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Maryland Carpal Tunnel Case Gone Wrong

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  • Maryland Carpal Tunnel Case Gone Wrong

    I was diagnosed with bilateral carpal tunnel syndrome in April 2004. I was seeing a hand surgeon at the time and when he got the results told me I had 2 choices: quit my job or have surgery. I agreed to have surgery and he set me up with followup visit to discuss the surgery. One month later went back and now the doctor tells me his office no longer takes workers comp. I asked him if he would note my account that he believed moreso than not it was work related and he refused, saying he could not treat me anymore therefore could not add any more notes to my file. (This appt. was 3 days b4 my hearing for WC.

    My attorney told me we had to drop case bcz there was no case without a doctor saying it was work related. It has been 2 years now and my hands have gotten worse. No one in my area takes WC bcz they pay so slow. I called my attorney and he refuses to open my case unless I can find a doc to say it's work related. Is this true? Can I hope to ever win my case without a doctor saying whether it's work related or not?

    I have called every hand doctor & orthoepedic doctor in my area (and there are alot) but not one takes WC--what to do? I've refiled my case on my own bcz Maryland's statute of limitations in 2 yrs from date of accident. Should I go this alone?

    Help!

  • #2
    There is no way that any workers comp carrier is going to pay any claim without medical evidence that it is work related.
    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

    Comment


    • #3
      Thanks CBG

      So, even if I have evidence that it's a repetitive injury i.e. mandatory overtime working 6 days a week, 10 hours a day, 2 fifteen min brks and 1/2 hr lunch, straight typing; this would not be enough proof that it's work related? I'm not doubting your expertise, just to let you know that this went on for one year straight. I've also documented that 51 of 136 employees developed CT related injuries incl mine during that 1 year time period.

      I had emg/ncs done that prove I have "moderate to severe" CTS, just no note that specifically says "this injury is related to her work." It says in my notes 'patient is a sales consultant at ..... phn co and her job requires overtime every day. But there is no note saying "yes, it's related to her job."
      Last edited by hangten52; 04-19-2006, 05:32 PM. Reason: forgot to add something

      Comment


      • #4
        You can try to tie them together all you want. But if your doctor will not confirm that it is work related, the workers comp carrier is not going to take your word for it.
        The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

        Comment


        • #5
          I'm in MD and I can tell you that without a doctor saying it is work related, you are out of luck. The WCC here is very liberal, but not that liberal. Just having a job where you type a lot is not an automatic presumption that your condition is related to work. There are a few presumptions under the MD WC Code, but this is not one of them.

          I'm not sure where you are located but finding an ortho in MD is not that difficult. Trust me. Your attorney should be able to refer you to someone if nothing else. The legislature did just up the rate for orthos to 144% of Medicare, which has helped. That is the reason most docs dropped WC, not the payment speed. The rates for WC are set under the law and doctors realized they could remain plenty busy and only take those with non-WC insurance which paid at higher rates.

          Still, if in the time you were seeing the doctor he didn't indicate it was work related, you are going to have a heck of a battle to explain why 2 years later it is. I don't generally like to make assumptions on the validity of the case without all the facts, but if a claimant's attorney in this state wouldn't take it to a hearing, that speaks volumes to me.
          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.

          Comment


          • #6
            Carpal Tunnel

            Originally posted by ElleMD
            I'm in MD and I can tell you that without a doctor saying it is work related, you are out of luck. The WCC here is very liberal, but not that liberal. Just having a job where you type a lot is not an automatic presumption that your condition is related to work. There are a few presumptions under the MD WC Code, but this is not one of them.

            I'm not sure where you are located but finding an ortho in MD is not that difficult. Trust me. Your attorney should be able to refer you to someone if nothing else. The legislature did just up the rate for orthos to 144% of Medicare, which has helped. That is the reason most docs dropped WC, not the payment speed. The rates for WC are set under the law and doctors realized they could remain plenty busy and only take those with non-WC insurance which paid at higher rates.

            Still, if in the time you were seeing the doctor he didn't indicate it was work related, you are going to have a heck of a battle to explain why 2 years later it is. I don't generally like to make assumptions on the validity of the case without all the facts, but if a claimant's attorney in this state wouldn't take it to a hearing, that speaks volumes to me.
            (Response):
            Actually I was referred to the hand surgeon by my neurosurgeon when I mentioned I was having problems with my hands back on Apr 21, 2004. Hand Surgeon made 2 verbal references that I needed to quit my job and have surgery--I asked him why I couldn't just have surgery and go back to my job, and he said "and have to have surgery done again down the road?" quote/unquote. Our first hearing was postponed by company insurer. In the meantime, attorney told me he had copies of my files and no where did the hand doc refer to our case as work related. He tells me we can't go to the next hearing without documentation that my injury was work related. I told him, no problem, (or so I thought), so, my next appt. when we were to go over surgery I mentioned this to my doctor. His attitude towards me changed from a warm, caring (I thought) doc to this cold shoulder doc who told me he couldnt treat me or add anything else to my chart bcz his office no longer takes w/c and that I needed to find another doctor. This was on a Friday and we were scheduled to go to court for hearing following Monday. When I told my attorney, he said we would have to drop the case and pick it up later. I know, hindsight, I should have made sure my doc put those comments in writing but I just assumed since he told me it was work related, he would put in my medical file.

            In the meantime, my attorney told me to wait til first of the following year (05) and he will call me back w/doctor's name so I could start seeing another doctor for CTS. He didn't cb so I called him around Feb. 05 and he told me we were going to have a problem because there was an internal protest going on among orthopedics, hand surgeons, neurologists community here on the Eastern Shore of MD and that I could call them myself to see if one might agree to take on he WC case but it would be unlikely. I actually called evey single doc that did CT surgery and not one doc would do it unless I put it on my health insurance. In the meantime, I had surgery (fusion on back) done Feb 05 and went back to work May 05 and continued to have problems with my hands.

            I was eventually fired from my job after I fell 2 mths after I got back. I fell at work. I had a doctor's note saying I was not supposed to be on the phone or typing but my mgr rfsd saying either do the job or be fired. So I did the job and winded up falling (my leg gave out on me from sitting to long and when I stood up, I fell and hit my head on boxes in front of my desk and the copy machine). I went out 3 days for that injury and was fired when I got back --guess they were tired of my problems and guess I don't blame them).

            My attorney calls me Jan this year (06) and tells me he has found an attorney in Baltimore (130 miles away) and I agreed to go but he told me since I didn't have insurance would have to pay them $250 cash for visit and couldn't guarantee what the doc would say. I still have not found a doctor local so guess I'll have to borrow the money from mom and hope he will see me and that things go well on the visit.

            I'm so sorry this is so long, but felt that I owed you an explanation on exactly what happened and why it's been so long in between docs. Oh, also, just to let you know, when I told my neuro that the hand doc didn't do surgery my neuro said he now does CTS but unfortunately, his office doesn't take w/c cases either. I've been going to him for 6 years for back, neck, leg pain and he has seen me a few times for CT b4 referring me to hand surgeon. Even tho he didn't really treat me, do you think he could say it's work related? He has all doc's notes and EMG/NCS study results from the hand surgeon? And if he did say in his opinion it's work related it would hold much weight since he only examined my hands and did needle ***** for sensation--he also did xray on hands bcz I have OA in all my joints and thought at first it was arthritis, but xray on hands came back negative?

            Again sorry so long.
            donna
            Last edited by wanabpainfree; 04-25-2006, 06:57 AM. Reason: date: 4/25/06 response
            DonnaC

            Comment


            • #7
              First of all, telling you that if you continue to do the job you were doing the CTS would come back is not the same as saying that is how you got it in the first place. It may seem like it to you, but it is very very different in the land of WC. If he did not state off the bat it was work related, you are going to have problems stating after the fact that it is. Commissioners are leery of these types of diagnoses. The doctor being silent on cause wouldn't have been fatal to your claim, but there has to be a good reason your attorney would not take it to a hearing or set you up for an IME for causation. It happens fairly frequently that way. An opinion from the non-treating physician is next to useless at the Commission.

              The WCC is well aware of the issue with orthos and nueros in the state not taking WC. You wouldn't be the first to have run into the same problem. It should not be a problem now though as they amended the fee guide. In fact, here we are running into problems with the fee guide being more generous than some insurance plans and the docs will take WC but not certain insurance plans. The politics of medicine at its best.

              I'm also wondering why your attorney would have you pay anything out of pocket for a WC injury. That is actually statutorily prohibited. Those bills should be sent to the carrier and if they aren't paid, your attorney should be filing issues for payment of medical expenses. If this is an IME, it would be paid for out of any award you receive. This assumes though that there is a reasonable case to be made for it being caused by work. How your attorney ended things last time may make a difference. If he withdrew issues, the presumption that your claim is not WC stands. If he simply asked for a continuance and filed it ROR (Reset on Request), then your claim is still technically pending. Bear in mind too that with occupational disease cases , the statute of limitations is 2 years from the date that you had knowledge it was work related. As you have known this for 2 years now, your time may be up. At the very least it is running short. If you hadn't filed for a hearing you may have been able to claim that you didn't know it was related to work as your doctor hadn't come out and said it. It is awfully hard to sell that you filed for a hearing on causation, then withdrew issues, but didn't ever think this was related.

              The incident where you fell would not fall under WC in MD. One of the few statutes the Commission takes a strict interpretation of is "arising out of and in the course of employment". Something at your job would have had to cause it to happen. I just had a similiar case earlier in the year where an employee fell and injured herself after sitting for a long period of time and falling upon standing which was denied. There *may* have been a case for wrongful termination, but you have passed the statute of limitation to file a claim for that.

              While you can try to pursue this through WC, seriously, I don't see this going well for you. Definitly talk it over with your lawyer. It is what you are paying him for. But I would ask him point blank about the statute of limitations, intervening surgery, and lack of causation to date before I shelled out $250 of my own money for a doctor's opinion. I can pretty much predict who he found to see you in Baltimore and while I'm sure that person will say it is related, it is not going to be enough to overcome all these other things. Your lawyer has a vested interest in pursuing this through WC. He doesn't get paid unless you win. His fee is based upon what the commission awards. The Commission also has a history of being "claimant friendly" and the bar for at least getting medicals covered is pretty low. That is why I would really think long and hard about how strong your case is. If your lawyer wasn't willing to take it to hearing, and let it go for two years, that at least raises some serious questions.
              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.

              Comment


              • #8
                Thanks Elle

                I know I've been a pain and as you know, I'm very persistent. But, thank you and others for your comments. One more question and I'll let it be.

                When I first filed for w/c for CT, I got a letter back within a week saying that my case had been denied by the company. (In fact, several other workers say same happened to them bcz this company because of it's type of business was being inundated by a multitude of CT cases). My attorney actually told me this bcz he handled many of those cases. He told me to see my PCP and I did and that appt. was denied so I had to pay out of pocket b4 my PCP would see me which I did.

                Anyway, are you telling me that if I found a doc today that acknowledges that it is work related, it's too little too late? I found my papers on the case and here's what the letter from WCC said about dropping the case "correspondence was filed with this commision requesting that the claim filed herein be withdrawn and the commision has decided to grant such request and will withdraw the claim filed herein."

                I recently (March 1, 2006) put in another claim for my CTS. I called WCC and they said it wasn't continued, it was withdrew. Is that good or bad?Anyway, was wondering what that, in legal jargon, means when I "withdraw my case."
                Last edited by wanabpainfree; 04-25-2006, 09:59 AM. Reason: need to add something
                DonnaC

                Comment


                • #9
                  The denial letter most likely had little to do with the type of case it is and more to do with the fact that none of the medicals showed that it was related to your work. That is the most common reason for denial. PCP's rarely take WC but the denial letter should have been sufficient to get it covered under your regular insurance. If it was later determined to be "work related" the insurance company would subrogate the claim. It happens more often than not and is far from unusual.

                  I can't say for sure whether it is too little too late. I'm telling you that you are operating from behind the 8 ball here and you need to be making sure you have a conversation with your attorney about that. The statute of limitations started tolling the day you filed the issues for the first hearing on causation. Technically, it started the first day you went to the doctor and heard it may be work related or filed the first report with your employer. In actuality, the Commission can usually be persuaded to accept the day you filed issues as the day you first knew. Don't ask, it doesn't make sense. That is one of those things that no amount of arguing or persuading can overcome. If time is up, time is up. I don't know the date you filed so I don't know it has expired, but you are at the very least darn close if this happened in 2004.

                  You also have a bit of explaining to do as to why this sat open with no treatment for 2 years after withdrawing issues. The Commission will not be impressed with the response that you couldn't find a doctor to treat you because if that was the case, they would have been awfully bored the past few years. Also, a denial from WC would have bumped it over to treatment under your health plan. If you had not ben represented this would not have been as big a deal to argue, but with an appearance entered from very early on, that becomes less of a viable argument.

                  Withdrawing issues the way you did basically stopped the claim. It is the same as dropping charges in a civil case. You are sayingthat for whatever reason, you no longer are challenging the other side and their decision stands. Filing for continuance and asking it to be reset ROR or even in the usual course for lack of medicals would have been a much better plan, but depending upon timing it may have been while the Commission was not allowing that to happen. You really need to speak to your lawyer about why it was done the way it was. A continuance is just that, a "To be continued". It just postpones the hearing and either side may request it.
                  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.

                  Comment


                  • #10
                    Carpal Tunnel Continued

                    Thanks Ms. Elle for all your very professional & informative information. After rereading my file on my case and your answers to my posts, I have decided to change attorneys. (My sister had a very good attorney who handled her carpal tunnel case against same company and she settled out of court so I think I'll contact him. If he refuses to take case, I won't go anywhere else, just too stressful). I feel like my attorney should have been guiding me through this whole process and hasn't. I have learned more from you over the past couple days about the process and what has to be done than I have from him. I also found a letter I had found in my file that I forgot all about. It was a letter addressed to me about confronting my doctor for him to put note in my file about being work related. Attached was a letter to my doc from him telling him he needed an opinion on the case and the doc wrote back to him telling him he wanted $200 for a narrative report. I remember the attorney telling me it would cost $200 for this report but told me I would have to pay for it--you're right, why should I have to pay these costs up front when I have an attorney to supposedly handle all that. Plus the fact that my attorney told me he would cb first of year and didn't, etc. etc.

                    I really don't think he handled the way the case was "withdrawn" instead of, like you said, filing for a "continuance" until "he" not me could get me in to see another doc for second opinion or IME. (By the way, I did have an IME done by other side June 04 (2 mths after I filed original case) and did get a copy of that report. It actually ruled in MY favor, but I don't suppose I could use that report could I). Anyway, thanks again for taking so much time to help me.
                    Last edited by wanabpainfree; 04-25-2006, 11:13 AM. Reason: need to add something to 1st par
                    DonnaC

                    Comment


                    • #11
                      If you have an IME, you will need to disclose that if you want it paid for an d considered. As it links your CTS to work, I'm not sure what it has been doing collecting dust this entire time. There has just got to be more to your case than appears or your attorney really needs a refresher because the whole purpose of an IME is to establish causation and support your side (assuming the information does). No statement from your treating physician was necessary unless he came right out in his reports and said it was caused by your compulsive knitting or something like that.

                      What a doctor can charge for medical records is set by the statutes and if subpeonaed, can not be charged for at all. It is $15 up front and .15 per page. $200 is a heck of a lot of pages. He can try to charge what he wants, and many will push it, but a simple call from your attorney or a subpeona is all that was really needed.

                      One small clarification, with WC you can not settle out of court. At least not inthe sense that you can with civil cases. All hearings are held by the Commissioners and while they are legal proceedings, Commissioners are not judges, nor does this take place in a court room. Heck, in part of the state it takes place in the basement of a hotel. Once a case is set in for hearing, any settlement must be approved by the Commission so there is no such thuing as even settling outside the WC system. And yes, if the settlement is "unfair" to any side, it will be rejected even if it only appears as such because of an administrative error. If both sides agree and submit it to the Commission and it is approved, no hearing is required. This applies only to Voc rehab, settlements, stipulations and PPD/PTD. Treatment and time off may be agreed upon at any time without involving the Commission at all. Appeals are handled through the Court of Special Appeals but that is rare. If you make it that far, coming to an agreement was not an option
                      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.

                      Comment


                      • #12
                        Carpal Tunnel Case

                        Here's a brief timeline:
                        4/20/04 1st visit w/hand specialist-possible bilateral CTS
                        5/12/04 EMG/NCS -results moderate to severe bilateral CTS
                        5/20/04 Filed for WC w/onset date as 4/20/04
                        6/05/04 Rcvd letter from ins carrier saying they denied claim
                        6/28/04 1st Hearing supposed to be held but recvd notice from WCC that
                        opposing side req continuance-new hearing date 11/19/04
                        7/07/04 IME-req. by opposing side done (not my attorney)
                        10/4/04 My attorney mailed letter to hand spec req opinion of CTS
                        for w/c case-is it related or not?
                        11/13/04 Hand spec sent letter back to my attorney req $200 for a
                        narrative report (payable prior to mailing the report)
                        11/16/04 Last visit w/hand spec due to office policy not to continue
                        seeing w/c patients and refusal to note acct whether work
                        related or not-cld my attorney & adsd him of situation and my
                        attorney basically told me if we didn't have a doctor saying CTS
                        is work related, we have NO CASE. He cld WCC and "withdrew"
                        claim
                        11/22/04 rcvd conf from WCC case "withdrawn"
                        1/17/05 saw neuro for CTS pain-expl why no longer seeing Dr Kang
                        2/13/05 fusion on back done-out of work 3 mths
                        5/14/05 back to work-told by company if missed any more time wld
                        lose job
                        8/20/05 terminated by co for attendance (unrelated to CTS)
                        01/5/06 wrote and got copy of IME report--CTS caused by my job and
                        recommended "light duty, no typing or any kind of
                        repetition work because doing so could cause "permanent
                        damage" -this company let me
                        return from back surgery go online full-time, with no
                        restrictions-evidently by "convenient lack of communications"
                        with my office, I went back to work and got fired because I
                        couldn't handle the pain in my hands and bcz of the pain and
                        stress of knowing if I missed one more day b4 1/1/06 I would
                        be fired, I started having panic attacks -and was fired

                        I know the company has a right to take the IME's advise or not but it burns me up knowing that if my attorney had taken the time to get a copy or asked me to get a copy of the IME report, I could possibly still have my job. AND, I could have possibly won the first round at the hearing instead of dropping the case. I wonder--if the IME had said there was nothing wrong with my hands and told me to go back to work with no restrictions, would the paperwork gotten lost in the shuffle? (Oh, and by the way, I guess I used the wrong terminology--when I said she settled out of court. The company offered her a settlement, she accepted it and the commissioner approved it without her going any further than the 1st step).

                        I wasn't going to bother you anymore bcz I feel like I've beaten the case with a stick long enough, but you mentioned in your last post "there must be more to your case than appears" and I don't want anyone to think I'm hiding anything or there's some major thing I'm leaving out. That's it.

                        I've been sitting on the IME's report, which I felt went well and beyond in my favor for 3 mths. and when I got the copy and called my attorney's assistant, she said she didn't have a copy but could possibly get me a copy--I told her "don't bother, I've got one, but you might want to get Mr. ... get a copy for himself.

                        Only one more question. What if anything can and should I do with this report? I don't have an attorney listed when I filed the w/c papers this time and think I could do a better job on my own than what he's done. Even tho the IME report was written and paid for by other side, can I enter it into evidence with the court (cuz I'm pretty sure they won't use it). Or can I not do that?
                        DonnaC

                        Comment


                        • #13
                          Usually I don't like to say this, but find another attorney. Unless there is something more to the story that even you do not know, yours has issues. Is this someone who normally handles WC cases? You don't withdraw issues when you've got the employer/insurer's IME showing causation. That's like WC 101. Heck, you don't even need a hearing at that point. There is nothing they could possibly contest. Their doctor said it was related.

                          Your attorney was entitled to a copy of that IME and if he was on the record, he had to get a copy of the notice that you had an IME (or he could have just asked you). There is no discovery in WC, but by law each side must share any exhibits that they plan to use in a hearing and he could have requested the results at any time.

                          While an attorney isn't required per se, you are going to want one. Your employer/insurer has one, you should as well. You will also want to remove your current attorney's appearance from the record. The Commission will not allow you to represent yourself if you have an attorney on file. I know a fair amount about WC and I always have an attorney with me.

                          Being frank, you are also going to want to have someone on your side willing to explain why the statute of limitations has passed but they should hear the case anyway. You are right now, technically 6 days past the "true" deadline. Various Commissioners are more inclined than others to accept argument that a different day should be used, but really, that is something that should be evaluated by whomever is representing you. Two years ago you might have been able to get away with DIY, now, I wouldn't want to be trying this one on my own and I have been through this before. I would call today as you really do not want to put this off a minute longer.

                          On the termination/ not pursuing light duty angle, you are too late to do anything there. That has an entirely different statute of limitations and that ship sailed. Technically, the IME belongs to the insurer anyway, though 9 times in 10, the employer does get a copy. As you didn't ask for light duty the summer of 04, and then withdrew issues, you shot yourself in the foot (not blaming you just pointing out the facts). They were not compelled to act based on something you didn't request and then essentially said you were dropping. Your termination really had nothing to do with the accident, or your restrictions. You missed more time unrelated to your CTS or another WC claim. You were terminated. That isn't illegal. It's iffy if you filed the fall as WC, even though the claim would have been denied. But again, it is too little too late on that count.
                          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.

                          Comment


                          • #14
                            Thanx

                            I will take your advise. Thank you for clarifying things.
                            DonnaC

                            Comment

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