Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 10-18-2007, 03:33 PM #1
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Question Voc Rehab Interview tomorrow! What to expect?

Meet with the voc rehab "expert" for opposing side tomorrow morning at atty's office. Opposing atty wasn't happy MY atty insisted on being present - something smell a little off aboutthat to you?

Supposedly he's flying out here to discuss alternative job options with me, as my Drs have said I can't return to teaching. Actually, Dr Togut has said, "she remains totally disabled for any gainful employment." And that related just to my pain and disability in my upper extremities, the bilateral TOS, not taking into account my dx of RSD or major depression! The RSD is increasingly affecting my feet and legs, making me walk slowly, my feet burn, and my knee ache. Standing or walking on hard surfaces like asphalt or concrete increases the pain in my feet greatly later on. Finding shoes and socks my feet will tolerate is becoming an issue. If I walk or stand more than 20-30 minutes I will have greatly increased pain later.

So I am very limited in use of my arms, and I can't stand for long periods. I am on an anti-depressant, a narcotic, another nerve pain med, a muscle relaxant, and Valium to help with sleep. And I have a spinal cord stimulator.

And my sleep is totally messed up, which may be partly why I am always fatigued, but that is also part of chronic pain and RSD.

As you know, any time I overdo, the next day or two I spend in increased pain with a flare.

I'm sure employers would be lining up to hire me!!!

I am confused as heck as to this "interview". Do I tell it just like this? Or is he looking for me to say something, anything he can use to show I'm not willing to "try"? Just WHAT am I supposed to be doing tomorrow?

Need some tips on how to play the game.....

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Old 10-18-2007, 04:42 PM #2
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I hope your atty will jump in if any tricks are tried.
Your atty didn't ask you to come in early or call with a heads up on what to expect? {if not, I'm not really surprised, but it would be nice if they did that}

I guess the basic suggestion is to keep answers brief and to the point.

If they ask just clearly explain your pain and how it affects all aspects of your life.

But I've never been thru a interview like that- so I hope if anyone has they can tell you about the experience.
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Old 10-18-2007, 05:29 PM #3
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Hello,
I have never been to that kind of Voc. Rehab. interview either, so i really can't give you any tips, sorry


I hope everything works out in your favor.

Judy
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Old 10-18-2007, 10:38 PM #4
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Thanks for replying. I just know this isn't for my benefit. And the IME, functional capacity exam and psych testing are all in my favor - they have found no way to contest those, they are all positives. So this is about the ONLY thing they have to somehow try and score points for their side - makes me leery!

I am supposed to meet with attorney early to go over what to expect Jo - that is, if he even really knows! Trouble is I'm REALLY not functioning all that well before 11:00 a.m. or noon - and am to meet with atty at 9:15, "expert" at 10:00 a.m. - afraid I'll mess up due to brain fog, you really have to be on your toes cause sometimes they are just hoping to make you give wrong answers!

Will just have to remember to breathe deep, take time to think, and if I get confused, say I don't remember. Thank God my atty will be present!

Wish me luck!
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Old 10-19-2007, 05:46 AM #5
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Good Luck SistahBeth!

I'd be honest. Brutally honest. "I'd LOVE to be able to do ____, but if I did ____ would happen."

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Old 10-19-2007, 09:56 AM #6
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Heart Keep Fighting Girl!!!

So how did it go?

I'm assuming I am too late to mention anything - besides, it's all been mentioned, and anyways, Beth, you are so knowledgeable of your own condition, and capable of expressing your symptoms in a clear and concise manner, that I don't think anyone here can add anything to what is "perfection."

And, you are HONEST, too.You always have been about your condition - and it is so strange / good in a weird way that it has been so close to mine - I totally relate to you. (YES, the walking is very hard sometimes now, due to fibro I think, but could be RSD...very painful.)

Sadly, you can't work in your condition. They will come to that conclusion I believe. And even if they don't fully "see" it our way, they can't deny the truth completely, so I joke, how disabled is 100%? I am 100% disabled, whether they believe this piece or that piece, who cares, if you add up all of the evidence that they WILL accept, I'm still 100%.

It sounds like you have a very good attorney who is not willing to let go of the details - I don't know of any here in CA who would be present for a VR meeting. And they usually send "lackeys" (less experienced attys) to stand in for them on their depositions. So I'm hoping this is a sign that you have really got a great attorney.

Please keep us posted. I care.

Most of what you describe is what I consider "the process." We all have the hoops that everyone has to go through - same hoops, whether we're trying to get work comp benefits, social security or ?, they all seem to have a similar set of required hearings, and/or applicant / defense opportunities for examination / evaluation. If anyone is going to get the $$$, they have to figure out the hoops, and thoughtfully go through each one. I know you have, and you do.

I TRY TRY TRY to take the personal out of it - but as Gibbrn has posted, there are times when I have just lost it and I get so frustrated by some aspect of the process that is either botched or just done to delay or harrass that I can't take it anymore...then I later get a hold of my feelings and go back to the drawing board to reconfigure my strategy to get my care back on track. But I know realistically that there is some evil adjuster wanting to destroy me - it just FEELS like that sometimes.

If nothing else, as you say, we have to do this for our kids' futures.
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Old 10-20-2007, 10:15 PM #7
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Thanks for the support Anne and Tam - I always know you (and so many here) have my back, and that means the WORLD to me, truly!

Hard to say how it "went" when you get no feedback and the first I will know anything is when I see what the opposing attorney presents us with. Very odd knowing this will be seen by the opposing side before I ever see the results, and what will they make of them??

The voc rehab guy was very laid-back, pleasant, almost hard to remember he was NOT my friend, BUT, he did seem very professional and I can but hope he is truly ethical and unbiased in his analysis. If that is so I should have no worries, right?

The interview was actually a vocational rehab evaluation, to determine my
fitness for my prior employment or alternive employment. It lasted 2 1/2 hours, with one 10-minute break.

The first part was the interview portion, and he asked me to list the Drs I had seen - which is WAY too many. Some I couldn't name, and a few I forgot. He asked about current sx, and seemed to be cutting me off but I told him I had only mentioned those due to TOS, and went on to state my RSD problems and sleep disturbance. I also brought up my treatment for depression. He asked for my current meds, and I had brought a list with me.
He asked about my work history, if my certification was still current (it's not), and what would be needed to bring it up-to-date to be qualified to teach in a public school again. (More math/sci classes, ugh. At the least.) He asked about my ability to do housework, and describe a typical day, and if I'm able to drive. Some questions seemed to be aimed at testing my memory - because he had most of this information made available to him months ago.

The second part was a written timed test - intelligence-type test that had math, language and recognition questions. These included arithmetic, algebra, geometry, comparing/contrasting, similes and metaphors, recognizing same or different in a list of words or numbers, extending numeral patterns, etc. I didn't finish, but made it about 1/2 way down the second page - it was 2 pages total. That some of the math slowed me wasn't surprising, especially since I wasn't allowed to use scratch paper - I'm great at basic math and percents, but algebra and higher than basic geometry have never been my forte. What bothered me most is how some of the language questions stymied me - language has ALWAYS been my strong point - and on a couple I just had to guess finally, drew a complete blank - that is NOT me!

The last portion was another test, only verbal - I was to answer the questions as best I could, trying to answer each one, without rushing but as quickly as possible, passing if I could not answer. The questions got harder as they went. This lasted 30 minutes at least. Some were easy, basic math or language questions. Others were harder as I was to listen an restate a series of numbers or a sentence exaactly. The number series were worst, if I lost the first one or two as I listened to the rest, I was a goner. We were on the 14th floor, and the hospital is nerby, their lifeflight helicopters kept going by the windows which wd distract me for just that crucial second!

Then he asked for me to repeat the numbers he read me, only backwards - that was REALLY challenging. Not sure how many of those I got correct, maybe 50%. Couldn't figure total sq yds of wallpaper needed for a room given dimensions of walls in sq feet. Just blank, couldn't even come up w/ the strategy. But knew immediately author of Sherlock Holmes novels was Sir Arthur Conan Doyle. After that I passed on most of the remaining questions, about 7 or 8, then we were done.

That's the gist of it. He didn't ask about what physically my teaching involves that I can no longer do, or about any restrictions my Drs have given me. I asked him if the fact that my Drs have found me totally disabled and not fit to return to work of any kind will be given consideration, and he kind of hemmed and hawed and said he needed to go back, go over "all of this", put it together, and then give it to the opposing attorney. No answer, basically. But he does have to use the findings from the functional capacity evaluation and the psych exam that were done last year ocally, and were in my favor, as was the IME done by their expert, so his results can' possibly contradict those TOO much without something smelling fishy!

Next Friday is the next "phone conference" with the Special Master and both attorneys, and while his final report won't be done, he should have some preliminary results by then, so guess we'll know more then!

Younger daughter had speech contest yesterday after school, she was part of a duet and small-group acting group, both got seconds and will go on to State contest next Friday evening. It was great to be there, she does a nice job! But it made for a very long day along with the voc. testing in the a.m., so today I slept til almost 5 p.m. This is why my sleep is so messed up, now I won't be able to fall asleep tonight, but will be dead tired tomorrow morning. After every busy day it is the same. Wonder if I will ever re-establish a normal pattern?

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Old 10-22-2007, 12:19 AM #8
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I wonder if the length of time of the exam had anything to do with it. Like if you could be there for 2 and 1/2 hours without looking in distress maybe they would say you could work part time. I don't know that, I'm just guessing. Did you get the chance to say if you needed a ride there ? Pain medication to get through it ? Explain how you'd be wiped out afterwards ?

TOS can be tough (doh!) because it doesn't "look" like anything is wrong with us. Haven't we all had the experience on our one "good day" when a friend says "Oh you look so good" and they don't get why we are not working. They don't realize that you skimped on meds all week to have extra to use that day so you could go out.....and that you might pay for it by spending the next two days in bed.

I hope they take all of that into consideration when making those decisions.
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Old 10-22-2007, 02:56 AM #9
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Yes, Finz hit it - and I forgot to mention that. There is too much to warn about.

And Beth - oh GOD, knowing you, you tried harder than anyone would normally...most of us would...feeling that we don't want to seem impaired, and we KNOW we know the answer, if we could just come up with it...and of course, coming up with it, works against us.

Guessing at an answer was the wrong thing to do - you should have skipped the question. If by chance you got it right, it worked against you.

Ok - enough for others to learn from...

Now the good news.

Yes, the other side gets to see the report first, but then you guys get it, right? And your experts can comment, yes? Your own doc can relate what you tell him - HOW BAD OFF YOU WERE LATER ON. THE NEXT DAY. THE NEXT AFTER THAT.

I KNOW TOS. That experience didn't just come and go. You must've had a hard night, next day, etc. And while there...I'll bet you got a head ache, and had to take more meds...

I am not coaching you, I am guessing since this is my reaction, and you and I are sort of similar in our TOS. Make sure you get your report, and unless it's very much in your favor - in which case your doc just reviews and agrees - but even then, make sure you see your doc soon, and get those symptoms recorded for the LEGAL EVIDENTIARY RECORD.

These are just my thoughts, not legal advice, you have a great attorney - what does that attorney suggest as far as relating symptoms during and after the hearing?

God bless you Beth. You're almost through the legal tunnel. Me, too.
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Old 10-22-2007, 02:57 AM #10
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PS - what is it with numbers now that zings out the brain?

I can't even pay simple bills and make out a check.

TOS is a real bummer.
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