My Workers Comp Story Thus Far

[TripleP]

I have been reading everyone's posts and thought I would share my story thus far. I apologize ahead of time for the long read At one time, I was a fairly well rounded individual, in good shape, and loving life. Today nearly 32 years old, I am tired, worn out from the surgeries, pain, and constant weight on my shoulders known as the Workers Comp minefield. My claim is in PA.

It was a brisk October morning in 2008 and as I headed out of my work trailer and I fell down 5 steps after misplanting. Well my knee gave out and fell five steps, and soon found my kneecap on the back of my leg.

My first doctor who received my injured knee said he could do nothing as it was beyond his expertise. The first OS I saw was confused and bewildered, and way beyond her expertise referred me onto another OS who had more experience with my type of injury. As it turns out, I had damaged my patellorfemoral ligament, torn cartilage under my knee cap ,and constant mal-tracking of my patella. I performed therapy for 2 months, but as time evolved the MRI's and CAT scans showed the damage was progressing and low level arthritis was setting into the joint.


At this time surgery was scheduled for December 08'. They performed what is called a Tibia Tubercle Transfer breaking my tibia and moving it over inserting 2 screws to hold in place. Additionally, they repaired my patellofemoral ligament, performed a chondroplasty, synovectomy, and a lateral release. It was a very expansive surgery leaving me in the hospital for 3 days. The recovery was brutal, but as spring turned into summer I started to make some decent headway in therapy. But during this time period I was laid off from my job, and the company I worked for also went bankrupt.

But during the summer my knee began to swell again, and the pain slowly crept back causing increasing discomfort daily. Another MRI was performed, showing massive scar tissue, advanced arthritic changes, and again mal-tracking issues. So we scheduled surgery for August and what was thought to be a simple surgery turned into 2 hour scar tissue removal, another chondroplasty, screw removal, and various other clean up issues.

This surgery with therapy provided mild relief for two weeks, and again pain and discomfort increased to pre-surgical levels. So they drained my knee, shot me up with cortisone, and scheduled another MRI. This MRI showed I advanced from low level arthritis to full blown degenerative changes, full chondral defects under my knee cap, and again showed mal-tracking/with subluxations of my knee cap.


At this time, my OS essentially gave up and pushed me onto a specialist. This specialist was very vain, insisted I work through the pain and despite the damage I do, that in the future I will need to have a total knee replacement. At this time he insisted their was nothing he could do for me. So, I heeded his advice and strengthened my quad and grew it from November 09 till January 10' a total of 8 cm. But still the pain persisted as the popping, grinding, and swelling increased.

At this time I became increasingly frustrated, contacted my Nurse Case Manager insisting upon another opinion, and she stated another opinion was be planned for me at an IME. I began to search, and found answers to what an IME was all about. I researched more and soon found I could schedule my own opinion which I did and hired a very respectable lawyer. My new doctor a very well respected Philly doctor who noted previous surgeries failed and that the damage to my knee cap and shallow trochlear groove makes me a candidate for a PFJR.  Said this may be the best surgery along with another realignment may be the best bet to relieve my pain. He compared my knee to a flat race track to a NACAR track meaning my knee continuing to slide/pop out without the groove.  Suggested two more months of therapy and will see me in early March for a follow up and plan. My original OS agrees with this doctors assesment.

Independent Medical Evaluation doctor for the Insurance Company says 12 more months of therapy, past surgeries have failed, obviously a bad knee with maltracking, positive J sign, knee cap damage/grade 4 chondromalcia, and with a 6 cm difference between the my two quads.  Does not think that C is right, but he may be as he put it in his view.  Suggested a very prominent PF doctor in CT who will not see me.

I saw my doctor again this March for what I thought would be the defining day with regard to scheduling and getting the ball rolling for my PFJR....As for the ball rolling, it's rolling alright but in a new direction with the same old spin as before. More months of therapy.  Why?  Answer is easy, but not so easily done from a mental aspect.  How does the medial joint line present itself after the 6 month mark after the injection of the synvisc-1 and continued therapy.  My doctor unlike my previous doctors that came before is not eager to slice me open.  He is not eager to cut open a 31 year old man who was an active adult.  He is not eager to scope me for fear on infection and the further growth of scar tissue....And in the end he is not eager to remove what can never be brought back.....bone...And when he operates he wants to know do I a PFJR with a unicompartamental replacement of my medial compartment....


So here I sit. Failed surgeries, lost years, and continued pain. My lawyer believes this case will settle with open medical and 4-6 years of wages. I can honestly say this thing above all other is the most stressful aspects of my life. At this time the IC performed a market value assesment and vocational assesment which has been explained to me that this will be used to push this thing towards settlement.

So please share your opinions, where do see this going, and sure ask questions.

P

[Bad Boy Bad Boy]

My opinion only;

You been shown to have a problem with scare tissue, and these doctor's are not willing to go any further now. So they are only going to continue PT for you. Sad thing, but work comp could care less about how active you were, they only care about the injured body part, nothing more.

[bronco54501]

Geez, that scar tissue is a sob. I also have scar tissue problems in my hip area... Are you still getting funds through wc??? It's a shame that wc could care less about what people did before and at your young age that just sad..... I really dont have much to offer but in my oppinion, no money is worth what we all injured people go through. And I would not settle for nothing ynless they keep your medical open............. I wish you well and good luck with your case, and by all means keep us updated as you know good reading helps others understand...........Bronco

[TripleP]

As of now I have no scar tissue, just moreso bone on bone with a breakdown of cartilage, arthritic swelling, constant gringing/popping with my knee cap constantly popping out of the joint and arthritic changes. The point in waiting the additional time is to do any surgery that is needed all in one shot. As for workers comp, my claim is still open, receiving my bi-weekly checks, with my medical still fully open.

[Still in Limbo]

Triple P, I'm from Pa., have had 15 Hearings with Number 16 this coming Monday, and I have Won the First Round, have a Portion of the First Round in Appeal, and the Second Round Starts Monday. So Technically I have 3 Cases going at Once for the Same Injury. They are going to try and get You on the 500 Week Clock, that's why Your Attorney is saying You will Probably Settle for 4 or 5 Years Pay, but it will be Your TTD Payment, not Your actual Wage, and They will Deduct Approx. 25-30% for Inflation. Have Your Attorney Explain that to You also. Then Your Attorney will Take Their 20% and the Balance is Yours Minus any Liens that May be Placed against Your Claim. I was Injured 10/04, and I'm still Receiving My Bi-Weekly TTD Checks. This Pa. System is Bizzaro World, (My Attorney's Actual Words)! My Suggestion to You, don;t Settle before All Medical Treatments have been Performed, and You are as Close to back to Normal as You can get, Medical Open sounds Good, but every 6 Months They have the Option of Sending You to a Dr. of Their Choice for an IME, and if They can get One Judge to See Things Their Way, Your Medical Portion can be Closed. You don't want to Live with w/c looking over Your Shoulder forever. Have You Applied for SSDI? You may want to, and if Approved at Settlement Time, Settle with a Medicare Set-Aside, so w/c is out of Your Life Forever. I know I'm throwing a lot of things at You, just Please Ask Your Attorney some of These Questions and See what the Answer is. I Wish You the Very Best, My Case is Very Complicated, and will Probably Drag on for More Years, but I Only want what I am Supposed to Have, not a Dime More, or a Penny Less!!