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2 surgeries pending/urged to settle Georgia

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  • #61
    Moving along....... Patty is correct that I'm not currently on WC, and that I deal with it primarily from the other side of the desk. Actually, several other sides of the desk as we are self funded. I have dealt with claims from coworkers and family as well, and it does not have to be a totally adversarial relationship. Truly it doesn't.

    Surveillance is very expensive but it can be used and is used in certain cases. Sometimes it shows that everything is just as the employee claims it is, and other times not. Unless you are doing things you claim you can not do to the doctors and insurance company, there isn't anything to worry about. Surveillance of mundane activities is of very limited value. There are laws that govern how surveillance may be conducted and those vary a bit depending upon where you live but the general rule is that you must be in public or viewable by the general public.
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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    • #62
      2 surgeries pending

      Thanks for responding Elle. I really don't see where it makes any difference which side of the desk you are on as long as you have the experience and the answers people are looking for. I appreciate the help.
      I wish I had never got involved with an attorney because I personally think that is where alot of my stress is coming from with this WC process. I know I need one for the red tape but I was getting along fine with the insurance company till I hired this guy. Everything was getting approved and taken care of in a timely manner. Now my mileage is 2 months late and I am having to go to a doctor that I do not like for a second opinion. He is in the same physicians group as the first opinion and that makes no sense to me. Thank God I am not having to pay them.

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      • #63
        GeneGene- I dont think the problem is involving atty's--it's you have the wrong atty. May husband was injured in May of 98-went through W/c procedures-diagnosed with whiplash (He was hit in the head by an 800 pound steel door on a downswing) and returned to work in Aug at MMI. Worked for 6 weeks and was in agony. He asked to go back to the drs and was denied due to MMI. That is when we hired an atty. The attorney got another w/c dr who gathered all previous medical records. Original MRI and xrays clearly showed 3 hernicated disc that were impinging the spinal cord. Long story short- The atty was able to get the surgeries needed and a lot of other test that showed brain damage with cognitive deficits. He was declared permanently disabled and is on SSD. He is no longer able to work. He visits dr's monthly now, is on heavy pain medication, has only one disc in his c-spine that is not fused,with all kinds of rods and plates and waiting for the day for that one lone disc to herniate.Which will happen as it is really carrying the weight of his head. To say the least our entire lifestyle has changed. Thanks to the great work of his atty we do not have to worry about being able to pay bills and he did not consider settling with w/c until all of his medical was completed and SSD had been approved. As I told you before this took 5 years to get through so it is not an easy process but with the right atty it will work out in the end.

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        • #64
          2 surgeries pending

          Carol, it sounds like you guys have really had a hard time, I am sorry. I totally agree with you about the attorney. Right now he is very upset with me because the back doctor told me yesterday that I have to have surgery. He wanted to settle without anymore surgeries Sorry. My leg and ankle ortho contacted him and told him he couldn't do the total knee untul he fixed my back.. Has anyone here ever had an anterior fusion? He told me it is were they go through your stomach. Sounds like a lot of fun.

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          • #65
            My leg and ankle ortho contacted him and told him he couldn't do the total knee untul he fixed my back.. Has anyone here ever had an anterior fusion? He told me it is were they go through your stomach. Sounds like a lot of fun.

            Funny, they told me they could not do my back untill they did my knee.

            Have you heard of spinal decompression? It is supposed to be successfull in 85% of the cases.

            I am not a doctor, but anything that avoids being cut deserves to be looked at. Check on line for one in your area. The first consult is free. Since it is much less expensive, (and has a history of proven success) the insurance might go for it as an option.

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            • #66
              2 surgeries pending

              I suggested the spinal decompression to wc case manager and she said it was not proven to last but from what I have heard about back surgeries they are not that reliable either.
              The reason the ortho gave me for the back before the knee was because of the rehab I would have to do on the knee and the fact that you have to lay flat for 18 hours after the surgery. Didn't think the back would hold up.
              Looks like it would be the other way around to me too.
              Thats what I hate most about this stuff is you have very little say in anything.

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              • #67
                I feel like I am watching others try to run my life.

                I would insist that your wc case manager look deeper into the non surgical option. Like I said, first consult is free, and if you have films for them to look at they might have a better suggestion. It does not help everyone, but then I just spoke with my neighbor, who had two back operations, and they are wanting to do more. You never know what to do. Everyone has a different opinion.

                Patty, Carol and Elle all have quality points and advice. (Sorry if I missed anyone )

                The only think that I know works is prayer.

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                • #68
                  2 surgeries pending

                  Prayer is what I have been relying on alot. I just hate that they have this control over my life and health. I will check in my area for the spinal decompression. It won't cost anything to check it out and you are right it might be something that we can compromise on with the surgeries. I have heard alot of horror stories about back surgeries; especially about complications and having to have it done again and again. Lawyer is wanting to see if they will leave medicals open and try settling again. I worry about that too cause they won't be responsible if it has to be done again after the medicals are closed.

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                  • #69
                    Your lawyer is a moron, and should be reported for pushing you to settle for his financial benefit, instead of your needs being met. Here is some info on doing that in your state.

                    For Georgia:
                    Filing a Grievance
                    If you feel an attorney has engaged in unethical behavior, prior to filing a grievance, we encourage you to contact the Bar's Consumer Assistance Program. CAP responds to all inquiries from the public regarding State Bar members and assists the public through informal methods to resolve inquiries which may involve minor violations of disciplinary standards by attorneys. All inquiries must be directed to the CAP Help Line at (404) 527-8759, or toll free at (800) 334-6865 ext. 759.

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                    • #70
                      Originally posted by genegene View Post
                      Prayer is what I have been relying on alot. I just hate that they have this control over my life and health. I will check in my area for the spinal decompression. It won't cost anything to check it out and you are right it might be something that we can compromise on with the surgeries. I have heard alot of horror stories about back surgeries; especially about complications and having to have it done again and again. Lawyer is wanting to see if they will leave medicals open and try settling again. I worry about that too cause they won't be responsible if it has to be done again after the medicals are closed.
                      I think workers comp claims can be reopened,(like when an old injury is reagrivated by something) that is if you keep the medical open with your settlement. I think there is a difference between settleing and closing the medical, and THEM closing it, because you are medically stationary (as good as you are going to get). Anything on this guys and gals???

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                      • #71
                        In some cases the claim can be reopened, and in some cases not. There are too many variables to go through all the hypotheticals here. Claims don't just close because you are medically stationary though.

                        Technically a settlement that leaves the medicals open isn't a true settlement, it is a stipulation. But that is just the term that is used.
                        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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                        • #72
                          Originally posted by ElleMD View Post
                          In some cases the claim can be reopened, and in some cases not. There are too many variables to go through all the hypotheticals here. Claims don't just close because you are medically stationary though.

                          Technically a settlement that leaves the medicals open isn't a true settlement, it is a stipulation. But that is just the term that is used.
                          Thank you so much for the response ElleMD!! I hope all is well with you!

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                          • #73
                            2 surgeries pending

                            Thnaks. Does anyone else just get to the point that you want to settle with whatever just to get it over with? Has anyone out there ever had an anterior fusion done on their back? It is supposed to be more reliable but right now I am having trouble believing anything I am told.

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