PCP/Ortho say restrictions, employer says no.

[Thain]

I went to an independent medical examiner (IME) October 1st of this year, about a week into a 3 week work conditioning program for an un-operated disc herniation in my lower back. My back was strengthening, but I was still very stiff and sore. The third week into the program it was found I can not safely lift and move objects on my knees, which is a primary function of an airline ramp employee. My PCP and Ortho doctors on the 11th of October, and then with a follow-up exam November 16th, released me back to work with MMI and permanent restrictions. I called my employer to let them know. A month went by before I received a call from my employer stating I was to report back to work FULL DUTY with NO restrictions the very next day based on the IME report. My employer says they always go by the IME report, and my claim adjuster and attorney have yet to return my calls. It's been 3 days since I was supposed to return, but I've been using sick days until I can get answers. Any advice on how to get the findings of MY doctors acknowledged, outside of just telling my attorney?

[1171]

your doctor's opinion can be acknowledged but that doesn't override the IME opinion.
even calling your atty won't resolve the dispute.
the issue can be negotiated or taken to the comp court for a decision.

[Backsout]

Thain Wrote:I went to an independent medical examiner (IME) October 1st of this year, about a week into a 3 week work conditioning program for an un-operated disc herniation in my lower back. My back was strengthening, but I was still very stiff and sore. The third week into the program it was found I can not safely lift and move objects on my knees, which is a primary function of an airline ramp employee. My PCP and Ortho doctors on the 11th of October, and then with a follow-up exam November 16th, released me back to work with MMI and permanent restrictions. I called my employer to let them know. A month went by before I received a call from my employer stating I was to report back to work FULL DUTY with NO restrictions the very next day based on the IME report. My employer says they always go by the IME report, and my claim adjuster and attorney have yet to return my calls. It's been 3 days since I was supposed to return, but I've been using sick days until I can get answers. Any advice on how to get the findings of MY doctors acknowledged, outside of just telling my attorney?

What was your permanent restrictions? I had to call ortho to get my results because it was in a seperate dictation. They should have offered you a settlement for your permanent restrictions,(Or a PPI) You have met MMI. Did they offer you a settlement ? I dont know how all states handle their w/c claims, I do know they seem to realy drag out.

[Thain]

Thanks for responding.

blackout - My Ortho doesn't want me working in aircraft cargo pits, which require me to work on my knees. I can do any other work my job requires though. I did receive a copy of the dictation explaining my restrictions, which he had sent to the claims adjuster. Just in case, I also sent a copy to my adjuster and my employer's medical department. We haven't started talking settlement yet. If I have to return to work full duty I want to keep my claim open, because it's inevitable I will reinjure myself soon after returning.

1171 - The people I've spoken to at work say there's nothing they can do, but I'm still looking into it. As far as the courts go, I don't really understand the process. I hope to speak with my WC attorney soon to discuss that.

[Georgedroy]

(11-28-2010 01:20 PM)Thain Wrote:  I went to an independent medical examiner (IME) October 1st of this year, about a week into a 3 week work conditioning program for an un-operated disc herniation in my lower back. My back was strengthening, but I was still very stiff and sore. The third week into the program it was found I can not safely lift and move objects on my knees, which is a primary function of an airline ramp employee. My PCP and Ortho doctors on the 11th of October, and then with a follow-up exam November 16th, released me back to work with MMI and permanent restrictions. I called my employer to let them know. A month went by before I received a call from my employer stating I was to report back to work FULL DUTY with NO restrictions the very next day based on the IME report. My employer says they always go by the IME report, and my claim adjuster and attorney have yet to return my calls. It's been 3 days since I was supposed to return, but I've been using sick days until I can get answers. Any advice on how to get the findings of MY doctors acknowledged, outside of just telling my attorney?

Helllo, I'm new to this forum, and I've been doing a lot of reading the past few days. It's sobering how many injured workers there are with the same types of problems.
I'm angry that I'm not alone, but I'm glad I'm not alone.

An Independent Medical Examiner (IME), to my understanding, is paid for by the company. You have your own doctor's findings. With the IME, they have thiers (it amuses me that they use the word 'independent' like the exam is unbiased).
I'll assume that the IME says something to the tune of, "Ok to be released to work with no restricitions" or similar type wording. Sure the company will want to go with the IME report. THAT'S the one that says you're ok. If YOUR doctor said you were ok, and the IME said you were not ready to return... I'm sure the company would 'always go by your doctor's report'.
Your lawyer should be aware that they can't 'go by the IME only'. There are two doctors that have evaluated you, and they have different opinions. Your lawyer will want a hearing to discuss the differences in the findings.
And no one at the employer is a doctor. "We always go with the IME" is an attempt at intimidation by your employer.
Don't fall for it. Stay on your lawyer about it.

[Thain]

I changed attorneys early December. It turns out my attorney was not doing his job - he even filed my case incorrectly - but have since found a law firm that is diligent and communicative.

I still have not returned to work. I'm currently taking unpaid sick days until my attorney can schedule an emergency hearing. My company's insurance company hasn't paid me since late November and won't pay me, per IME findings, despite pressure from my attorney. I figured it would go down like this anyway, they don't really care. So once the hearing is held they should side with my treating physician and I should start receiving retro WC payments.

I guess at that point the company has a few options. They can either accommodate my work restrictions (which is possible but unlikely), or they can continue to provide WC benefits while sending me to a placement firm (still possible but unlikely), or they can fire me and deal with more legal battles (they have deep pockets, what do they care?), or they can appeal the decision and stretch this matter out even longer (again, deep pockets). I'm expecting one of the latter two. Being union represented makes the firing part a little more difficult, but it's never stopped them from trying. I think they'll stretch it out with appeals.

Regardless, I feel like this is going to take much longer than anticipated. They know it must be hard on me not having any money coming in. I think they figure I'll fold under the financial pressure. Not happening people! I have to stay focused and optimistic. I'm ready to fight this out to the bitter end! Knowing that I'm fighting for what's right against what's wrong is more rewarding than any other reward I may get from this.