If you have been approved for SSDI then Medicare must approve a set aside amount in order to close out the medical portion of your case. On the one hand this is ideal, but it sure seems like the best way to comply with all this requires is to use a service to manage the funds and all the requirements, so it's also complicated.

My lawyer said I am getting open medical, nothing else was offered. It could be, because I am not eligible for SS disability.

It took me years to get to pain management. Godsend.
PM doctor was the first person to take me seriously.
I recently got a private, cash doctor, close enough to home that I can ride my scooter over there. Was there yesterday in the middle of this flare. I'm now 28 hours into it. It literally knocks me down.
What was I trying to say?
I hired my own psych too. Cash. Found her while researching ketamine infusions and paid for a round of that. I can't afford her either. WC denied her. They denied ketamine too. I need her. Maybe today I can mooch a ride to her office. She usually keeps hours on Saturday.
I need to prepare a cost estimate for future medical bills. I can barely stand up.

Same here. I have had CRPS for years and had a work related accident couple years ago that exasperated the disease. First IME perfect. Nice guy performed the exam with the utmost professionalism. Second IME horrible. Report said I was faking it, could go back to work no restrictions, nothing but a muscle strain. I was actually traumatized, both physically and psychologically. He kept claiming no doctor patient relationship when I questioned him on all this behavior. Case manager really hyped him up. Wrote the book on crps, will really help you, bla, bla, bla...
This does not give them the excuse to abuse us. Never again! My MD insisted I report him. I have since read he got away with this for years.

At times like these I thank my booty for generalized health care here in Belgium. Gosh you guys have it so hard, especially under this administration.

It is not clear to me what has already changed with Obamacare.

How are you guys experiencing that?

"Obamacare" gets a bad rap from our right, but it has been invaluable helping many of our citizens, especially those that are disabled but not qualified for Medicare or insurance from a spouse, etc.

What we're discussing in this thread is medical coverage for injuries that occurred at work. The insurance companies are very aggressive denying coverage.

I suspect a diagnosis of CRPS results in what they term a "high value claim". Our crowd is expensive because it isn't easy or simple to get better.

From what my lawyer has hinted CRPS must be a very high value claim. Once you have it you don't just get better. It progresses. It often renders you unable to work. You certainly need medical (expensive medical) care.

My AME recommended I ask my doc for a prescription for a scooter. I'm quite sure that will be denied. W/C won't even approve exercise equipment for me, not even cheap equipment. He also said ask for a CAT scan to verify that one fracture didn't heal so that podiatrist can try again to get the device that's supposed to help with bone healing.

Oh and I DO have arthritis in my big toe joint, but podiatrist said its cause by the trauma from my fall. Multiple cysts in the joint. But he can't do any of the typical treatments due to the CRPS.

I can't believe a doc could just change their report. That sounds like medical malpractice to me!

If you were fine, you would not be begging for help or paying for it out of pocket. It’s a red flag. You would think they would get this.

WC law varies from state to state so this does not always hold true. In MA your WC carrier owns your medical care for life so there is no way around their corrupt system.

I once had an IME (requested/paid by the insurance company) with a very well respected hand surgeon. His report agreed with everything my pain doc and hand surgeon said. Once the insurance company saw the report they made him amend it. The main body of the report stayed the same except and addendum that stated he received new information that led him to the conclusion that it was all in my head! I don't know how he can note the color change, etc in my arm, but then state I'm crazy. Apparently I am a magician that can make my arm change color, swell, etc. on demand.

The bottom line is that the WC system in this country is rigged towards the insurance company.