Independent medical exam

[Adk98]

I work for the railroad and injured my knee at work. I had surgery in late February but I still have little improvement. The MRI shows nothing significant but I still have terrible pain and limp. They want me to go to there IME, what if he says he see's nothing but ignores that I'm still hurting? Will they stop my weekly pay? What would be next? I have a lawyer but isn't real informative.

[1171]

if you are released to return to work or the ime believes you have reached maximum recovery, disability payments will stop.
your opinion is not considered medical evidence.
you can appeal to the comp court.

[Adk98]

What are the chances of an appeal with wc ?

[Manley2]

Have you talked with a lawyer yet? Might be a good time to do so if not. Medical evidence is the important part of it and you will need something on your side that goes along with your problems. Many times WC send you in for an IME so they can stop payments to you and the only thing you can do is get supporting medical evidence on your side to appeal. I've been to 2 IME's, first one was for the very reason of stopping me from getting a SCS. Didn't work other then to delay the surgery. Second one was the first of this year and so far they are not willing to share it with me or change any payments so the only thing I can say is this doctor sided with my doctors and agreed with my injuries. I think he had some treatment ideas that would only cost them more money so they have not wanted to show it to us.
Doctor's charge good money for these IME's and WC knows those doctors that for the money will write what they want them to say. The doctor is not treating you so he has no worries of saying the wrong things

[Adk98]

Yeah I have a lawyer and will have to talk to him on Tuesday. They said last MRI looked ok but I still have all symptoms of same problem so I guess if he just looks at MRI then I'm screwed!! I just want my knee fixed period!! I'm tired of all the bs!! Any ideas?

[1171]

if treatment is denied by workers comp it's possible to use your health care.

[LeglEgl]

(09-03-2011 11:30 PM)Adk98 Wrote:  I work for the railroad and injured my knee at work. I had surgery in late February but I still have little improvement. The MRI shows nothing significant but I still have terrible pain and limp. They want me to go to there IME, what if he says he see's nothing but ignores that I'm still hurting? Will they stop my weekly pay? What would be next? I have a lawyer but isn't real informative.

Pain is subjective and unless it's supported by some clearly discernible medical evidence, will receive only a nominal amount of consideration. That consideration would ONLY be given coupled WITH some medical evidence that there is something causing the pain. With a "clear" MRI, you have only your assessment of the pain, but nothing to explain it.

Everyone has their own level of pain tolerance and unfortunately, no matter how real it is, the "my tummy hurts" level of evidence isn't evidence. (No offense intended here.)

[Adk98]

No offense taken. I have never had knee trouble or pain and since the incident at work it is non stop so I guess if they can't figure it out I'm screwed. Sounds like our government. Lol.

[LeglEgl]

(09-04-2011 04:33 PM)Adk98 Wrote:  No offense taken. I have never had knee trouble or pain and since the incident at work it is non stop so I guess if they can't figure it out I'm screwed. Sounds like our government. Lol.

I can fully understand your plight. I've had surgery on both knees throughout my life. The first was in 1986 and even though I was "fixed" I had chronic pain for almost a year, but as the knee got stronger, I've had no problem with it since.

My last one was in 2007, (torn ACL) and still had pain, although the problem had been repaired. That went on for about 6 months (advances in medicine). Near perfect recovery.

I'm pretty sure that with continued use, barring any unforseen additional injury, you'll probably get close to 90%. Just a guess.

[Adk98]

Do you know what would be next if the IME doc says I'm good? Process wise I mean. I work for the railroad so I know it's different but not sure what's next besides go back to work and tuff it out.