And Pain Psychologist says....................

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Scarred_for_life
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   Posted 3/4/2009 7:15 PM (GMT -7)   
Well guys and gals today was the day for my psych Evaluation for the trial on the Spinal Cord Stimulator. Spent 3 hours doing their tests.....and then headed off to have lunch with my son before my appointment with the Psychologist. I had a very nice time with my son and I will miss him lots with him going to TX and all. Anyway...when the psychologist and I were talking, hubby was patiently waiting in the atrium downstairs with bated breath.


Ok so here is how it went; he says that I am still repressing some mental issues with my pain, but that he thinks that if I go and see a pain psychologist that these issues can be worked out. I thought I had everything pretty much figured out but I guess not. Anyhoo it isn't going to be a mandatory thing, he says that if I feel comfortable with it that he thinks it will help bunches and I have to agree with him. Now he would not tell me what his decision was going to be but I did get a hint....in his exact words "you won't be upset with me in anything I write in my report and after that a smile. Of course I asked what he meant and he said that he thought that the other two eval's were not a definite no but that at that time I had some more issues to deal with.

Now, do I think that he is going to brand me "Good to go for the SCS"?? No clue. But I think there was a hint of good news in his voice and I think that just maybe I now have a little more hope!

Hugsssssssssssssssssss

Scarred
What doesn't kill us only makes us fight back harder! :P


edt
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Date Joined Dec 2008
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   Posted 3/4/2009 7:18 PM (GMT -7)   

Scarred,

I hope its a go for you!!  Hugs and lots of prayers from me to you!!

XXOO Patti


PAlady
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   Posted 3/4/2009 8:18 PM (GMT -7)   
Scarred,
Congratulations on getting through it!! It sounds to me like he's not going to block your way!

Of course you're repressing some mental issues that probably relate to your pain; look at all you've been through recently! I wouldn't let that worry you much, and talking with a therapist is probably good for all of us.

Anyway, glad it's over and it went well!

PaLady

Chartreux
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Date Joined Aug 2006
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   Posted 3/4/2009 8:56 PM (GMT -7)   
Well scarred, I sure hope it works out for you, hun and that he does brand you as
good to go that would be so wonderful for you....Hope ya don't mind a big WOOHOO!
will says a prayer for you if you don't mind and keep us posted when you find out....
will be pulling for you hun.......

{{{{{{{{{{{{{{{{{{{{{{{{{{{{{{{{{{HUGZ}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
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* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc, Fibromyalgia, Gerd, Enlarged Pituitary Gland
******** "We could never learn to be brave and patient if there were only joy in the world" from Helen Keller *********

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skeye
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   Posted 3/4/2009 10:18 PM (GMT -7)   
Congrats for surviving the eval, Scarred! I can only imagine how never racking it must have been! Sounds like you're probably on your way to getting the SCS! Glad everything went pretty well. I'll say a prayer for you! (((((hugs)))))).

Skeye

straydog
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   Posted 3/4/2009 10:59 PM (GMT -7)   
Hey Scarred, sounds pretty darn positive me. I think he is giving his approval when he stated you would not be unhappy with anything he wrote in his report, sounds like a yes to me. I think if he was going to flunk you he would have said something like I will have to put my report together or something along those lines and not leaned one way or the other.

So, you son is moving to Tx? I live in Ft Worth, where in Tx is he moving to if I may ask. I had my grandbaby today, we kept him after he got out of school. He & I played and he wore his Granny out, but its a good tired. He is just growing up so fast.

I wonder how long it will be before you do the trial now??? Hugs, Susie


Scarred_for_life
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   Posted 3/5/2009 9:45 AM (GMT -7)   
Thank you all so much! Your posts have given me so much inspiration over the last few months and weeks. If it was not for each of you with all the support that you all gave me I probably would have been a wreck yesterday and maybe barely gotten through it. For this I am eternally grateful to each of you and if I could reach out and give you all hugs I would! But for now ((((((((((((((((((((((Hugs)))))))))))))))))))

Susie; I was amazed that this guy had both of my last evaluations at hand and looked each of them over right there in front of me. He told me that neither evaluation actually said that I was not approved but that I needed to re-evaluate my priorities at that point and time. My first eval I had no clue what to expect from the SCS device and I had unrealistic goals for what the SCS would do. I was also very submissive with my treatments and medical things. I have changed so much over the years that I have actually dealt with this and I am now quite active with my disease. I think it was my need to decrease my pain and get off some of the medications that helped with the evaluation and I am pleased with my results. BUT (and I hate to say this) I am still having problems feeling like I am weeks or months away from this decrease. Workers comp has already said no to two evals that have supported me getting the SCS and I can't help but think that it will happen again. The only thing that keeps me going with this is the fact that I have a very aggressive doctor and I think that he will fight like hell to get this done.

My son.....he is not actually moving to Fort Worth TX but is headed tomorrow into federal custody and will be the resident of a federal corrections facility.


How long will it be?? Hopefully not long!

Hugs,

Scarred
What doesn't kill us only makes us fight back harder! :P


BrentE1961
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Date Joined Jan 2009
Total Posts : 47
   Posted 3/5/2009 11:21 AM (GMT -7)   
I have a question. Why do patients need an evaluation with a psychologist to receive a neurostimulator? Is it an insurance issue? I have Blue Cross PPO in California, and my PM and I have discussed a neurostimulator for me on a number of occasions, but he has never mentioned a psych evaluation. Does everybody need one or is it part of somebody's program, an insurance issue, ???

Thanks for any clarity that anyone may provide!

Brent
47 YO Male, chronic back pain. Herniated disc L5/S1 2003. Discectomy with partial laminectomy 2004. Now told I have Failed Back Syndrome with discogenic pain.


Pain level varies from disturbing to nearly intolerable.


Pete trips again!
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Date Joined Nov 2006
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   Posted 3/5/2009 11:53 AM (GMT -7)   
Scarred>>>I knew you could do it!!! Good for you! Here's a pat on the back for you>>
PAT>PAT>PAT!!! Thats great news! I'm sure he wouldn't have said anything at all if he wasn't going to OK it for you! It wouldn't make sense! I'm so happy for you, it's been a long haul and now you're almost there! YIP>>EEE!!
HUG>PAT>HUG>PAT>HUG!!!
Pete
56 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> new 2/6/09> 400mg injections every 2weeks . 56 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 the aircraft carrier USS John Stennis in port in Japan and the other on a Gator Freighter USS Bataan stationed in Norfolk, Va. I am one proud PaPa! 


PAlady
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Date Joined Nov 2007
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   Posted 3/5/2009 1:02 PM (GMT -7)   
Brent,
It's often to assess someone's expectations, as Scarred mentioned, and overall a person's emotional framework and coping skills. A lot of major medical procedures now require this - especially things that are chronic conditions where someone could have the expectation that a particular treatment or procedure would "cure" them. Or that they wouldn't have to work to manage aspects of their condition.

It can also be a part of insurance requirements such as worker's comp., but that's more because it's also been shown that people with unrealistic expectation, poor coping skills, etc. may not manage well afterwards. That's the medical piece. The insurance piece is that insurers don't want to spend a ton of money only to have something fail. Course, I also think insurers can abuse this and just keep adding it as an extra hoop, repeatedly, as I think happened with Scarred.

Scarred I think if they refuse you it will have nothing to do with the psych. eval and everything to do with W.C. throwing up yet another roadblock. Let's all hope that doesn't happen! You at least deserve a trial!!

PaLady

Scarred_for_life
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Date Joined Jul 2008
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   Posted 3/5/2009 2:10 PM (GMT -7)   
PA your correct in all aspects, but it is also a requirement for all patients seeking a Neurostimulator. It does not matter if you've got BC/BS or Work Comp or your paying cash. All doctors require a Psych Eval before a patient gets the SCS device.

Unfortunately I have been through gobs of hoops with WC PA and I am so tired of their games that I would pay cash for this darn thing if I thought I could get away with it. I know that not only is the surgery expensive but too the replacement batteries are 50 grand a pop every 7 years if you don't get the rechargeable one. It's outrageous that WC has to be so stuck on "The SCS devices do NOT work on ANYONE" that any one has to go through so many hoops when dealing with Ins. and the likes that its frustrating for all of us.

PA; On a side note....if they refuse it I will be taking their butts to court to get this done. Period. Done playing with them. If this psych eval says its a go and WC denies it they can just see me in court.

Hugsssss

Scarred
What doesn't kill us only makes us fight back harder! :P


Tirzah
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Date Joined Jul 2008
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   Posted 3/5/2009 2:15 PM (GMT -7)   
Brent,
Sometimes it's the insurance company that requires it & other times it's the doctor's practice. My doc never said anything to me about it until he was preparing to schedule the trial. Since my insurance company didn't require it, I made sure that my PM did not mention it anywhere in his notes (no need to give the insurer any reason to not cover something they otherwise would). If your clinic requires one, make sure you check with your insurer to see whether they also need it & otherwise take steps to ensure they don't inadvertently get copied.

As far as I'm concerned, the MMPI being given to people who are only diagnosed with a physical illness is completely bogus. The first two times I took it, I was completely honest & it came back saying I was a sociopath. My counselor thought that was entirely ridiculous. The third time, I learned how to answer the questions -- which is incredibly difficult to do & I really don't recommend trying that -- and got approved for the SCS.

You can google it & there are a lot of sites out there discussing whether it is really appropriate to give mentally healthy people the MMPI. There are other sites that discuss how different factors can influence the results and further how even the exact same results are interpreted differently based on what is shared during the pre-testing interview(s). So, while I understand the underlying premise behind administering these tests to CP patients (see PA's response above), I think it is a misuse of a test that was designed to be used in mental institutions, and a dangerous one at that. If we are now being required to show that we aren't expecting SURGERY to "cure" our emotional problems, how long until we are required to take it to show that we aren't expecting PILLS to "cure" our emotional problems?

Perhaps that's a bit cynical, but the cost of certain meds (Actiq/Fentora, for example) over a few years can be just a costly as surgery so it's not a huge jump to wonder when insurers & others will start requiring this for all costly medical treatments.

Scarred_for_life
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Date Joined Jul 2008
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   Posted 3/5/2009 2:28 PM (GMT -7)   
You know Frances I agree! I did mine and it came back as I was totally psychotic the first time! I don't understand why a psychologist is required or how he/she is a proper person to diagnose CP or whether a person should have any surgeries. Some Neuro's are requiring that a person go through a psych eval before they can ever be touched by a scalpel for back surgery! I could not believe that when I heard about that! How can someone who works mainly with your emotions and mental state be the proper person to look to when it comes to surgery? Isn't that profiling? It is in my books!!
What doesn't kill us only makes us fight back harder! :P


PAlady
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Date Joined Nov 2007
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   Posted 3/5/2009 2:59 PM (GMT -7)   
Scarred, Frances, & others,
Since I know some things about this professionally, I do believe there are medical reasons to have psychological (or more appropriately, psychosocial) assessments done prior to a number of medical procedures. In many cases now it is considered part of standard medical practice - such as with bariatric surgery, the SCS. and others. However, that does not mean the MMPI is the only or even the appropriate tool to use. I would aggree it's not, unless a person has shown some serious psychological problems already that need to be sorted out. I've always said I could do as good an assessment with an individual in 2-3 sessions as any MMPI. The only thing it may detect more quickly are serious personality disorders, which is another topic altogether. And now they're being given via computer, with the initial interpretation being done by computer. If the interpretation is done out of the context of knowing a person's situation, it is likely to be inaccurate, and many psychologists may do this because it's faster, and they can keep a dependable income.

The medical requirement is generally for an evaluation by a licensed professional, not for the MMPI, per se. The initial version of the MMPI (the MMPI 1) was revised years ago because of serious bias against women and cultures. There were studies that showed that abused women were labeled as "paranoid" when in reality they had reason to be in fear. Anyway, I'm starting to get way off track. It's just that medical outcomes can often be drastically affected by an individual's emotional make-up, coping skills and (what often gets left out) support system or lack thereof. So I do see a valid reason for requiring an evaluation in many cases. The type of evaluation and the person doing it can make all the difference. Plus, just like other so-called I.M.E. (Independent Medical Examinations), if the person doing it is being paid by a biased party (like the insurance company) they usually are not very useful except to help deny or limit coverage.

If they do deny you, Scarred, I sure would get an attorney. And you can also get your own psychological evaluation by a therapist of your choice who isn't paid by W.C.

PaLady

Tirzah
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Date Joined Jul 2008
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   Posted 3/5/2009 4:54 PM (GMT -7)   
PA-
I don't totally disagree with you. Certainly, emotional health can affect perception of pain & our ability to manage it. While I'm not opposed to taking that into consideration during any treatment, what I am opposed to is using the MMPI to do so. It may well have been that the original two exams that I took over a decade ago were the first version of the test -- I really just don't know. But many people insist that even the most current MMPI is designed to differentiate between various mental disorders, and not to determine whether or not a person is mentally healthy. The interpretation has everything to do with the goals, training & experience of the administrator and can easily enough be skewed even by an administrator with no financial incentive to "fail" the person taking the test. It concerns me that it is so rapidly being accepted without question by many in the insurance & medical community as a valid test for determining whether a person demonstrates any of the markers for hypochondria, malingering or general inability to adapt when there has not been sufficient research to demonstrate whether they are helpful to identify those characteristics in physically ill patients nor has there been extensive research to show whether the tests are weeding out the right people (i.e., whether certain responses on the MMPI actually equate to a failed SCS implant).

I certainly meant no disrespect for your field. I just feel that there needs to be a lot more research done on whether the MMPI tests administered for these purposes are actually accomplishing what they set out to accomplish. In my case, answering truthfully disqualified me for the implant. "Cheating" the test got me my SCS & my life has vastly improved as a result. Do I still have some issues resulting from past abuse? Sure, from time to time it still gets to me, but the way that it affects me is unrelated to my pain. Without the MMPI there was no indication at all that I had failed to sufficiently adapt. I held a good job. Had my own home. Had many healthy friendships & had otherwise done very well for myself. I took more pain meds than I'd have liked to in order to accomplish those things & after hearing that the SCS could cut my meds by 25-50%, I was eager to give it a shot. I wasn't very hopeful it would work, but as it turned out, the SCS well exceeded my expectations & after lengthy reprogramming, my case resulted in being just as "successful" as most people who legitimately passed the test. There are other tests out there & while some of them seem more promising to me than the MMPI at present, I will reserve judgment on them until more studies come out showing their efficacy in accurately clearing patients for these procedures.

I wish I had a quick fix for this issue, but I honestly believe that our best hope is to do what we can to encourage medical professionals, MH professionals, CP advocates & actuaries to support, fund & conduct research in this area. I only want what's best for my fellow CPers. God forbid the MMPI is what's best, I will get behind it, but I haven't seen anywhere close to enough proof to make that case. I do appreciate your input on this issue & greatly respect your views & opinions. I hope you will continue to share your views on this critical issue b/c we can all benefit by being more aware of all the angles & perspectives out there.

peace,
frances

PAlady
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   Posted 3/5/2009 5:24 PM (GMT -7)   
Frances,
I really don't disagree with you at all regarding the MMPI. And I'm not a psychologist, and do not do psychometric testing. Never had a desire to get certified to do it, either. Yes, it has its place, but I don't think it yields the kind of information that's relevant to many of these procedures. So we're really on the same page!

I really think that most of the evaluations that are required by worker's comp., etc. are predetermined in many cases. And you're very right the interpretation of the results is critical. It isn't a "pass/fail" test, and yields way too much information than is needed in most cases. In the past when I've done evauations (I never did them for the stim.) for various medical procedures I've either used shorter instruments or designed my own evaluation sheet, and then wrote my opnion based on all the information, most especially that gained from the interview with the person. But that's when it's truly being used for medical purposes, and to guide physicians in their decisions. When legal issues and insurances get involved, it gets messy and is generally biased.

PaLady

Scarred_for_life
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Date Joined Jul 2008
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   Posted 3/5/2009 6:02 PM (GMT -7)   
You know I think that this is a good discussion for those that are thinking of getting the SCS device or have been told by their doctors that it is a viable option. It gives them that added insight into the actual things that go on when it comes to the psychological Evaluation that they will, if they choose to go this route, encounter.

When I did mine yesterday there was not only the MMPI that I was tested on. There was in all 6 tests that I was required to do. One was something to do directly with my pain, the MMPI 1 another shorter test that was alike to the MMPI 1 and three others that helped the guy get a full picture of my mental make-up. I don't remember doing all of these tests the last time I did this and maybe they are re-evaluating their testing procedures, but I do know that the abuse that I suffered many years ago apparently did have some factors in how the guy interpreted the tests. I have appropriately dealt with these issues in my life and I really do not understand how something that happened 27 years ago could have any impact on my current pain issues (if you understand what I mean).

I would gladly welcome any suggestions into this and I look forward to hearing what each of you have to say.

Hugs

Scarred
What doesn't kill us only makes us fight back harder! :P


Tirzah
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Date Joined Jul 2008
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   Posted 3/5/2009 6:18 PM (GMT -7)   
PA-
I think that's a much better way the way you handled it. You're absolutely right that there's just too much info on the MMPI. Why does my PM need to know whether I enjoy doing math problems?!! ;) lol

Hopefully in the future there will be something that will just deal with whether the person thinks everything hurts, whether they blame everyone else for their problems, whether they have reasonable expectations for the implant and whether they would be able to handle things if the implant completely fails. Honestly, I can't quite understand why it would matter even if Scarred was psychotic (Scarred, sweetie, I don't think you're crazy, just saying I don't see how that's relevant). Unless she's invented the pain in her back, I would think the implant could still help with the pain.

Beyond it not being a great metric for predicting success of an implanted SCS, it seems quite an invasion of privacy. If I'm not getting treated for a mental disorder, what right does anybody have to get a complete profile of my mental health & personal history? Fortunately, I was able to keep it out of my insurance company's hot little hands, but I would have rather that my doctor not know some of those things about me. He said it did help him to understand how I could have had some of the injuries to my vertebrae that I had, but honestly, all he had to do was ask me whether I had ever been involved in any type of activity that would cause repeated stress fractures & I would have answered honestly. No need to put me through the torment of trying to sit there for hours answering hundreds of annoyingly stupid questions.


Scarred, my friend, I'm with PA. If your test doesn't get you the green light time time, fight it. We will be here to support you. :) Do you know when you will find out the results? I think it took almost 2 weeks for the report to reach my doc b/c all 3 of my exams were administered by students & their work needed to be reviewed by a licensed psychologist. Do you have a personal counselor? If so, you can maybe ask the administering psych to fax the report to your counselor. It's not an unusual request & maybe your counselor could even make the request for you. That way, if it's good you'll know sooner & if it's not ... well, you'll have your counselor there to support you. And we will be there to celebrate or support you either way. Plus, maybe PA & I can invent a Workers-Comp-Butt-Kicking Monster to take down anyone who tries to stand in the way of you getting your implant. smilewinkgrin (grumble, grumble, grrrr) don't mess with the monster! skull lol

Scarred_for_life
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Date Joined Jul 2008
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   Posted 3/5/2009 6:33 PM (GMT -7)   
I should know by the time I see my pain doc in April. If WC decides to fight me on this they will have a huge fight on their hands. It surprises me that some people that are qualified for the SCS are turned down because of the Psych evaluation. I am going to find out from WC whether they will allow me to do some counseling as hubby and I feel that it will help and two show WC that I am willing to do whatever it takes to decrease my pain and the medications that I am on. I know that many that have gotten the SCS that I have talked to have had to fight tooth and nail to get their ins or WC to pay for anything past the implant. Which means if I have to fight them that means I have to fight them each time I have to have a battery implanted or a lead replaced. I might be able to get my attorney (if I have to go that direction) to fight to get them to continue the coverage but I'm not holding my breath. According to WC when the SCS is implanted that is end game they don't pay for anything more including Medications.

We shall see.

Scarred
What doesn't kill us only makes us fight back harder! :P


straydog
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Date Joined Feb 2003
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   Posted 3/5/2009 8:44 PM (GMT -7)   
Hey Ladies, I too had to do an MMPI test and of course the psych eval before having my pain pump put in. I do know for a fact Medtronics requires the psych eval. before having the inplant done. I do remember a part of that test was questions on health and pain then some of it seemed off the wall for someone having a medical procedure done. The only problem I had doing the MMPI was I was not able to sit long and kept having to get up and move around but they had no problem with that encouraged me to do. I remember thinking the MMPI was a crock and what did it have to do with my pain, but its just one more hoop to jump thru.
 
PA, I know you said you worked in the medical field. May, I ask what you did in your work. I know you probably told us a long time ago, lol. but my CRS is acting up so thats why I am asking,lol.
 
I am feeling much much better thank goodness. I kept my little wild man yesterday for a few hours. Boy, did he ever wear me out.
 
Scarred, what do you mean comp says once the stim is inplated they pay no more medical on you including medication. I think your atty needs to request a copy of their ins policy to see that in writing. Thats BS. How can they legally authorize the stim and then say after surgery they are not legally resonsible for any further medical? I must have read your post wrong. I mean of course you will have further medical expenses.
 
Susie 


Scarred_for_life
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   Posted 3/5/2009 8:57 PM (GMT -7)   
That's what I thought susie. I was told my doc that all patients are required to go through the eval. I mean susie that as far as they are concerned and this is what I was told that "Once the SCS is implanted......its End Game. We will pay no more for any medical." Funny that she would say that though and I have talked to others that have dealt with Wyoming WC and they find the same problems when the SCS or pain pump are implanted. WC cuts you off completely!
What doesn't kill us only makes us fight back harder! :P


straydog
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   Posted 3/5/2009 9:11 PM (GMT -7)   
Then it needs to be in their ins policy and worded to that effect. I would sue them and force them by Request For Production to furnish a copy of their ins policy. This is very doable too Scarred getting them to produce the ins policy. I am not satisfied that a company would write such a policy. Or is this one of their unwritten rules that no one has ever taken them to mat over???Hugs, Susie


Tirzah
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   Posted 3/5/2009 10:39 PM (GMT -7)   
Scarred,
Susie makes a good point that if your attorney hasn't already reviewed the policy language that he should do so before you have the implant. Nonetheless, in some states that is the case & if it is in the policy there isn't much to be done to contest it. You could possibly sue your former employer for the costs of continuing care, but it really is a tough deal. Since it usually costs upwards of $40K to get this thing implanted & then another $5K or so every ten years when you need the battery replaced, the insurance people get sneaky about writing in what they will or will not include for payment of your case beyond that. It's unlikely it just outright states that continuing care after an SCS is not covered. It could be above your maximum lifetime payout or, more likely, that the contract language does not include coverage for SCS implants & therefore the insurance companies can say that if they are going to cover it that you must agree to new terms & conditions (e.g., that you will not receive any further payments from them on this claim). In some state, they are allowed to do that if the original contract does not cover the costs of SCS implant.

The law is incredibly complex and while it is important to be involved in your case & follow up on every opportunity, do understand that there are many scenarios where the insurance company would not need to pay. If they won't cover continuing care, it is important to come up with a plan to get your meds covered before you get the implant. Recovery is quite painful & you will definitely need something in the short term to be sure, if not for the rest of your life. I don't know how much your medication normally runs, but just do a comparison of which way would be better for you -- staying on meds, or getting the implant. Also, in many cases if you have had continual health insurance coverage for your condition for the previous 12 months, a new health insurance company is required to cover you for that condition. Maybe that would be worth looking in to. Can your husband's insurance cover you? Do you qualify for any other type of health insurance that you could get? Maybe you could contact your state's department of insurance to see what options you might have going forward. Obviously, the best option would be if you can keep getting your care covered by WY Worker's Comp, but if that isn't possible, just wanted to encourage you that there likely are other options out there & you just need to look for them. :)


Susie,
It may have been just another hoop for you to jump through, but there are others like Scarred & me who have endured all kinds of nightmares trying to prove we're not dangerous killers as a result of a test supposedly administered to determine whether or not we should have an SCS implant. I'm glad you didn't ever have any issues with the test, but there are plenty of other people out there who have had traumatic childhoods, abusive marriages or crimes committed against us & while I believe that the MMPI is not even normed properly for diagnosing healthy people in general, from what I've seen it is especially skewed against people who've come out of those situations.

This test is becoming more & more common every year. My NS is now mandating any patients of his in on-going litigation take the MMPI before he will agree to do surgery -- even if the defendant doesn't require it. If a surgeon feels a patient is malingering, it is certainly within his rights to refer that patient for counseling. What I don't feel is right is giving them a test normed entirely against people in psych hospitals. What few studies that have been done have shown that there are plenty of reasonably well-adjusted individuals in mainstream society both with and without chronic pain who would "fail" the MMPI (i.e., be diagnosed with one or more mental disorders which could be used to deny coverage of a medical procedure). Until it is both normed for mainstream individuals & studied for efficacy in determining who makes a good candidate for SCS surgery, I will continue to raise every objection to its administration.

I don't protest the hoops we go through too much. I can't see how most of them can be misused. Yes, there are some U/A tests that are inadequate to give accurate results & I'm not okay with that, but short of that I understand the hoops. They at least give accurate information. They are not open to interpretation. The MMPI is being treated as if it is a medical test with a positive or negative result. In reality, two people can give the exact same answers on the test, have the exact same administrator, and be given two entirely different interpretations. For example, my psychologist explained that the same answers I gave which resulted in me being labeled a "sociopath" had I not had a background of being brutally beaten as a child, would have gotten me labeled "unusually honest & deeply religious". What the heck?! I don't get how that even makes the slightest bit of sense.

In fact, the only way to make any sense of it is to realize that the way those labels were developed was by interviewing thousands upon thousands of people locked up in psych wards & prisons about their histories. Then they made some changes after years of post-grad psych students taking the test themselves as practice. Certain changes were made as a result, but last I checked post-grad psych students were not reflective of society as a whole. So it ends up that the rest of society is measured by whether they are closer to a post-grad psych student, or closer to a psych patient/prison inmate. Sadly, since very few psych students endured abuse vs. a decent percentage of the patients/inmates, I ended up more closely matching the profile for an inmate. And it seems something similar may have happened to Scarred. Well, I'm sorry, but I think that sucks. And I stand behind my statement -- this is not just another hoop; it is a misuse of a test that can easily enough result in keeping people from getting needed medical treatments.

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 3/6/2009 12:11 AM (GMT -7)   
Frances,
My eyes are bleary right now but from what I can read what you've said is very well put. And accurate. It's one of the reasons I was involved decades ago in protesting its use with abuse victiims. There an additional problem which may in some ways be even more serious; much of this data can end up in the hands of untrained people, in various storage systems, and well, we already know about insurances and legal processes. It can be abstracted and inappropriately used against people unless someone has a good lawyer and psychologist to interpret results through a different light. Your NS should consider an alternative approach; finding the therapists in the community with the right expertise, and asking them to evaluate for the relevant criteria via a series of 3-6 interviews. If the professional believes the MMPI is indicated, that could be done at that time.

I'm tired so I'd better not try to talk intelligently right now!!

PaLady

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13481
   Posted 3/6/2009 9:03 AM (GMT -7)   
Frances,
 
I read you post and I agree with everything you said on the MMPI. I truly did not understand how some of those questions would relate as to whether I had normal thoughts on what the pump would do for my pain. I can understand testing a person like the pain part of the test I took. That in itself should have taken care of any issues on whether or not I would be a good candidate.
 
This is something that really needs to be improvised and revamped terribly as far as I am concerned. I had a horribly rotten childhood, very dysfunctional family, but what in the hell would that have to do with my pain? Back then there was no word such as dysfunctional,lol.
 
There are other tests that can be done to rule out malingering, oh, I hate that word. Or if there is a monetary motivation point. I know this for a fact because we had back in the 80's a big pain clinic type program that hit town. It was ran by a group of physical medicine drs that came out of the woodwork along with their inhouse psychiatrist. It was so biased and was pathetic. Alot of people with worker's comp claims were sent there for an eval. of course the drs always wrote malingering and in it for money. They even asked on their questionaire of the person had a lawyer. What difference would that make. They had an inpatient program and an out patient program. It was nothing more than a ins racket and scam. They eventually left town.
 
There is no cap on medical benefits paid dollar wise on comp claims. Thats just applies to health insurance. Let me say if it is state workers comp. Now some employers elect to buy an Occupational Accident policy which is not regular worker's comp ins. Those have all sorts of clauses.
 
Scarred's atty needs to see a copy of the comp's ins policy for sure. In some instances even tho its work related, if you are covered under a health ins plan, they will sometimes kick in and pay what comp refuses.
 
Susie

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