Now being charged with medical bills!

[bagpussinamerica]

Ok, so I hit MMI, was declared 12% PPI and given a payment for the impairment. The letter stated that this is not a settlement of any wage loss or medical entitlements. Before I received the letter from w/c, I started having severe pain down the lower back and left leg. I contacted my surgeon, who told me if I had any severe pain that did not go away or was unbearble, to call him immediately. He set up a MRI, which was approved by w/c. I contacted the w/c to keep them informed of the situation, they said have the MRI and if the surgeon decides to recind the MMI, the he would do so and I would be back to square one.

Today I received a bill from my hospital stating that I owe them $1088.00 since my insurance carrier has denied or not made payment on the claim.

I was told that any further treament required as a direct result of this injury would automatically open w/c again. So what is going on? OR does this sort of thing happen all of the time? I am seeing my surgeon on Monday morning. I can ask about it then as well as contact w/c....but what happens if they say I have to pay the bill?

[lfoster21]

I know that once you are at MMI, if you have further problems, your case needs to be opened again before they will help you again. When you go to the Drs. office, ask him if because of this new stuff, he would recind the MMI (if he hasn't already). then, I'd make sure you get ahold of your case worker (or lawyer if you had one), and let them know your MMI has been recinded and you need these bills to be paid. They are suppose to take care of you medical, but like w/c said...once it is recinded, you start from square 1. This may take some time, because they will have to start the investigation all over to determine if this is due to the original injury or something new. Make sure you get your Drs. notes, so that you have a copy to send to the w/c...other wise it could take them months to get them and that would mean that you would end up having to wait. If this doesn't seem to work, I would be getting a lawyer soon.

Good luck.

[sparkey]

I also received my PIR award and have been going to my PM doctor every month since then. I am also getting gangloin block injections and I never had any paperwork that I had to sign when I got my award. I do not have a lawyer and have no idea how it goes from after the PIR award. I would imagine it has nothing to do with my treatments I am receiveing and that they should continue to take care of my medical treatments.

I am also set up to see a hand surgeon on Tues. and see if they will do the recurring carpal surgery. I am also curious what happens after a PIR award and if they continue to pay for medical or surgery if needed. I have many questions, and need to get advice either from the labor board or calling a lawyer just to see what is ahead for the future in medical. I just know I never signed anything when I got the check except for the back of the check!!!! Which I know means I accepted my award. I did not appeal it, as I felt I would not get much more than 10% and not worth the fight. But if they stop paying my medical, I am heading out to search for a good wc lawyer! That would be the final straw that broke the camels back!

[bagpussinamerica]

When I spoke to the woman at the w/c she said that she authorised the MRI, but maybe by that she meant the she needed proof that this current problem is related to the accident. I can't see how it can't be. I've had this same pain since the surgery, only origionally in spits and spats. It has grown progressively worse over time and is now constant. The only thing the actually relieves it is to lie down completely and after about 1/2 hour is will ease up. But as soon as I am up again it gradually comes back until it is so bad I have to lie down again.

I know that the MMI doctor told me, and it is written in her report to w/c, that she expected regular flare ups in the future, for life. And that w/c would be required to pay for medical when this happened. Problem is, I don't think that this is just a flare up. This thing is staying for good.

I don't have a lawyer, though I am seriously thinking about getting one now.

[Still in Limbo]

It's Time for a Lawyer, by the Sounds of things You may have Epidural Fibrosis, (Scar Tissue) which has Crippled Me. Your Symptoms sound like Mine. I'm not a Dr., and that's only My Opinion, but an Attorney can Ease Your Mind, and Help You through this Confusion. My Best to You,and Please Keep Us Informed!!

[bagpussinamerica]

Thanks Limbo,

How long after your surgery did you start to feel things going backwards, so to speak?

I see the surgeon again tomorrow morning, but now I am worried about seeing him in case they charge me for that visit as well. Still, I neeed to know what is going on. The pain in really incredible. It fills all the requirements of sciatica, but like I said, I never had that before so can't be sure. And what I read says it usually only affects one side, and sometimes this will partially affect the other leg as well.

The other thing I noticed on my visits through the web sites about the AMA....it clearly states in everything that surgery is supossed to sort the problem out, not end up with more problems. It seems to me that the guidelines don't deal with that siutuation. Then again, maybe I should never have been put at MMI. It does say that pain is not figured into the equation until it has been documented for a year! A year of dealing with this. OMG!!! Anyhow, the way things are going, I would never be able to work with the situation as it is at present.

I will see the doctor tomorrow, then contact the labour board and w/c depending on what happens with the surgeon. I will let you know what is going on when I get home.

[Still in Limbo]

I Started feeling a Problem after about 1 1/2 Months after Surgery. I had Started Walking the Bike Path near My Home, and was Walking 3 Miles a Day. Then it Started only being 2 1/2 Miles, then 2 Miles, You get the Picture. The PT Facility had seen the Decline also, and Sent Me back to My Dr., they Stopped the PT until after the Dr. Visit. I had to Argue with the Dr., but He did Finally allow an MRI with and without Contrast,and the Scar Tissue was Found. At the next Appt., He said Very Clearly that He would not Operate Again, and Literally threw a Script at me and Said, "Go get ESI Shots"!!! I Saw My Attorney Directly after that Appt. Good Luck, and Please keep Us Informed!!

[bagpussinamerica]

Just came back from the surgeon. He told me that he was actually waiting for the other shoe to drop.....so to speak. The last surgery had so many surprises that he really expected something to go wong after surgery, but he didn't tell me that. Then when I started to improve we both actually thought, well, heck, its going to be ok after all. Well, not. Apparently I have herniated again, same spot, and then to add to that is further scarring all along that nerve root area. He has obviously recended the MMI. We think I was actually herniated at the time of my last visit to him, when I told him that I was getting some pain back into the leg, but would work through it. So, funny thing, when I saw the MMI doctor the day before and she cleared me....I was herniated. Go figure. And when I saw her I could hardly stand straight. Guess I wont be so confident about her again.

Now I have to call w/c and tell them. Which I don't look forward to since she made me feel like I was making it all up.

The surgeon did say he was going to discuss this whole thing with some other surgeons at the hospital since the first surgery was so odd, and we talked about videoing it this time too. He thought that would actually be a good idea. So I don't have a surgery date or anything yet. This time I will get everything settled properly since the last time I was completely out of it for 6 weeks after. I am not looking forward to this.

[Bad Boy Bad Boy]

This is so very confusing.

Before in the other Threads it was said there was nothing to remove for the Disc was gone. And now it's being said it re-herniated again. How can that happen unless you grew a new Disc?

Plus the fact, you knew you needed a fusion.

Why not, just get the correct surgery, before it's to late, and the damage goes to far, before it can be properly fixed? The type surgery you had in the past, is well known to have a fusion fiollow it anyways. Your surgeon know's this, and that was why they said you need a fusion before. But, you waited it out.

[hurt at work]

this sounds like what happened to me but i can do anything until my hearing if i win.my dr. was like well it was alot worse than we thought.then the L-3 herniated and his first words were i was afraid that would happen.the you should of fused that with the rest,now im worse than before and can do nothing.sorry didnt mean to take away from this thread just sounds to much alike.