Any suggestions for this worker's comp situation?

I suffered an injury due to a fall at work approximately 2 years ago. I was attempting to sit down in a chair, it was a high chair with wheels and a ring on the bottom to put your feet on. Anyway, my left foot got tangled in the ring and the chair pushed away from me causing me to do a split and I fell. (I don't know if this makes any difference, but the chairs were inappropriate for use on noncarpeted floors and other people had fallen using them.)

The diagnosis at the time was a hamstring sprain. I missed several days of work. The time off and the medical bills were paid by worker's comp. The leg never felt right after that. I had been treated by the doctor at employee health where I worknad have been to see them many many times since. I really thought that the hamstring just needed a long time to heel. About a year ago, I went back to the doctor at employee health complaining that my leg still didn't feel right and that I still had pain. So for the last 10 months or so, I have been going back and forth to an orthopedist, cortisol injection, employee health, 2 MRIs etc. The diagnosis is a torn meniscus that will require surgery. I am 100% convinced that the injury resulted from the fall because my walk has been affected and this was apparent to me from the time I started walking without crutches. I did not have problems before and I am tired of hobbling around like a gimp. After seeking a second opinion, I have scheduled surgery for Oct 23. So today I get a call from the woman handling my case at workers comp. She says they want me to see an "independent" doctor to evaluate whether my injury is a result of the fall...and oh, they made an appointment for me on Nov 3, so my surgery will have to be rescheduled. Now I have already seen 2 orthopedists plus the doctor in employee health, so that's 3 doctors who have all said that my injury is consistent with the fall that I had but for some reason, their "independent" doctor's opinion will supercede these other doctors.

I know it has been a long time, but it's not my fault the crappy *** doctor in employee health missed that I had another injury besides the hamstring tear.

I guess my question is, what are my rights? I'm not surprised that worker's comp is giving me a hard time, but I am not happy about rescheduling the surgery. I have health insurance, but there is a $500 deductible and copays for prescriptions, physical therapy etc, that I'm sure will add up. Also, I do not get a lot of paid time off and I do not want to use it here. Can I have the surgery anyway then if they refuse the claim, deal with the hassle afterwards? I have MRIs, x-rays, doctors reports for 2 stinking years, isn't that enough? If I notified my health insurance that the injury is work related, won't they want to fight it out with worker's comp? Any suggestiosn would be greatly appreciated. Thanks.Any suggestions for this worker's comp situation?
I agree w/ Dr Les. You need to get a workers comp attorney asap. My husband has been going through the same thing for nearly 5 years with foot problems related to a work injury. Luckily, he knew some other people from his job that had had w/c claims. When they tried to assign him their chosen dr, we already knew this was the guy that they send people to when they want to get rid of the claim. We got an attorney %26amp; he already knew about this dr. He filed a motion with the board of workers comp %26amp; they agreed that there was no reason he should have to go to another dr when he had been receiving appropriate treatment all along. Be sure that your current doctors can document everything that has taken place, and that they agree that your current problem is related to the initial injury. Their statements will go a long way. It seems like everything you do is never enough. You really need the influence of a good attorney that knows the ins %26amp; outs of the law before the insurance company takes advantage of you.



Good luck!Any suggestions for this worker's comp situation?
A co-worker is having the same problem from a 3 year old injury. Her doctor said surgery and WC said no. So instead of my friend getting an attorney, she took the time off under FMLA and had her health insurance pay the bill which now WC is no longer involved. She will be out of work for 8 weeks on her own time. Hang in there and see their doctor or get an attorney. I had to see a WC doctor who agreed with my doctor's finding which worked out well. Best of luck.

P.S. Be ready to tell the WC doctor your whole story from the time of the injury along with dates, pains, medicine taken, and how the injury still effects your life in general.Any suggestions for this worker's comp situation?
Your failure to let the injuries get examined by the workers comp doctor, before surgery, will pretty much guarantee that they're off the hook for everything.



Most likely the health insurance company also doesn't have to pay for a work related injury (it's written into the policy that way, in most states).



Going ahead with the surgery could mean YOU foot the entire bill for this. Why don't you call the adjuster, and ask if you can have the appointment moved up to sometime this week or next, so you can keep the same surgery date.



You have to play the game. Sorry.



But my big question - and maybe theirs, too (although I'm not a doc) is twofold:



1. After going for most of a year without treatment, how do they know that the tear was actually caused by the original fall, and not a subsequent fall?



2. Can you GO for almost a year without treatment for a torn meniscus? I'm going to guess, that if it really is two years old, you're going to see some serious healing showing up on the MRIs, even if it's scar tissue. You can TELL the difference between an older injury and a newer one, on the MRI. I'd strongly suspect you did something to aggrevate it - which workers comp would not necessarily be on the hook for.
You need to talk with a lawyer who specializes in comp cases. He will send you to his doctor and you will go from there. You should have done that when the accident first occurred. I hope it is not too late.

Best of luck