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Treatment terminated in California

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  • Treatment terminated in California

    In 1991 (after seeing a doctor for a year at Kaiser), it was determined that my neck problems were the result of the computer and phone work I was doing in a law office. After numerous physical thereapy visits, nerve root blocks, different pills of all shapes and sizes (over a period of 6 years), I finally was put in touch with an orthopedic who recommended an MRI be done. Surgery was needed to fuse C-5 and C-6. As a result of that surgery, I was able to again use my left arm (which had begun to deteriate). Unfortunately, my neck muscles cannot relax and ongoing chiropractic and massage therapy are needed to prevent the muscles of spasm and headaches.

    Now, W.C. has arbitrarily decided that chiro and massage are not "medically necessary". This decision was made by a W.C. doctor who I have never seen or spoken to. W.C. is basing this on erroneous facts: They assume I am working full time (which I am not), the assume that I don't do home exercises (which is untrue).

    I have requested an expedited appeal and that appeal has also been denied, again no doctor talked to me or my treating physician.

    Is my only choice an appeal? I have requested a QME, but the form assumes that I am still working for my previous employer, who has since retired. Even though I still work for a law office, I am hesitant at this point to hire an attorney, if there is anyway to avoid it. The Code section 4062 doesn't seem to apply in my case.

    Can anyone help?
    Last edited by mogrit; 11-28-2004, 03:21 PM. Reason: misspelled word

  • #2
    Appeal

    I don't know of any other process than to file an appeal. The following website gives you a lot of helpful information, re: Massachusetts workers compensation:

    http://www.mass.gov/dia/QUESTION/EmployeeQuestions.htm

    Let me know if you have any other questions.
    Lillian Connell

    Forum Moderator
    www.laborlawtalk.com

    Comment


    • #3
      I cannot offer any advise but I can relate completely. My story is very similar to yours (right down to Kaiser doctors). Good luck to you with your appeal.

      My struggle is just beginning I'm afraid.

      K

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