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Cervical_Fusion · 04-06-2009, 06:07 PM

I called the dr today only to find out that I have a new adjuster. I called the adjuster and she approved the Cybalta, just drove to where I work and got the scrip filled. Just took the first one. Also while driving to get the script the Dr office called and I have an othho appointment on April 22 for the cervical fusion area. The Dr who did the fusion has not reiterd and moved out of state. I reqursted to be seen by the Ortho who implanted the SCS in my body, a separate claim. Iam off work untill the 15 of april but the ortho app. is not untill the 22, what are the odds that my POR will keeep me of work untill after the Ortho visit. They are closing my place of employment on May 9, while I was there today I was treated as that old saying like a red headed step child. My immediate supervisor acted at tho he did not want to even speak to me.
Talk about the cold shoulder.

jayne · 04-06-2009, 06:12 PM

gets cold going back sometimes doesnt it? good thing is you will get a check while you heal she will get a unemployment check

Cervical_Fusion · 04-07-2009, 04:54 PM

Finally got approval for the Cymbalta yesteray, got it filled and toook my frst one yesyerday and today I seept untill 2pp. I feel like a walking Zombie today. Will this last for a long time untill my body adjus to the Meds. Also while I was in route to get it filled at work my POR Dr's office called me and they got the Othro consult approved for April 22. I had 2voice mails when I got up today and one was from the Ortho's office said they had a canellation for this Friday and wanted to know if I wanted it. I called them back and they had already filled it so i did not get it. Will have to wait untill the 22 unless they call again. I asked them to put me on a list if then could for and earlier appointment. Not sure if I should see him earlier than that as my Por has me off work untill the 15 of April. since I have the Orto app. on the 22 maybe he will keep me off untill then. Maybe this could work to my advantage or may work for my disadvante. I am just taking one day at a time. I spend a lot of time looking on line for jobs and sending out resume on like. Numerous one daily, but no response, and when then find out my work restrictions they would not hire me anyway. I did have a phone interview with one retails company there corporate office only to find out that I was over qualified for the position in there Risk Management Corporate level position. I thought I would be a great canidate for the job as it was a Return to Work Program for there workmans comp injured employees. Seeing I have been on both sides of workmans comp I felt I could be an advocate for the injured worker and a advocate for the company. But how does a person take it when then are told they are over qualified. I would of love to do that job for them. It would of meant relocating to the other side of the state where my wife would love to be. as her parents and family are in the city and my sonand his family are about 30 minutes from there. Would of been able to see our only grand child a lot. We miss them so much and as now can not watch her grow. She will be 2 in May.
I do not know which way to turn at this point of the game. I am off work untill Apri 15. If I return then the store will be closed during that week and inventory on the 18 and will reopen after that for a few weeks clearance mode. and Doors will be locked a few weeks later. Right now nothing has been offered to me to work at a different location.I am stuck as what to do. Any help would be appreciated, or advice.
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~~Still in Limbo~~ · 04-09-2009, 10:41 AM

Hi Cervical, I'm Sorry I didn't Answer Sooner! I Wish I had the Answers to Your Questions, but if it was Me, I would Ask My POR to Keep Me Off until Your Appt. and See how that Goes. Other than that the Only Advice I can think of is What My Attorney Told Me: You Deal with Feeling Better and Taking Care of Yourself, and let them do the Worrying, that's what You Pay them For!! My Very Best to You, and Please Keep Us Informed!! Wink

***kate*** · (This post was last modified: 04-10-2009 01:37 PM by kate.)

Cervical_Fusion Wrote:stopped by work today and my script will still not go through on WC. Still comes up saying needs prior approval. I HATE WOEKMANS COMP. I called the 3rd pary billing company yesterday I guess the WC adjuster cold not get off her ass and fix it for me. Today I called my DR's office and talked to the person who handles all the WC paper work and told her, She promised she would call that company today.. Well it is 6:30 pm and I have not heard from my Pharmacist or one of my techs.

I worked with many of the 3rd party RX providers as an adjuster and many times I would get calls that an rx that I had approved 3 times had not gone through. So it may not always be that the adjuster hasn't authorized. Sometimes it's also the pharmacy not putting it through correctly in the computer and sometimes its the 3rd party RX company. Some of the computer systems they have automatically require someone to change the status manually on certain drugs even if it's been approved already.

Speak to your attorney and ask him/her to call (not write to) the adjuster and let them know what's going on with your prescription. Trust me, the adjusters don't want to, nor do they have time to get 3-4 phone calls a day about one RX. Unless they are outright denying it, it's probably a mix up somewhere.

Your doctor's office can not give the approval to the 3rd party company so even if they called, it wouldn't help.

Cervical_Fusion · 04-12-2009, 12:59 AM

The Meds were aproved along with a Orto conslut for the 22 of april. I received a letter about the company closing the store where I work from my attorney. He wants me to find out if my restrictons from my cervial fusion that was done in 2003, if they are temporary or are they permenant, the lettter states if they are temporary and the comany makes me no offer to work in one of the other stores then we can get the TTD started back if perm, then we possible could go for wage loss payments. anyone ever been n this situtation if so please help. I think they are still temp as I have an ortho appointment on the 22. any thoughts.

jayne · 04-12-2009, 01:25 AM

Bubba they gave me a 77% disability rating with almost the same problems... I also had c4-5 c5-6 c 6-7 with l4-5 and s1..after the c-5-6 and c6-7 fusion and the massive scarring they refused to do any more fusions...so ask your doc for a quesstament rating....it may be time to look into SSDI

Mad Bomber · (This post was last modified: 04-12-2009 06:56 PM by Mad Bomber.)

Doc has had me on Cyblata that were only samples. Finally doc went to bat and got W/C to get it for me.

I could tell when I ran out and doc could tell aswell

60 MG A.M.

I had C6-7 fussion

Cervical_Fusion · 04-13-2009, 05:25 PM

I went to Dr today, he added nerve damage to my cervical claim.
He also that the restrictions are still temp. as I see a Ortho again on the 22 of this month He said that I was MMI on my lumbar claim. and the restrictions are permenant. I am still off work on salary continuation, see Dr again on wed to see if he will leave me off or put
me back to work. for the last few weeks the store is open. before i loose my job.

Cervical_Fusion · 04-15-2009, 10:28 PM

Saw dr today for the cervical he says my new issues are comming from the c6-c7 disc. bellow my c5-c6 current fusion. I see the Ortho next week for a consult. Today he increased the cymbalta to 60mg a day. Theraputic level. I have an appoinment with my family dr sat morning about depression, panic attacks ets. could this all be because of the injurys. or is it just depression from me possibly loosing mu job. early n May?