WC OMGosh!
 

Well, I don't know what to do or think.

I spoke to a representative from my city regarding my WC case and during the discussion I learned that they did not have my medical notes, the ones I brought to one of the WC doctor meetings. The ones the doctor said he did not need, because he had access to all my notes. I even asked how it was possible since these notes were from doctors not paid by WC. He re-affirmed he had access. He supposedly copied all my scans.

I got into the outside WC predicament, because WC refused to allow me to see the rheumatologist I was referred to by a WC doctor. Once I saw the rheumatologist I was put his queue. He sent me to a foot and ankle surgeon who said I had CRPS. He referred me to the PM doctor, who also said I have CRPS, and to PT, all under my insurance.

The last WC doctor meeting was strange. He told me it would take me at least a year to recover and that I should never tell WC my CRPS was spreading, because they didn't like that.

To be continued...

Do you have a good atty on your side..
The causation of your RSD will be hard to prove , even if a clear witnessed work injury, proving that the RSD was caused by the injury is very hard to do on your own..

We have a WC forum here also if you haven't explored it yet.
It isn't super active , but still has info in stickies and posts of how the system works , or not as may seem that way sometimes.

But it will help you learn what to expect and maybe aviod some pit falls, as you progress thru your claim.


*I would not fully trust or believe what WC Drs verbally say - the truth is in the paperwork, and get copies of all tests & reports.. often there is "mistakes/incorrect info" that will not help your case..they need to be corrected..

Jomar,

I have no attorney.

Last year I had what seemed to be a minor on the job accident. Within weeks it was apparent something was wrong. The pain kept getting worse and worse until I was put into a brace and a boot. No one could explain why I was in so much pain, because X-rays showed nothing, finally I called a doctor I knew, who sent me for MRIs. I had a hair line fracture, a bone bruise, bone edema and tendonitis.

I missed a few weeks of work, came back on light duty, for 3 days a week, but suspect it irritated my co-workers, because after the holidays I was switched to work 2 days on the most demanding shifts. Even the WC doctor was surprised by this. I protested, but they refused to change this. It did me in, after a few weeks I could barely walk. And after the WC doctor said strictly "sedentary" I was sent home and have not been back since. Also, I was re-assigned to a new WC doctor, dr2.

Dr2 is the one who said he had all my records and did not need the copies I brought with me.

Recently I was sent to Dr3 the one who said it would take a year to recover.

I have a meeting with the top brass at work and I fear this is end.

I don't know what I am entitled to and/or what to do next.

Check your state website for work comp/employment sections.

I really suggest interviewing with a few work comp attys to get some input and hear what they suggest for you. Take notes.. for comparison afterwards.
Don't sign right away with any but talk with them and them look them up online to find more info.
Many will talk themselves up and make promises, just to get you to sign with them, but then they may only do the minimum to get an easy % of any payout..
So just be wary when talking to them..

I don't know how long you were on that job, or if it was high pay.. but something like this is very hard to prove if comp & the company decide to play hard ball.

Usually an employer does not have to hold a job for an injured worker after a year has passed of being off the job.

This is your life & your future so at least talk with a few attys before the meeting if you can . or at meeting if they offer something.. ask for some time to consider.. then
see some attys..

WC can always argue that the RSD may have happened due to some other activity, or that the RSD is a condition that happens in very rare cases and can't be proved to have happened because of the original injury..
This is where your own dr & any long time notes of treatment would be handy.. that no problem relating to same area was ever treated..
but that is all stuff a good atty would ask about..

I don't know your age , if older they may mention early retirement , if a long time employee..

I am older, 65. This was a new job. I was only on it a year when I had the accident.

The RsD is in my foot and ankle. The before and after X-rays should be proof.

I am resigned to whatever they decide to do, but I am not resigned to not getting health benefits for RSD. Especially since it can spread. I think it already has.

You absolutely need to document when you have flares to new areas and treat those areas aggressively. If they turn into permanent spread areas, of course WC won't be happy. The only thing that will make WC is your spontaneous recovery with no cost of treatment to them. WC law varies widely from state to state, so you need to know what your options even are.

Due to your age, I'd encourage you to apply for SSDI. You can receive up to 80% of your gross earnings between WC and SSDI. When you hit retirement age in a year or two, your benefits will convert to SS retirement. You can apply using your Alleged Onset Date as the month after your injury where you made less than $1090 and didn't have subsequent months above that. If in doubt, it might be better to pick a month with even lower earnings or no earnings. Your Alleged Onset Date (AOD) can be prior to your application date. There is a 5 month waiting period, and you can receive up to 12 months retroactive benefits. So, in an ideal situation your AOD won't be more than 17 months from your application. Pm me or post on the SSDI forum if you have questions.

You MUST insist SS approves your medical set aside if you decide to close out your WC case and settle. So long as you do that, SS will allow you to use Medicare to pay for your work related injuries once you exhaust your WC medical funds.

Hiring an attorney might be crucial or not much of a help. It really depends on your state.

My CRPS is from a WC case also. Every state has different WC laws. It is important that you get a lawyer ASAP. You do not pay WC lawyers upfront. They get a percentage of your final settlement which is set by your state.

Also remember that WC doctors work for WC not you. They look out for the insurance company not the injured worker. If your state allows for it, insist on choosing your own doctor (not one suggested by WC). Also a lawyer will help you get paid back for any out of pocket expenses associated with your injury (ie. copays for seeing doctors related to your injury- rheumatologist, etc). Many will also help you navigate applying for SSDI.

I've been dealing with WC for a long time. I'm also a medical provider. You will get screwed without a lawyer.

There are different types of WC docs, at least in the state I live in. Some truly are paid by WC and that is there full time jobs. Others, have practices where a percentage of their client base are WC patients and they accept payment from WC companies. The latter often realize the games WC plays and struggle to get treatment and meds authorised for their patients. As WC laws have become even less patient friendly, some have stopped accepting WC patients.

I disagree that medical providers are the place to get help with a SSDI application. Very few understand the complexities of the system and assume that if they say a patient is disabled and can't work that this will help them be approved. In the OP's case, she will like be approved due the GRID Rules in the first stage if she does a thorough job preparing her application, since her impairment should be considered severe and due to her age. The SSDI process is a medical/legal evaluation.

I am not eligible for ssdi, because I do not have enough credits. I was a stay at home mother and when I did work it was in government jobs. I am eligible for SS benefits through my husband.

The doctors who treated me were regular doctors. The WC doctors are doctors paid for by my city. I believe that Drs 1 and 3, fall under this category, but maybe not Dr. 2. Although all 3 are affiliated with the same hospital.

Dr.1 insisted on multiple occasions that I had a metabolic syndrome and on our last visit he said that I should take a leave of absence and use all my vacation time to take care of my health. LOL, as if. The nurse practitioner in my PCPs office laughed her head off when I told her. As it turns out I do not have a metabolic disorder. Every blood test is normal and every test run by the endocrinologist was normal.

I suspect dr. 1 knew I had CRPS from the beginning. He's been doing this job for a long time and he probably has seen CRPS more than an average doctor would.
You would think they would suggest it as a possibility for early treatment.

Every doctor I have seen has groaned when they see this is a work related case.

Even though you don't qualify for SSDI, you probably will still need SS to approve your medical settlement since you'll be eligible for Medicare through your husband.