pain meds after mmi

[bama50]

I know ttd stops after MMI, but does the IC stop paying for pain management doctor visits and pain meds also? I live in alabama.

[Manley2]

Allot depends on how you settle. Since you said you are getting SSDI they will want a set-a-side from WC to cover medical bills before medicare will pay for anything.

[1171]

a set aside is not required for every settlement.

[bama50]

I have not reached MMI yet. I'v been in pain management for 7 months. I'v been on ttd for 13 months. There isn't any law suite with IC and my ssdi is on appeal. I've lost everything, the car was repo the house was forclosed. After MMI there will be no income and the clowns at ssdi will deny me again. Even if ssdi approves me i have been told its 2 years before medicare will help with anything. My question is after MMI and before any type of talk with IC about settlement, will i have to pay out of pocket for my pain management and expensive meds(fentanyl 25 / loratab 10) ?

[jayne]

MMI may stop your TTD but your PPD may start...depending on your state I am not up on you states regs....as far as your meds they should continue to pay all dr and med bills until settlement unless your Dr say no more meds or visits are needed....if you get SSDI before medicare you may apply for medicade...

[UndercovrAngel]

Also, if you win your appeal with SSDI, they will go back retro-active to the date you first applied, add 5 months and that is when your SSDI will start.


Example: You applied December 2009 + 5 months = May 2010

Medicare wait = 24 months. Medicare would start May 2012

Your SSDI payments would be paid retro-actively back to May 2010 as you would still be withing the One year limit on retro active pay.

Your medical benefits for treatment and meds would continue after you are found MMI until your claim is settled/closed. Some states have medical benefits for life, TX is one, after you are found MMI and claim settled. Other states offer medical buyouts, others require an MSA if your needs are high.

It's unfortunate that things work out the way they do for many injured workers. I lost my home and new car while under a work comp claim in NV. Then lost my job shortly afterwards due to personal health issues, thus loosing my personal insurance as well. Really hard not to be able to afford medical care and meds when you are diabetic.

This time around, my car was paid for before I was injured in TX and I live with my boyfriend so I know I always have a roof over my head. However, I once again lost my job (Oct. 2008) and my insurance Feb 2009. I haven't had any medical treatment or medications since other than the 3 times I ended up in the ER for different things.

I was lucky enough to be approved for SSDI on the first go round and have just now become eligible for medicare. Due to the low income I receive (less that $1100 including SSDI for my son and child support) I am also a QMB (qualified medicare beneficiary) so my monthly premium for medicare, all co-pays and any deductibles will be paid for by medicaid. All I will have to pay out of pocket on is my scrips (which I also recieve help with through RX Help) and the most expensive one will run me $6.30 a month, no matter what the actual cost is.

It's a long, hard haul, but I made it through. You need to start looking for help where ever you can find it now. Apply for all state benefits .. foodstamps, medicaid (however that won't pay for your work injury) TANF (Temporary Assistance to Needy Families) .. which is generally cash benefits (most states have websites where you can apply for all of this online), assistance with utilities, food pantries etc... also apply for SSI (different than SSDI) as it based on your income. If you are eligible for SSI, you become automatically eligible for medicaid.

Angel ^j^