Knee injury nightmare

[cherokeegal]

The PT is only making things worse. I am going to call my employer Monday morning and request a new physician on the grounds that I don't feel like I am being treated correctly by the one they sent me to due to a conflict of interest. He admits patients to and does surgeries at the hospital that is my employer, and the first thing he told me when he walked in the room for my last appt was "I've got to get you back to work, the hospital is mad at me." I am going to request someone who is not affiliated with my employer and uses another hospital. If they don't allow me, then I'll have to get an attorney involved.

[hurt back]

(07-28-2012 10:18 PM)cherokeegal Wrote:  The PT is only making things worse. I am going to call my employer Monday morning and request a new physician on the grounds that I don't feel like I am being treated correctly by the one they sent me to due to a conflict of interest. He admits patients to and does surgeries at the hospital that is my employer, and the first thing he told me when he walked in the room for my last appt was "I've got to get you back to work, the hospital is mad at me." I am going to request someone who is not affiliated with my employer and uses another hospital. If they don't allow me, then I'll have to get an attorney involved.

Remember in TN, you can request one... But I belive you can only change once.... As I too am having problems but thats because my nurse case manager is "manipulating" my dr. and once she found out I was comminucating with my other Dr thru email she stopped that as well..

I would call an attorney and get a free consultation. In your current situation it might be a good idea to hire one due to the conflict of interest you working there and being treated there.. I would drive to the next big town..

My dr is in Nashville a/b 1 hr away from me.. They will reimburse you travel past 15 miles.

[cherokeegal]

Well, I did find out that there is an ortho group here in my town who is not affiliated with my employer hospital. They do office visits here, but if they do surgeries, they send you to Centenial Hospital in Nashville. I'm hoping they are on the approved panel. I know somebody in Nashville was on it, because she asked me if I wanted to see someone here or there.

I haven't had to deal with a nurse case manager yet. Only the workers comp lady at my employer, and the adjuster. They've been hateful enough, I don't I don't get a nurse manager. LOL

[cherokeegal]

Well, I did find out that there is an ortho group here in my town who is not affiliated with my employer hospital. They do office visits here, but if they do surgeries, they send you to Centenial Hospital in Nashville. I'm hoping they are on the approved panel. I know somebody in Nashville was on it, because she asked me if I wanted to see someone here or there.

I haven't had to deal with a nurse case manager yet. Only the workers comp lady at my employer, and the adjuster. They've been hateful enough, I don't I don't get a nurse manager. LOL

[hurt back]

(07-28-2012 10:33 PM)cherokeegal Wrote:  Well, I did find out that there is an ortho group here in my town who is not affiliated with my employer hospital. They do office visits here, but if they do surgeries, they send you to Centenial Hospital in Nashville. I'm hoping they are on the approved panel. I know somebody in Nashville was on it, because she asked me if I wanted to see someone here or there.

I haven't had to deal with a nurse case manager yet. Only the workers comp lady at my employer, and the adjuster. They've been hateful enough, I don't I don't get a nurse manager. LOL

They will normally in TN assign you an attorney when the injury is as follows :

Illnesses and injuries that are serious, life-changing, and potentially life-threatening require immediate assessment of the client's condition, prognosis, and treatment recommendations. Claims warranting Catastrophic Case Management include but are not limited to:
Traumatic brain injury (TBI)

Spinal cord injuries

Multiple trauma

Organ transplantation

Burns

Stroke

Reflex Sympathetic Dystrophy

Premature birth

Cancer

Amputations

I got that somewhere from a TN website..

Here is info on the dr changing :

What if the employee is unhappy with the physician he/she selected from the employer's panel?
Under Tennessee law, the employer or insurance carrier is not required to offer a second panel of physicians or a second opinion. If asked, however, the insurer or employer MAY provide a second panel. An employee may always seek a second opinion or obtain treatment with any physician at his/her own expense. However, only the restrictions of the authorized physician must be followed by the employer.

My attorney stated if we did not like the results they give us after the emg and fce then we would request a second opinion.. And go from there.. After that switch though that is it they are your dr for the remainder of time..

[cherokeegal]

I called my employer this morning at 9 and requested to choose a new physician from the panel on the grounds that my current ortho has a conflict of interest between myself and the hospital, and I am being treated unfairly as a result. The WC lady acted very surprised and shocked, and said that she didn't think I could do that. I told her that I also want to stop PT until I can get a new evaluation, because it is causing me horrible pain and not helping, instead it's making things worse. She said she had to call the adjuster. At 3, she called me back and said the adjuster is out of the office until Monday. She suggested I call the doc's office and tell his nurse about PT and ask that I not be made to go due to pain. She said she will get me an answer about the new doc on Monday. She also said, "Or you can just refuse to go to PT any more on your own and stop going."

I know that if I refuse to do doctor ordered treatments like PT then I'm screwed, right?

[1171]

(07-30-2012 05:34 PM)cherokeegal Wrote:  I called my employer this morning at 9 and requested to choose a new physician from the panel on the grounds that my current ortho has a conflict of interest between myself and the hospital, and I am being treated unfairly as a result. The WC lady acted very surprised and shocked, and said that she didn't think I could do that. I told her that I also want to stop PT until I can get a new evaluation, because it is causing me horrible pain and not helping, instead it's making things worse. She said she had to call the adjuster. At 3, she called me back and said the adjuster is out of the office until Monday. She suggested I call the doc's office and tell his nurse about PT and ask that I not be made to go due to pain. She said she will get me an answer about the new doc on Monday. She also said, "Or you can just refuse to go to PT any more on your own and stop going."

I know that if I refuse to do doctor ordered treatments like PT then I'm screwed, right?

Treatment like comp is always at the patient's option.
If your time off is not authorized by a doctor, disability can be suspended.

[hurt back]

There has to be someone there until then overseeing your case.. Mine too was on vacation the week that my MRI was requested but someone else there approved... They don't just walk off and leave all the claims until they return....

[cherokeegal]

One would think, but that's what I was told.

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One would think, but that's what I was told.

[AQA]

I recall a time that I had an issue with getting approval for my meds. I called the adjuster and got a recording that she was on vacation for the week. I then called back again and this time I requested to speak with her boss. I explained the situation to him and my meds were approved and filled 10 minutes latter.

I mearly tell the story to say there is an option when the regular adjuster is out. I do not suggest that it be used all the time. Such as, when the adjuster is out for the day and your situation does not require immediate attention. However; should your situation require immediate attention (as in my case) then use it.