When I got injured on the job, I WAS seeing the (wk comp) insurance companys doctors. Because I didn't know how to find a doctor. BUT They "blew me off" almost immediately, putting me at MMI after about 3 months of TIBS. They never even looked at my problem, far less did ANYTHING to help. Not even so much as physical therapy.
My case is such a mess as the result.
What started all this apparently, was the specialist my primary care had referred me to. The most obvious thing he did, was write a letter he wrote to my primary care dr. That said: "as you know, the initial x-ray yielded nothing." (It actually said I had a fracture at L1 and an issue at L5) the myleogram said minimal chance of any nerve root impingement.." (which it said I had deviated nerves on 2 levels. Several ruptured disks and end plate irregularities on numerous levels).
Also efforts to get her in PT and pain management were ineffective due to patients lack of compliance" BUT we never were able to get an approval from the insurance company for PT, and the so called pain management they sent me to, did one epidural injection - that made it worse, so I refused to have another. At this point he cut me off all pain meds, SAID it was all in my head & pushed psyche meds. On me. The only "non-compliance" issues I had came from refusing to take psyche meds and associated with their Psyche issues, because of the way they made me feel!
The doctors never even looked at what was causing my symptoms, far less. The x-ray said an L5 issue, but they only looked at T11/12 (As per the copy of prescription for the myleogram)! But the radiologist did a little more. But only did from T7-8 to mid L3. My two worst areas are T6-7 and L5-S1. Regardless of such, they had enough on the myleogram to substantiate getting some treatment.
When I couldnt get any help from these doctors, I called the insurance company to ask for their help. They told me I was going to see a Dr to get the treatment I neededBUT he turned out to be an impairment rating Dr.!!! When I got there they had me sign a paper, that said I agree to see him. I crossed out that stuff on the contract, and I HAVE A COPY of it. But he said I was at MMI months ago, and my primary care signed off on it.
BUT 2 years later I went back to him with evidence of the doctor talking lies. He didnt want to look at nothing, but barely did (since I had witness with me) And did write a letter merely saying that because of the deviated nerves at T10 & another at T10/11, that I should be reevaluated. But did not touch anything else that I wanted him to address.
So I went back to the doctor who wrote the letter of lies that I mentioned above, hoping hed fix what he did. BUT he tried to hurt me more. Called the ins. Company, and come in with a peer review letter written in Feb-02! It read that I only have a soft tissue injury and this does not require extensive treatment as I have had over the years. I told that Dr - you know this is not true. 1) I have not had treatments, and 2) I have a lot of injuries. That Dr said anything other than the bone is soft tissue - like it was right.
But after I got home, I looked at the last myleogram report. It said No soft tissue injuries noted and there is a lot of injuries on it. Even more than the first myleogram because they did all of my back. The review letter also said that I 'have had extensive treatment over the years', and 'don't need the medicine my Drs are prescribing for me.' Although the FACT IS: I have several ruptures (7 or 8 I think), one is into the spinal cord, 2 sets of spurs grew now, several deviated-abutted nerves. And end plate irregularities at almost every level from T5 to L5-S1.initially they said I had a fracture at L1. My injuries range from C3 to L5-S1.
My current doctors have been fighting for 2 1/2 years to get me the treatment I need (ins always denies everything! Including physical therapy, even though no pre-auth. Is required now), AND to get me the TIBS I was eligible for all the long. Or S.S. Or something, being as I have not been able to work since the accident!
The commission is so corrupt (don't know another word for it sorry). The more we fight for what is right, the more they blow me out. Right down to making me get a notary for DRIS notes (did many TWCC-153s and never needed any notarized until I "tried" to submit a complaint, that got ignored by ALL except Virginia May (who wrote as if she never noticed any evidence I submitted in the 70 page packet). The commission just changed my 'expedited' CCH which was already set for 45 days after the BRC, to way past the 60 days required as the rules say they should set it. My address keeps getting changed to bogus address over and over, they tell me wrong rules all the time. Like the one that I have 45 days to get my petition in to get my judicial review. (which I found a written copy of this statement on-line on their site!) But the court would not hear of it, because at the time, they would NOT put it writing, even though I knew who told me.
I really-really-really need some kind of help, and don't know where to turn!
Attorneys won't take a case after you've been put at MMI, believe me I talked to every one in town, and even some in Dallas, Waco, and New Braunfels too.
Ive had been to a CCH last year for DD disqualification, because they sent me to a DD that treated me for back injuries after a car wreck in 95, same areas, but now a lot worse and many-many more areas. Being as they had cut off my TIBS instantly (got a little over a week after report came back since they back dated my MMI date and gave me a very small rating), It caused me to loose my home because I "could not work"... SOO by time the letter to see DD was mailed to tell me who I was going to see and when, (it had to be transferred to a PO Box since I had no home). So, by time I received it, it was way past the 10 days allowed to cancel. So I had to go see that one. The DD's rating was even smaller than the insurance companys doctor. FYI: the first impairment rating report had a question of can the employee return to work? He said I believe she could have gone back to work months ago, in my opinion on light duty and then mentions restrictions. But nobody noticed and now no body seems to care. The first rating was for the Lumbar. The DD did Thoracic. Both are compensable now.
BUT at the CCH a year ago The CCH officer completely LIED (four times)! YES I have plenty of proof. He even changed my testimony to say another thing in his report. Then said a lot of his decision was based on my credibility, &. And the fact do not show he should be disqualified. He said I waited a year to do anything, but the DRIS notes showed other wise. I knew they did, because the ins. Attorney tried to use that at the BRC, and she set him straight.
AND MORE STUFF. The appeals panel said he said this that and the other because of something different than he did. And affirmed his decision. They did not disqualify DD. And I missed the deadline for filing for judicial review by 2 days.
Ive delivered these packets to the Governor, State rep (that I have documents to show they lied to her differently too), the Senator, and all the others in the commission, and NOBODY gave me any justification, other than the CCH officer retired as they say it. Mean while I sat over a month with-out electricity, every month something else is cut off. AND they are not just hurting me! I am the sole provider for a 8 year old daughter (she just turned). And that hurts me the most, because she is so inicent and I AM her sole provider. She has to take care of me more than me taking care of her, far as doing stuff around here too! Weve asked for help around the house, but thats always as far as it goes! A lot of my friends quit calling cause I need so much. And its been so long now.
God Knows, I sure hope you can help! Or can think of SOMETHING I havent tried
.
Thank you so much for your time,
Please call me, maybe someone can post some suggestions. As soon as you do, consumer complaints automatically sends an
e-mail to notify me to look at my Report.
Being as I can not sit at my PC for long enough to do email any more. It took me 3 days to write this.
Very sincerely,
Jean O'Neill
P.S. This probably all sounds like - 'this couldnt really happen.' But I can back up everything I said!
P.S.S. State rep talked to her attorneys, and said I could legally take the CCH officer to court, but need help! The initial petition was hard, and had a layout!
Http://www.twcc. State. Tx.Us/information/dispute.html
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