. When they phoned for authorization, they were told no one was there and to call back on Monday. The tech also said that last time I filled my patches I used a one time override (?) and that workers comp requires an authorization now. I asked the tech to call them back because I am supposed to change my patches today and I don't have the luxury of waiting until Monday...I will end up in the hospital. The tech calls back and is told the same thing. I haven't received any information in the mail about any new procedures nor was I advised that I used an override when I filled my patches last month. I phoned my attorney at his home number (he works from home now) and left a frantic message and will hear from him tomorrow I am sure, unless he is out of the area due to the holiday, which would be my luck. I am really afraid of what is going to happen to me if I don't put on new patches. I wear two 75mcg patches and change them every 3 days. My guess is that I am going to get really sick with withdrawl symptoms. I don't have $750.00 to pay for the patches and I shouldn't have to because I was awarded lifetime medical. My question is this - Any suggestions on what I should do and has anyone ever just stopped this level of medication? I will phone my doctors office in the morning and hope to speak to someone - anyone who is on call. Please see it in your heart to respond. Much appreciated.

Could you afford to pay cash for one or two (however many you need ASAP)? Not that you should have to! If not, and if you can't get a dr to fix it for you ASAP I'd probably go to the Er and demand to be admitted....let workmans comp pay that bill instead of one med! Ugh sorry, ins is such a bs money making game

Thank you Hannajane for replying. I just called Walgreens and they said that the smallest amount that can be purchased is a box of 5. Normally I pick up 4 boxes each month which totals 20 patches (5 patches in each box). So that makes it around $189.00 instead of $750.00. If only I wasn't unemployed. Once upon a time a few years ago, I had a decent job in the financial district and my own place. Trying to get back to that reality, but currently I am living with my daughter and her husband and their sweet basset hound that just had an expensive surgery to remove bladder stones, so this is all happening at an inconvenient time. I would hate to even ask. Shame on workers comp to put me in such a stressful situation which doesn't help my pain at all. Sorry I sound like I am playing the victim. Ok, I need to put on my big girl panties (just a saying my daughter and I have when we need to find our power) and think of what to do next.

I can well relate....my life has changed so much in this past year! I hope you were able to find help!

NOBODY understands until they are in this circumstance dealing with this AWFUL disease. I have not been in your dilemma but have been dealing with RSD for over 18yrs. I would go to the E.R. and have them admit you if it comes down to it!!!!!! LISAR
PS I will say a prayer for you!

That's Awful!
 

I had my Lidocane Infusion from the 17th-22nd and wasn't release until Sunday morning on the 23rd. During that time my monthly prescription for oxycodone was due to be refilled. I've been on it for a little over a year. Right before the infusion I had been to rapidly be taken off of my Methadone, as it can have a bad interaction with the Lidocaine, like my heart could stop..lol. Since it was such a rapid stop we had to replace it with a higher dose of oxycodone, which is really only 20mgs 4 times a day. Not that much compared to what some people are on as a chronic pain patient.
Anyways when I was released my doctor wrote a new persciption, which was an increased dosage from my old one. After I dropped it off, I got a call from the pharmacist, who first said it couldn't be filled without a pre-approval from my insurance company. Well it was a Sunday and they were closed, and I had 0 medication left to take! My doctor said it was extremely important to take it, not only for pain, but to prevent withdrawals that would flare my Crps. Then he said he could do a "emergency override" and get 90 pills filled instead of the 240 my doctor wanted filled. I said to do it. Then I got a call right back saying that it still wouldn't process!! Turns out that my insurance company, within the week I was in the hospital, stopped covering the medication completely!!!! He couldn't find my medication on the covered medications list at all!! So then I had to call my doctor's office and hope I could get through to my doctor on a Sunday!! God had to be looking out for me because she happened to be the On Call doctor! She was livid that the insurance company did this. She was Amazing! And personally went to the pharmacy and wrote a prescription for a new medication, which is still oxycodone but had to have the Tylenol in it...... Ridiculous!!
So I know exactly what you're going through!
CALL your doctors office! Hopefully they will find a way to get you something else that would at very least keep you from going into withdrawals, and help you with your pain! I'm so sorry you're having to go through this too! It's so ridiculously unnecessary!!! How do they think they have any say over what a DOCTOR has ordered?! Makes me so mad!

Thanks LisaR624 for responding. I have had this disease for 18 years also. I am sorry we have that in common, but it is nice to have the opportunity to talk to you. It is Sunday and I am not feeling so hot. Last night I had the chills followed by feeling hot, a weird sensation in my throat like sore but it feels more like swelling inside and a headache. This morning I feel extra achy all over. I am formulating a plan for today. Fingers crossed.

Thanks Hannajane. I haven't found help yet, but today is a new day or something like that.

Unfortunately, there was a major overhaul of WC rules in CA in January of 2013. The process is crazy now and yes, even with people that have been on the same meds for years, they're just refusing to fill them. Your doc has to fill out 2 new forms every appointment (a PR2 and I can't remember the 2nd) to request your prescriptions are filled, and if this isn't done, WC can flat out ignore the request. Even if it is done correctly, they can string you along for something like 10 days. If they deny you, you must respond to the paperwork that is sent which is new--my attorney did not explain it AT ALL when I called. WC flooded me with paperwork by submitting 3 reports on the same day concerning the same meds, listing incorrect dosages, and approving a reduced amount to withdraw me, but even those amounts were never filled. Then a few months after they started going through again! I went of pocket to the tune of $1500 in the past 6 months and WC will not reimburse for any of my meds now. Things got WORSE when my attorney did the official appeal, which I lost, and the law doesn't allow you to have a hearing anymore. I can't request for them to pay for those meds for 1 full year now. (You must use an IMR now) link: http://proclaimps.com/news/californi...es-for-2013-2/

If you have Medicare, you can attempt to put them through after getting the final denial which takes about 4 months.

There is a definite push to get everyone off opiates and WC in CA is taking advantage of it. My attorney's office said they're getting overwhelmed with calls from clients that settled their claims 20 years ago with open medical...

And just to give you a heads up, the ER was super nasty with me when I went in with withdrawals. They don't care if you can't afford your meds.

Mz Migraine listed this site to check your drug pricing:
http://www.goodrx.com/
which lowered the costs of one of my meds by about $300 a month.

And try these links as well:
http://ssdfacts.com/forum/index.php?board=33.0
http://ssdfacts.com/forum/index.php?board=26.0

A very inexpensive option is Methodone. It might be worth trying to see if it works for you--it's my fall back option if I can't afford the copays long term (or if they deny me as well) with Medicare Part D. :(

good luck!

Thanks for sharing that, CRPSSongbird. Sounds like you do have an amazing doctor. It's kind of hard to focus on your treatment and be positive with all of that going on. I wish there was a list somewhere of all of the current hoops that we need to jump through so that we could keep up instead of having it happen to us when we are in such need.