[SandyRI]

On December 3rd, my husband and I drove several hundred miles to see Dr. Getson for a ketamine consult for my RSD. I was injured at work on Nov 1, 2006. Getson issued his report for me within a week, and sent me a receipt for his (not insignificant) consultation fee. I quickly submitted it to my attorney for reimbursement from The Hartford.

Upon denial of the reimbursement and the related ketamine infusion treatments, (not unexpected), my attorney filed a petition for a pre-trial conference in RI WC court. I don't yet have a date.

What's just so amazing now is everything else that the WC carrier is doing to me - I can't fill a script. NOTHING goes through. I have to use my personal insurance and remit the co-pay. My doctor's bills in Boston from MONTHS ago appear to be in the process of being reversed to my personal insurance carrier - with "balance owed by patient." Stuff from April and June of 2009! I found out because my insurance carrier sends electronic alerts when changes are made to your personal account.

Merry Christmas, huh?

These guys have NO SCRUPLES!! And it all started because I wanted to be better!! Like pain-free, so I could go back to work. I did my research, and got my paperwork together, and sent all my stuff out, and my husband and I drove a lot and met this doctor and loved him.

And now it turns out this battle is getting really ugly, and these guys play dirty and pick on sick people in evil ways.

There's no end to how WC continues to surprise me with its ugliness.

XOXOX Sandy

[Jomar]

I feel for you and anyone else having to deal with wc, it's a very messy and stressful thing to go thru.
Hang in there and best of luck with the fight.

[AintSoBad]

I agree, Sandy!
(I've never heard a good thing about Hartford), but ALL ins. companies are going to start getting tuff, with this new law that may probably pass.

I got a notice from B/C, who are eliminating my policy, and will no longer cover lots of things they did, and I'll hafto pay 20% on Everything, and, that's after meeting a 5 or 10 THOUSAND Dollar deductible for the year!

If this legislation passes, the health care industry is going go nuts!

Waiting for the next elections.

Sandy, You do all the good and right things. Is your lawyer good? What's he say?
On my original injury, I had full coverage for life (auto), Nationwide pushed that law through, and they pulled it out. (Through the PA legislature). Then, they stopped paying.
Forcing me to sue. That's when my lawyers said, Pete, they're just gonna keep doing this. Take a buy out . I did, it was substantial and fair.

But, that's the game, they want you to put it on your personal insurance, and if you sue, they buy you out (hopefully), and get you off of their books.

It's Craziness..

Hope you're feeling well, Sandy!

[stressedout]

I'm right there with you. I am dealing with wc comp too. Every month they give a hard time about filling meds and now are asking my doc if I can start coming off?! They just had to be increased. I am not looking forward to this battle but have a good lawyer and know that all I have to do is make the call to him and it's done. Hopefully it stays that way and doesn't get as ugly as I've heard it getting for alot of people. Obviously they don't want us to get better.

[SandyRI]

Thanks so much for the advice, Pete. I still have a lot to learn.

My attorney is good, very good. And he has advised me against settling at this point in time. I trust him to know the laws of RI and to know what is in my best interests, I have to. So far I have gotten everything I have needed. I have let my attorneys know that the reversals and denials are taking place, and they assured me that they will take immediate action. All my legal bills are paid by The Hartford under RI law.

So, in essense, it appears the new legal costs that are associated with this lunacy will just cost The Hartford more money. It is not just mean, and will likely make them look really bad in court (If the judge is made aware of all of the facts), but very expensive and time consuming in the long run. Dumb, dumb, dumb.

Merry Christmas, all! Peace. XOXOX Sandy

[kathy d]

Hi Sandy,
I feel your pain because I am going through the same thing. After waiting over three years now for Ketamine and doing all the clearances NOW the workers comp ins does not want to pay for it and are fighting me. They said chiropractics was not helping me which is was and I am fighting to get that trmt back...it's been 1 1/2 years now and still don't have a judge's ruling on the matter since this past Spring. It is a nightmare. I've used all the small settlement (if that's what you want to call it) up and will be losing my home in the next few months if I can sell it but have no idea where I can live now. I was up almost all last night and spent days on the telephone trying to get help from everyone. No one will help me. It is a nightmare. I keep thinking "How can I do some type of work and get paid?" I can't even come up with doing work since I am bedridden 22 hours per day. Who would hire me when I can't even sit up for ten minutes on the computer. I feel like I just can't go on anymore. I am worn out...but I know I have to fight for what is right as you do too. Go to the news and call your congressman and senators like I have done. I even wrote to President Obama.

My advice for what it is worth is not to settle with ins since they get worse once you settle and the claws come out big time. I don't know how they sleep at night treating people how they do. I feel like I am in a nightmare and never waking up. Hang in there as I am praying for everyone each day. Try and have a decent holiday and just block this mess out as I am doing on Christmas Day.
Best of luck and keep us informed,
kathy d

[hope4thebest]

Hi everyone,
It is comforting to know that others are going through the WC shuffle. I don't mean comforting in the typical sense of the word..I mean that I don't feel so alone in the WC quagmire..

At some point I know my case will have to come to an end, but I don't understand how it can when RSD'ers are never really 'permanent and stationary' in their disability. That is a term used in California when eveything has been done medically for the "patient" and their disability is "defined."

As we know our dis-order is unpredictable and, therefore, how will we ever know that we are "stationary"? Philosphically, I know that everything changes, and I suppose so will the RSD !!!

My WC experience has been a mixed bag...they did approve the electic lift for my car and a mobility scooter.. (I had been told those items would never be approved!!, but they were!) I fought like the dickens!!
They are still approving injections and neurontin..and I've had 6 lumbar blocks..My pain management doc missed the spot on two of them...that's why I need to see an anesthesiologist!!

I'm trying to get approval to see an anesthesiologist and look into bier blocks for my foot/leg, and infusions, epidurals, etc. I'm sure I'm going to have a memorable time trying to get that approved
I am still fighting for continued use of the aqua therapy pool and footgear (shoes and/or orthotics) Seven months later and I'm still wearing flip-flops with socks to work!!!!! Long story... (the flip flops have the fabric piece in between the big toe and the rest of the toes and it hurts!!
I'm also fighting for chiropractic and acupunture..
So, Sandy, Pete, Stressedout and kathy D, I'm thinkin' about all of you and praying! that you get some positive results!!

I've stayed up too late again... Feet and legs are burning...an innovative way to save on the heating bill....
Thinking of all of you
love,
hope4thebest xoxoxoxo

[RNcrps2]

Sandy, I am also w/c. They have been ok until it spread to my feet and now they are denying feet as part of the injury. I was referred to my attorney as an experienced w/c att. but when i first told him RSD he sounded more like it goes away. I told him i was chronic and concerned that he didnt know current info on RSD and he assured me he knew what he was doing. How did you pick attorney? How can they ever settle when symptoms fluctuate. I know he is a top w/c in my area but how do i know he will be the best for RSD? I dont know how you do it Sandy. Its like we have enough to worry about and we dont need w/c jerking us around. I cant believe they can stop paying ur scripts! I know you are waiting for approval to do ketamine. I am also going to see Dr. G but my pmdr insists that ketamine is not a cure and i will need to do boosters. I fear getting ketamine and it working-w/c dropping me before seeing how long ketamine will hold me over. Will w/c pay for boosters forever? I know i wont be able to afford boosters for life. I hope for x-mas you get approval and scrips filled! momof4

[screwballpookie]

Hi Everyone,
I myself have been fighting wc for years. The first time we settled after 4 yrs of fighting.The only reason I settled is because they agreed to leave an open file for my medicals. That is what i wanted so I didn't have to pay for the rest of my life for everything pertaining to my rsd. They renigged after we settled meaning after papers were signed dated and sealed by the state they still haven't paid for my medicals yet. I live in Iowa by the way. We have now had to open another lawsuit to get them to do as they agreed the 1st time and it has been 2 yrs going 3 yrs the second time around. I do have a date set for a trial which is actually April 15,2010. They also have a mediation set up for me at my attys. office on Feb.15,2010. I am not a hundred percent sure of what a mediation is but i guess I will find out when I get there. I am definitely not settling out of court this time.They screwed me over the last time and there are not doing it again. Sorry, but I am unemployed due to the place I worked for fired me due to restrictions i brought back from the doc due to an injury on the job. I lost everything that day. I had already lost what i have for a life due to not functioning like i should,I lost the money i was earning and I lost my familys health insurance. I now can't get health ins. due to my rsd. I have tried 3-4 different ones and have been rejected everytime. So i have no health ins. My husband is the only one working and we are still havingj to pay full price for my meds. We spend between $700-$900 in meds every month. I turn my reciepts in to my atty. everytime I get one so they know that wc is to pay for that. They owe me $2900 from the last settlement we had in meds and now for everything we have paid and are going to pay in the future. My psych bill is over $3400 and climbing along with the last nim rod of a psych,sorry, I had before which is $1300. I have doc bills up to wazzuh and have already been turned over to the collection agencies due to non payment of bills because of rsd.I have to worry about making sure i have my meds every month before I worry about paying for wcs doc bills. We are going through a lot right now and will continue at least till this is over. Not only is all this going on I now have what I call spys for the other side watching and following me cuz they think I am faking.I have had at least 2 at Wal mart following me and how do i know cuz they make it obvious that they are following me. They act like they are looking at something else but they are really watching me cuz no matter what aisle I am in they seem to be there after I get there. I even had one of them push his way through between my friend that was helping me shop and me using my walker. I wanted to ask him if he had a problem but I didn't cuz I was afraid of messing my case up. I am not trying to scare anyone but this is how my wc case has been so far. Any questions please ask and I will do the best I can to help.

Sincerely,
Tracy

[SandyRI]

Originally Posted by RNcrps2

Sandy, I am also w/c. They have been ok until it spread to my feet and now they are denying feet as part of the injury. I was referred to my attorney as an experienced w/c att. but when i first told him RSD he sounded more like it goes away. I told him i was chronic and concerned that he didnt know current info on RSD and he assured me he knew what he was doing. How did you pick attorney? How can they ever settle when symptoms fluctuate. I know he is a top w/c in my area but how do i know he will be the best for RSD? I dont know how you do it Sandy. Its like we have enough to worry about and we dont need w/c jerking us around. I cant believe they can stop paying ur scripts! I know you are waiting for approval to do ketamine. I am also going to see Dr. G but my pmdr insists that ketamine is not a cure and i will need to do boosters. I fear getting ketamine and it working-w/c dropping me before seeing how long ketamine will hold me over. Will w/c pay for boosters forever? I know i wont be able to afford boosters for life. I hope for x-mas you get approval and scrips filled! momof4

Hi Mom,

Sorry for the late reply - we were away for a few days.

After several denials, it seems that I am back in the system again at the drugstore. And after a handful of my PM doc bills got transferred over to my personal insurance, it stopped. I have to guess it was because I called an e-mailed my attorney to let them know what was happening. Now I have to make a copy of the receipts that I paid for and send them to my attorney for reimbursement.

In RI, everything related to my RSD is supposed to be paid for by the Hartford forever. So when the ketamine is approved, I don't knowhow it will work. I will need it for life. Dr. Getson wrote that in his report.

I know that for a while there was a problem with my PM doc over him getting authorization for any treatment that might be for "neck" pain. And then my RSD spread to my right leg and was treated with a block. My whole case has been appealed by WC, I don't know what is going to happen when it goes to trial. For a long time WC was fighting the "RSD" label on all of my reports. But then I was sent to THEIR doctor for a loss of use rating (the surgeon who did the 2 surgeries where it all started) and he marked on his report that I have RSD. So I don't know how they are going to try to get out of it now...It's a valid diagnosis. I can never settle with them, per my lawyer. Ever. The Hartford will screw me forever if I do that. I need to keep my claim open so that my lawyer and their lawyer, both named John, can go to court every other week and beef over my case, and then the Hartford can pay them.

I am going to court on the ketamine petition on Jan 21st. That means if its approved Getson might get me in his schedule for February.

All I want is to get better so I can go back to work. I know, keep dreaming, right??? We all need a goal. That is mine, even if it ends up being part time for a while.

I think I answered all your questions...

XOXOX Sandy