update

[jimmyo1]

Hello all, hope all is well.

MY last post I had my rating done by the AME. The AME gave me a 25%.He put in the report that he felt that I should see a urologist for a possible neurogenic bladder and also suggested a sleep study to be done. I recalled the doc saying that may rating could increase if there is probable cause.

So I started receiving PPD payments without notification. I had to call the lawyers office twice in order to get the benefit letter, stating what the payment amounts would be. I've recevied a total of three payments one large payment dating back from Oct. 2008 through March 2009. They had stopped ttd in Oct. Because I was to return back to modified duty. Was not able to because of issue with my lower back. My Orth doc took me of work pending conservative treatments and if all else fails than spinal fusion.

The letter from the IC stated my rating is only 20% and that I do not have to call the disability rating unit. I spoke to the paralegal about the 5% difference and she said they go through a formula, such as age, occupation etc. I know that but how can it be a 5% difference?

I have not heard anything about settlement thus far and one other question, the AME report left Open Medical. Is medicine a part of Open Medical?

Thank you for any advice that you can give me at this stage of the game.

[Still in Limbo]

Hi Jimmy!! I don't Remember Your State, but Open Medical Usually means any Medications Prescribed by the Dr. the Ins. Co. has Chosen or Accepted to Handle Your Work Related Injury.

Settlement is not Always an Option, it seems Some Settle Quickly, while Some Never do, if You have an Attorney and want to Settle at this Point, Maybe they could Write the Ins. Co. a Letter Stating that You would be Open to Settlement. That May get the Ball Rolling, I Sent 2 Settlement Letters before I even went to My 1st. Hearing, they Said the weren't Interested, and my 14th Hearing is this Month, and it's going on 5 Years so I haven't been One of the Lucky Ones!

The 5%, I'm not too Familiar with these Ratings, I have a General Idea and don't know what 5% would do for You , Hopefully Someone Else will be on to give You Assistance in that.

Best of Luck, I Hope All Goes Well!!

[sparkey]

As far as medicine being included in your open medical. When I went for my IME they had the medicine as a question for the IME doctor to if I should be taking this medication or not for pain and the IME doctor replied back that for recurring carpal tunnel he has NEVER had pain medication given to his patients, and as far as the cymbalta he does not feel that I was depressed from having recurring carpal tunnel ,so because of this IME doctor stating all this information in his report they no longer had to pay for my medication. It immediatly stopped!!!

I then had to have my adjuster write me a letter saying that my WC fefuses to pay for my medication in case my ic is wondering why they are paying for my pain medication. I have that notice on hand just in case it is questioned. I have had no trouble getting my medication but do have to use my own insurance and pay a co-pay for it. My medical bills are all still paid for by WC.

[Still in Limbo]

As Sparkey has Mentioned, they May try and Stop Certain Medications. I'm in Pa., and the Ins. Co, did a "Utilization Review" on My Medications, which Basically Means a Panel of 3 Dr.'s. (Supposedly Unbiased) Reviewed My Medical Charts and tried to Cut Out about 3/4 of the Meds, I Use. My Attorney Filed a Petition to Review Medications, and when All was Said and Done, My Dr. was Found More Credible by the w/c Judge, so they had to Accept Any Meds, My PM Dr. Prescribes. My Ins. Co. also Stopped Many of My Meds. on a Whim, and My Attorney set Me Up with a Pharmacy that Continued to Fill My Scripts while My Case was Under Litigation, and even though I Won, I still Continue to Use them, they have been Great to Me. Many things can Happen Depending n the Ins. Co., each is Different, and I Hope You don't have to Deal with any Problems!!

[jimmyo1]

Thank you Still in Limbo and Sparkey.