Does treating doc have final decision

[genegene]

I have been treated by the same ortho for over 2 years since I was injured and now WC is arguing with him about treatment plan. Doesn't the treating physician have the final say so or can WC override him. I have heard from 2 different people and 2 different opinions. I know they can send me to someone different at any time but wouldn't the treating doc have the final say so. Just wondering.

[Sithie]

I thought they did, but they have had 7 dr tell them I can't work, but the ic just sends me to another doctor, and still won't pay me.

[genegene]

And then they wonder why your case costs so much....It is such a waste of time and money on their part...It seems to me like they want to keep trying till a doc tells them what they want to hear...
Sith: How long have you been out of work without pay? I know WC has to fine themselves for any late pay after 30 days...

[vickinat]

Hi genegene,
When I switched to my choice of doctors in May (in Pa.you can switch to your choice after 90 days of using WC choice). I've finally been getting the help I needed, but WC adjuster began questioning his treatments and prescriptions he gives me. They have filed for a utilization review of him in July, which I've already been notified of and was allowed to send a letter of my personal statement, stating why I feel that his treatment is necesary(spelling) and appropiate.
They sent me for an IME of their choice, he gave them a paper with alot higher work restrictions, than my treating doctor. My work said that WC said that I had to start the new restriction today when I go in (Operating brake press).
My lawyer said absolutly not, and that I'm to do what the treating Dr. says. I had an appointment with my Dr.,this past Friday and he gave me my restriction paper to take back to work, stating to continue with same restrictions and to avoid brake press. He also told me to go by his restrictions and not the WC's.
Where are you located (state), it didn't say in your post or profile. Each state has differant laws and regulations. I understand from my lawyer that the treating doctor can't be forced to change his treatment or restrictions of an Injured worker. The other doctor which WC had picked, seemed to be persuaded by the nurse case manager, to do things her way. I'm much happier since I changed doctor's, I also no longer have the NCM bugging me or my doctor. The lawyer had me revoke her authorization to verbally communicate with any of my treating person and to not be allowed to come to any appnts, back in July. Check with an attorney, and check your state laws, to see of they can force you to switch Drs.
Good luck
Vickie

[genegene]

Thanks Vickie....I am from GA and I have found out the hard way that their WC laws are definitely for the employer. My job fired me after the 3rd surgery when the ortho told them that I would never be able to go back to my old job. I had no clue that they could do that.
My treating physician for the back is the one they sent me to, they didn't like that he agreed with everyone else, so they sent me to an IME. He looked at the notes and MRI from the first 2 docs and came up with something totally different. I thought they should have to go by what the first treating physician said but apparently not...God knows what is going to happen next...
You are so right about the NCM influence with the docs, too. Mine knows everyone of them by their first name. Really gives you the chills when they are talking like old friends and they are supposed to be concentrating on you.
As far as new docs go, I am allowed to go to a new one if I pay for it myself out of whatever settlement I get, which I think is totally wrong. You know they are not going to listen to another and that is just another expense added to the lawyers bill. Drives me crazy...

[vickinat]

genegene,
Do you have a lawyer yet. I would advise you to talk to one. I had talked to several until I recently signed with mine. It might even be a federal law that you can receive compensation if your employer fires you, due to being medically unable to perform your job.
My lawyer said that the WC or my employer can have a judge look at both sets of restrictions and decide which doctors to use, but since the IME seen me once, his is his opinion, my doctor has been treating me and also the physical therapist has even said that I'm not ready yet. I haven't had an FCE or work conditioning yet.
Your right about the IME being only for the WC company, I was so upset when I read all of the lies and inaccuracies in his report. I have some other post in here and in ask the expert if you want to read some of them, you'll see what I'm talking about.
Feel free to email me direct at vickinat2000@yahoo.com, I would welcome any email, all of us injured workers need to stick together.
Take care, I have to get ready and go into work and see what happens.
Good luck
Vickie

[genegene]

I have a lawyer, its the second one. They told me today that we are going to have to go in front of a judge and let him make the decision on my back. I don't understand when they are the ones that sent me to these guys. I got a bill yesterday from the 2 back surgeons and when I called and reminded them that it is WC they said WC had turned down everything pertaining to the back and I am responsible. This is a bill that started with the first visit last year....NCM is the one who made the appointments and went with me and now they have decided not to pay. They were all approved at the time but now they are reneging on the payments. I don't see how they can get away with this. I think there should be some way to sue WC for aggravation or something...

[D{Powell4]

The IME agreed with certain aspects of my case and even pointed out the C-7, C-4 deterioration in my neck and that is when the attorney for the employer wanted to settle with an amount but the attorney working with me states that I should go to trial in august even though I have not been employed for a whole year and have not been compensated, what should I do? Settle for the first amount?

[1171]

don't hijack this thread; other readers are confused when you grab another's topic.
start a new thread.

if you don't trust your atty's advice talk to some others and choice one you do trust.

[Buzy]

(05-20-2012 11:49 PM)D{Powell4 Wrote:  The IME agreed with certain aspects of my case and even pointed out the C-7, C-4 deterioration in my neck and that is when the attorney for the employer wanted to settle with an amount but the attorney working with me states that I should go to trial in august even though I have not been employed for a whole year and have not been compensated, what should I do? Settle for the first amount?

Kansas. If you are impatient and just can't wait for money, settle. But if you want what your injury deserves, wait and go to court. I was offered $5,000 and $12,500 and refused both. After 7 years I was awarded $125,000. You make the decision. I worked with a guy who had his finger cut off due to a work injury. They settled immediately for $7,000. Was it worth it? I felt sorry for him but he said he needed the money. It's your choice.