Is your WC gov't or private DreaB?

I'm wrestling with the US Dept of Labor, I can't exactly tell you what to do, but I have a lot of experience at what not to do.

Hope you find the help you need here, I did. And many in the balcony cheering me on!
Pat e

Hi, I'm so sorry to read that you've been dx., with CRPS and also that WC will not grant you this med. Like yourself, I had an on the job injury and two surgeries, the CRPS was dx., later after I had reached MMI. And like yourself, I had a SGB with little results. Pain doc said that I didn't have CRPS but later changed his mind, and said that I had a mild case of it. Since then I've had two blocks and the last one was like a dream come true. I've had much relief going on one month now. But here is the kicker! When I went to see a DIME doctor WC didn't put the report in my file that the Pain doc said that I DID HAVE A MILD CASE OF CRPS. They only put in the report from the first SGB, that said that I didn't have CRPS. When I was being examined the DIME agreed that I wasn't at MMI but THAT I DIDN'T HAVE CRPS! When I read the report, I couldn't believe my eyes. Now I'm going to see an IME, who in all likelyhood will say that I'm at MMI and that I don't have CRPS.

Don't get me wrong, God knows I don't want this, but I know I've got it. I hope you have an attorney on your side and best of luck with WC! By the way that med you mentioned...beware!!! Been there tryed that! I'm rooting for you!
Lefty

Its been a few since I been here, I wanted to play catch up. I have now had 2 Blocks and will have the 3rd one on Monday. They have been what I perceive to be successful as the pain is getting less and less with each block. I have on the other hand been having the side effects of the Amptriplyn (sp) it has raised my blood pressure and man all i wanna do is sleep even when it is in 2 hour increments. I have felt somewhat depressed but that can all be also due to the fact that I'm no longer doing light duty as of 1/31/11 policy states no more than 180 days I have reached that limit....go figure. I have been slowly reading posts and research how to handle things from here. I feel ready to go back to work by the end of the month as PT is beginning to progress since the blocks. I pray that everyone here is blessed by the hand of GOD in all there struggles with this condition. Will check in soon.

Lefty,
what is a DIME? and my pain doc said that I have CRPS Type I and also what is a MMI? How do you know when to get an attorney

We are self -insured but theyre still governed by the state.

DreaB,

WC is a very cruel system to have to deal with CRPS. Most states use the AMA Guides to Evaluation of Permanent Impairement 5th ed. as their standard. That text is not CRPS friendly at all. Do not expect great things to happen under WC, but if they do, take advantage of it!

Unless you have had EMG/NCV/SSEP (neurodiagnostic studies), they cannot rule out CRPS type II. Period. Not that it really matters much unless they are setting you up for your CRPS to be labeled of "non-industrial" origin which would be easier to sell if you are labelled type I (no obvious origin). Part of acceptance of an indutrial-related injury is proving causation. Type I would be harder to prove. And while Neurontinin and Lyrica may not be authorized by WC, you should still ask your pain doc why it is not being prescribed. Amytryptaline is not specifically for nerve injury/pain but helps some.

A DIME (in other states DME or IME) , I suspect is a defense (insurance-ordered and biased) "independant" medical evaluation. It is not independant, but it is a "defense" exam. It is NOT designed to help you, although on rare occassion you might get a sympathetic evaluator that calls it more neutral! MMI stands for maximal medical improvement which varies from state to state but usually means something like, you have reached a point where further time or medical intervention is not likely to significantly improve your condition. It's a fancy term for, they are cutting you off. Issues of future medical care for residual pain, flare-ups, exacerbations are then decided upon by either your treating doc or still another evaluator (this is absolutely when you should talk to an attorney) so that when you get your permanent and stationary exam and it is determined that you are MMI, it is almost (but not always) engraved in granite. In my state, there is what is called new and further disability if filed for within 5 years of the date of injury or 3 years from MMI (P&S). Every state has their own rules and regs but to be sure, you want to consult an attorney BEFORE you are labelled MMI and thrown to the wolves.

I am not pro-attorney but I do very much understand the WC system. Just when it seems like all is well and everyone is playing fair, the rug can get ripped out from underneath you, the party is over and there is no one to drive you home. Because you are very much likely to have permanent residuals, I think you should consult with an attorney sooner rather than later to watch your back! You potentially have much to lose.

And since you are WC, when you are MMI, you definately want future medical addressed because from that point forward, no group health carrier by law will cover ANYTHING related to CRPS because it was originally an industrial-related injury. It is a legal exclusion under group health. Sucks. And no, this is not an endorsement for universal care, it would be even worse under those rules.

Glad to hear the blocks are helping!

DreaB,
I never intended to have any attorney at all and now I have two. One specifically for my WC, my first lawyer said it was too complicated for him. The Dept of Labor is difficult because they are the judge and jury. No impartial mediator, everyone works for the Dept of Labor. I still don't like having a lawyer, but being this far down this road, I wish I had gotten one sooner. Part of my delay was just deciding who to call. I didn't like the first two. I didn't feel like my interest was a priority. I am glad I have the 2 I have now.

Make a decision you can live with, without regret! So you don't second guess yourself later on.

With prayer for you,
pat e