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Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 1/19/2009 2:25 PM (GMT -7)   
You know how I have been saying for months that I would love to have one doctor go to bat for me against Wyoming Work Comp and actually prove to them that I deserve a chance to try the stimulator. For the last 5 years 7 doctors have told me and WC that the Spinal Cord Stimulator would be the best thing for me to relieve my pain. But WC has been very adamant about the fact that the Stimulator's do not work and are an expensive useless solution to pain control. Even though there are countless people in the U.S. that have these machines implanted in their bodies that are living useful lives and have had their lives given back to them because of this machine WC of WY still has decided that they do not work.

Now with that said my last psych evaluation was promising but WC turned it to their favor. The Psychologist said that if I had gone through several weeks of biofeedback, counseling, as well as some other things that he would consider the stimulator to be placed. But WC turned that and said that he did not actually say that he would agree to it and told me that he denied it. Don't know where they got that from but it really ticked me off. Ok so I have been on very strong medications for the last 5 years straight and of course they have been increased through the years. My new doctor has looked at my newest Mylogram, plus my records and determined that the stimulator is our best shot for a 50% decrease in my pain. Now I know that anyone in this forum would love a 50% decrease in their pain, hell I'd settle for it going from a 8 which is what it is on a very good day to a 6. But we are talking going from a 8-10 to a 3-5!

Here is where it gets very interesting. My doctor put the paperwork in for my stimulator. He got a reply...no a demand back from WC stating that they wanted the following to happen before the trial was to take place:

1.) Patient is to go through Nerve Conduction Study.

2.) WC wishes to see a 50% decrease in medications in one week before the trial is done.

3.) WC would request that they have their own questions for the psych evaluation.

My doctor got really mad and shot back a reply at once and here is what he replied;

1.) Nerve conduction studies are not 100% conclusive in determining whether a patient is a good candidate for a neuro stimulator nor do I see a reason to put this patient through such a painful test. There is conclusive enough evidence that I have shown stating where the patients nerve damage is located and I feel that this is her best chance at getting the best pain relief. (it was actually more tech but I kinda ironed it out a bit)

2.) (here it got rather hot) I do not understand why you would wish the patient to decrease her pain medications so abruptly in this manner when it would be better and more tangible to decrease the patients medications over the course of time. By doing so there is less chance of withdrawals and best chances for patient to recover fully from this procedure. (I toned this one down cause he was real mean about his words he actually called them ignorant to the medical side of things)

3.) I'm not sure exactly what it was that was said here but I'm sure that Dr.Parks really got on them hard for this one.

He was not happy with the whole letter that they had written, in his eyes they were being unreasonable and were dragging this whole thing out for their own benefit just so they would not have to deal with doing the trial. In the end he gave them an ultimatum which frightens me something horribly. He told WC that either they allow him to treat me in the manner that he feels is best for me or that he would let me go to find a new doctor.

So....the ball is in WC's court and we shall see what they decide. Keep your fingers crossed gang that things don't fall in a bad way for me. Of course there is another side to this......I am released from Dr. Parks.....and I go find another doctor only to be told the same thing the Stimulator is the best course of treatment then WC has to do something. But I do have a recourse here.....I have a Wyoming Senator on my side!

Hugssss

Scarred
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Slight herniation at L2-3 but Neurosurgeons will not operate because of previous failed surgeries. Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Lunista, Topamax and Robaxin.


Pete trips again!
Veteran Member


Date Joined Nov 2006
Total Posts : 1899
   Posted 1/19/2009 3:17 PM (GMT -7)   
HOLY SHMOLY!!! I think the good Doc has done you a favor and would say that if you do have a Senator on your side, that you get a copy of the letters to him ASAP before these A-H's try something else! It's pretty obvious that they are jerking you around. It would be a different story if you were asking for drugs, but you want to reduce them! What the Hell??????? I don't understand, some people just have to feel like the are more powerful than others and unfortunately their little sceams & agenda's don't prove anything except how stupid they are! We will be praying for you S! Like you don't have enough on your plate already!!!!
Your S.Fla. Buddy,
Pete
55 years old, Surgury, Radical Prostatectomy 8/20/03, PSA 6.6, Gleason 3 + 3 = 6, Adenocarcinoma extent (moderate) Stage & Margin:T2NOMX, No Metastases, Organ Confined, bone scan: Neg. 3 1/2 years of depression after surgery prior to Hypogonadizm DX, Testosterone Theropy (Testim Gel)since 12/06 but switched to a higher dose of (Androgel) 6/08. 55 and still alive and so glad to still be here to see my two sons grow up to be fine young men. They are both serving in the US Navy, one on an aircraft carrier heading for Hong Kong and the other on a Gator Freighter stationed in Norfolk, Va. I am one proud PaPa! 


AndreaRN
Regular Member


Date Joined Mar 2007
Total Posts : 91
   Posted 1/19/2009 3:22 PM (GMT -7)   
I have been dealing with work comp for 16 years so I understand your plight. Sadly my feeling is that there is a good chance they will let your Dr. walk.

I finally settled a few months ago. I accepted a low but half decent amount of money because it was written up as to be tax free. I have medical on my neck for life.

If they refuse to pay for a procedure the signed settlement states that they will also have to pay my attorney fees to ensure I get the needed medical help. After 30 days of them refusing a medical option my state law is that my own personal insurance will have to provide the care.....at that point my attorney will bring the issue to court for my ins to be reinbursed.

Do you have an attorney? From your post it does not sound like it. Do you have your own personal insurance and a state law similar to mine?

Any questions?

Andrea
Women who behave don't make History!

C3-4 herniation
C4-5 disectomy & fusion (anterior)
C6-7 & C7-8 L laminectomies (posterior) (need R)
Partial removal of supporting Cervical Posterior Ligament
Constant shoulder pain & tightness.intermittent neck pain
bulged discs at C6-7 & C7-8

Chronic Pain with Vicodin 7.5/325 rx

VIEW IMAGE


ryand
Veteran Member


Date Joined Dec 2007
Total Posts : 639
   Posted 1/19/2009 3:45 PM (GMT -7)   
Scarred:

I am so sorry that you are having to deal with such unreasonableness. Especially as you are going through a rough personal time right now as well after losing your father. I wish there was some way that insurance companies could be made to abide by the decisions made by our doctors. I have not had to deal with WC, but I have also had medical decisions forced upon me by my insurance company. In one instance, my doctor wanted to try a new anti-inflammatory medication with me, and when I arrived at the pharmacy (a big chain) I was told that I would not be allowed to have the prescription filled AT ALL. Not that it wasn't covered or that it would cost me extra, but that I couldn't have it!

The nurse called the insurance company and was told that the insurance company's on staff "doctor" had "reviewed my records" and decided that there was no evidence that ibuprofen wouldn't work for me. Ummm.... hello? Maybe the chronic intractable unrelieved pain that was NOT RESPONDING to the meds I was on? Or maybe the six or seven previous variations of anti-inflammatories that had been tried and failed?

The worst of it was what the nurse told me later. Just like what your doctor has said to you... She said to me "the doctor gets so mad when the insurance company does this that he just says 'fine, if they won't let me prescribe what I deem medically appropriate, then I just won't prescribe anything at all!'" I was mortified! Talk about punishing the wrong people. I can understand the doctors' frustration, but I wish there were a better way for them to make their point than just deciding not to treat us!

I hope you have a better outcome. I am glad that your doctor had enough integrity to be incensed by the WC demands, so I hope he is able to knock some sense into them.
Ry

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 1/19/2009 4:03 PM (GMT -7)   
Scarred,
shakehead shakehead shakehead

More hugs to you,

PaLady

Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 1/19/2009 5:15 PM (GMT -7)   
Well gang....let me put it to you this way. I think this is going to take a legal team to fight my case to get anything done in the end. I would be willing to fight to keep my current doctor as he is the only one out of probably 8 doctors that I feel is on my side for once in my life. As you know my pain has been horrible....the sleeping has been terrible but yet they are not wanting to increase my medications quite yet until this gets resolved. I want so badly to scream at WC and say "Wake UP!" But I know it is falling on deaf ears so if it takes me writing an email to every single senator in the WY congress and US I will. I will do whatever it takes until someone stands up and says "Whoa this is wrong!"

What I am hoping is that this was a wake up call for WC but I cannot let myself get hopes to high then be crushed. I will keep you all posted as we go along with this.

Hugsssss

Scarred
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Slight herniation at L2-3 but Neurosurgeons will not operate because of previous failed surgeries. Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Lunista, Topamax and Robaxin.


skeye
Veteran Member


Date Joined Mar 2008
Total Posts : 2976
   Posted 1/19/2009 8:50 PM (GMT -7)   
Hi Scarred,

I'm sorry to hear about your continued problems with WC (I don't think I've ever heard of anyone who hasn't had problems with them, come to think of it, although some have it worse than others & they seem to be particularly nasty to you), but I'm happy to hear that one of your docs is standing up for you! That is wonderful that he won't take those stunts from WC & is advocating for you with all his might. Hopefully your new doc will do the same thing! And I cannot believe they demanded a 50% reduction in pain meds within a week! Obviously the don't know, or care, about what decreasing that quickly will do to you! Geez! Are these people really human? Where is their compassion? I guess it's all in the money... I'll say some prayers that WC will listen to your doc & do what is BEST for YOU!

Hugs,
Skeye

Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1559
   Posted 1/20/2009 3:50 AM (GMT -7)   
Skye; Its a power trip for them. They are trying to gain control over my care. The surgery really is not that expensive but it is very evasive. The battery is to be replaced every 7 years and its a surgery that costs 50k. But for what they are paying for pain medications along with the long term affects on my system I would think that they would jump on the chance to get me off of their system or at least decrease the amount of bills that they would have to pay out without any squawking. Apparently I am wrong in this thought. It's sad to think that many who are dealing with WC across the nation are going through these problems like I am and after talking to hubby last night I think we are now developing a plan to handle this if WC decides to refuse to allow me to see Dr Parks.

I will write a letter to 10 senators that are on a board set up by the state to look into the problems with Wyoming WC. In this letter I will state what I have been dealing with for the last 9 years and what the problem is currently. Then hubby wants to find an attorney to fight to keep Dr. Parks as my doctor feeling that he is doing the best job with my care. I believe that this is the best possible recourse that can possibly happen at this point and that if I don't fight to keep Dr Park that all will be lost and I will be forced to deal with some doctor that really doesn't care and won't want to try to keep WC going on the best care for me.

Scarred
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Slight herniation at L2-3 but Neurosurgeons will not operate because of previous failed surgeries. Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Lunista, Topamax and Robaxin.

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