work hardening/ how 2 make MD appmt after MMI? - Printable Version
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work hardening/ how 2 make MD appmt after MMI? - Lilly - 09-07-2007 09:19 AM
Well...I'm STILL fighting to get my scrip refilled ( 7th attempt yesterday!!)... my pain level is not good, as I've been out of one of my medications for over a month. Then to top it off, I get a call from voc rehab giving me a start date for my work hardening program (I will actually go to work within my restrictions)...apparently she didn't hear the part where I'm in pain and need to get some meds in me, prior to WH....someone's jerking me around with my pain meds. I'm not totally sure if it's WC?....or the darn out of state Pharmacy, that WC insists I use?! So, I have a call in to my lawyer as to what to do.
I also need to go back to my MD....as since I've been off one of my pain meds....I have terrific burning skin, muscle spasms, overall deep pain...but how does that work if one has been at MMI for over a year, and is considered stable and not likely to get better? I haven't had to go back to the doctor for any scheduled appmnts. But feel the need to do so now. Does WC have to approve it first? I have questioned lawyer about seeing the MD, but he has yet to get back to me this week. As usual, I'm impatient and squirming!
RE: work hardening/ how 2 make MD appmt after MMI? - Timothy Belt - 09-07-2007 09:46 AM
MMI is just maximum medical improvement, it is not all better. I don't know about your state, but in PA reaching MMI will not effect your entitlement to medical benefits. So, if you didn't have to approve doctor visits before, I wouldn't think that you would need to now.
RE: work hardening/ how 2 make MD appmt after MMI? - Lilly - 09-08-2007 12:06 PM
Still no luck with getting my meds
I wrote again to pharmacy customer service...and they told me they did call IC adjuster and SHE DENIED my medicine refill! I have been taking it since 2004.
What a bitoch!
I sent the letter on to my attorney. So now we'll see what happens.
Tim...FYI I am in Mi. Does the Bad faith claim apply here now?
RE: work hardening/ how 2 make MD appmt after MMI? - Spring - 09-08-2007 12:56 PM
Hi Lilly..As you know I am not WC knowledgeable....but we tell you how my case has been going. Back at the first of the year...I was sent to the IME and they said I was MMI...but my Dr's have medical treatment that they would like to contine to do for me...but the IC continues to deny that treatment....and the IC follows what the IME Dr's approve me. So even though that I am at MMI by the IME I have continued to see my Dr's for care...and the IC is paying for them. They just refuse to approve any of what my Dr's request....So I was thinking what could it hurt if you where to make an appointment with your Dr. and get new prescriptions. Plus if you are having new problems with your injury you need to be seeing you Dr. and having some treatment for the problems. Then if the IC refuses you the Dr's appointment and the care and medication...You need to get that Attorney to do something for you. Lilly if you have to go to the ER have some treatment there....Maybe they will help you atleast get some prescritions for your medications...and you could go to a local pharmacy for a few....until you can get somewhere with the IC. I just can't believe that any of us have to go through something like this....I hope you get some anwsers really soon. Keep us updated so we know you are okay....
RE: work hardening/ how 2 make MD appmt after MMI? - sparkey - 09-08-2007 01:58 PM
As i stated in a few of my post, i reached MMI last week and the NCM was there for my closing of my case to speak with the PM doctor to see how long i would be on my meds. The PM doctor told her i could be on them for a year or more. Depending on me and how i heal. I go to PM once a month for my refills. My IC has to approve of my meds each time i go to the pharmacy they have to email the adjuster and the adjuster has to okay them with the pharmacy. If i ever have troubles i directly call the adjuster myself.
You said you have been on meds since 04? Depending on what kind of meds you are on you should not go cold turkey and stop them as it can cause withdrawls and possibly death with some meds. You will get flu like symptoms etc. My IC has been trying to get me off Cymbalta as it is 300 dollars a month. My PM doctor totally refuses to take me off them. If i was you, i would contact my doctor again and try to get an appointment to get pain meds. If you have to , you should try to go to PM to see a doctor monthly to have them monitor your pain.
I think it is totally wrong that these IC's can decide if they should refill these scripts or not. The doctor prescribes them for a reason. Like others have said, if you cannot get meds for your pain through your doctor , i would go to the ER and try to get something from them till you get ahold of the doctor or IC to tell them of your pain and how you need to go to pain management to have your pain under control. Good luck. You should not have to suffer and go cold turkey like that.
RE: work hardening/ how 2 make MD appmt after MMI? - vickinat - 09-08-2007 07:54 PM
I know what you mean my adjuster started not approving some of my meds because she felt that the letter from my Dr was too vague and that my meds weren't for my injury, then she stopped approving any of them, since she has my doctor under a utilization review. I have to pay for them and send the reciepts to my lawyer, after the review is over, I should get reimbursed if the review was in favor of my doctor, otherwise I have to appeal. It's wrong that an adjuster can do this, and since she also has stopped my TPD, it makes it finacially hard to pay for all of these meds. I do still work, but miss time every week for appointments or when I'm having a lot of pain.
Good luck to you.
Ps. I remember someone posting a site awhile back where people can get there meds for free, if it is because of a WC injury.