I am SO sorry that you are going through this. I am currently going through the process with work comp myself. Last August they decided to start denying everything. So my attorney is in the process of getting everything ready for trial. I've been using my regular health insurance in the mean time to still continue to get care...but as I can no longer afford them I have gone off all meds except my Lidoderm patches. It's definitely a tough situation...and unfortunately it takes TIME to sort it all out which is something that those of us in pain don't really have. My regular insurance has been pretty good up to this point but they will not approve my DRG treatment that I want to get so I am now having to appeal that...when it's a treatment that work comp should be paying anyway...and it's a mess. If you ever need to talk, just vent, etc, you can PM me any time.

If we had single payer this would not be happening, your doctor would prescribe and you would receive what you need. It's hateful and unconscionable that this is happening to you.

I was denied more PT, so I had to join a gym to exercise in a pool and to take balance classes on my own. I get my LDN on my own dime, because it is not covered by either of the two prescription coverages I have. In addition I am owed significant money in co-pays that will never be refunded to me, because it has been impossible for me to find the person in admin, who can help me.

I dread the final settlement, because I do not trust lifetime medical to ever allow me to have any treatment and at the same time I worry that a bulk amount won't be enough, but stories like yours make me think the latter is a better option, something is better than a lifetime of refusals.

We live in a country that is run for the benefit of corporations and not the people.

Please do copy your post to the WC forum here... It does need some activity, and that may bring in more persons looking for information.
search that forum or the whole site to bring up past posts -
work comp
California
Independent Medical Review
Utilization Review

When WC began telling me to reduce my pain meds I turned to my private insurance for pain meds. My dr was furious and tried over and over to get the meds to be maintained, but it was only delaying the inevitable. Previous docs I've had actually stopped doing WC because they were tired of having the things they prescribed for their patients denied over and over. It was too frustrating and made medical care impossible.
Having a lawyer can help, but still doesn't cure the problem. WC has become too powerful and seems to think we are ALL gaming the system.

The bottom line is they don't want to pay. Insurance is a bad bargain with the devil imo. If I had not lived through this WC thing I would be ignorant that injured/sick/in pain workers are treated dismissively.

I am so sorry to all of you. I know how difficult it is working with WC. It has set me back in my path of healing.

I was denied all treatment after a second IME contradicted the first WC IME and basically said I strained my arm and that I am exagerating my symptoms. I was told by my case manager he specialized in CRPS and even wrote a book about CRPS. I actually believed them and let my guard down. Big mistake. I find it difficult to get into specifics. I am so glad my husband was present. At one point we both decided to stop the exam and he reminded us we needed to complete the exam or it would be an automatic denial of coverage. We also had to ask him several times to slow down as we could not understand. He said "this is how I talk".

I have worked full time with no restrictions for 25 years same employer. I have had CRPS since 2003 and had a work related injury mid 2015 that brought it out of remission. Before my work related injury, I had pain around a 2 some days and have learned how to manage my multiple symptoms and meds. Post work related injury my pain shot up to 7, 8 and 9 and has spread. The second IME physician was unethical. My primary demanded I report him. I have been unable to work and applied for SSDI and was granted coverage first try with no lawyer.
My husbands work insurance has covered most things, but we now have a new insurance that refused to pay for my acupuncture, for example, because there is no proof that it works for CRPS. They covered multiple nerve blocks and would agree to SCS but not acupuncture that has been the only thing that drops my pain just enough to get out of bed. Medical science has failed chronic pain patients. I have to gear up to fight, but am so drained from pain and insomnia, I have made little progress. I have a lawyer after the second IME. The second IME has caused a sort of PTSD. Just awful.

Please stay strong and don't let these b******* deny our treatment. I am not giving up.

Hi Jo*mar,
I have posted a modified version of my original post over on the workers comp thread and thank you for that suggestion.

This article speaks to the issue of insurance companies controlling doctors.

Insurance companies’ ‘fail-first’ policy enough to make you sick | The Seattle Times

We have single payer. It comes out of something. It isn't free. We are taxed like 40-50% of our income, so we pay dearly for the system (and other social systems in place).

I doubt Americans (in general) are willing to go there, or as far.

Also, with the system in place, I *still* pay between €100-150 for my medication monthly. So it's not free by any means.

I mean it is nice to dream, but the reality of it isn't that great either. It would be far *better* than the system you have now, even though Obamacare was a step towards this.

Info about single payer: How much would Bernie Sanders’ health care plan cost the middle class? | PolitiFact

An Actual Doctor Debunks 7 Myths About Single Payer Healthcare :: Politics :: Features :: Healthcare :: Paste

Misinformation About the Cost of Single-Payer National Health Insurance | The Huffington Post

One of my online acquaintances just published a book about the issues. An American Sickness: How Healthcare Became Big Business and How You Can Take It Back: Elisabeth Rosenthal: 978159426757: Amazon.com: Books

Currently I have 3 insurances, WC, Medicare, BCBS supplemental and two prescription insurances. Despite this I am not getting the PT I need, nor am I getting my LDN paid for or getting it with a co-pay. Imo this is theft. I never minded paying for insurance that I did not need for more than four decades, I was grateful that I was healthy. Now I need help and I cannot get it, despite paying through the nose.

Regarding the tax implications, please read Bernie's plan.