WORKERS’ COMP HELL

It’s been going on for 4 years, 9 months, and 13 days.

As most of you know, it started with me intervening when a very drunk, out of control rugby player was throwing my girls around like ragdolls — into walls, down stairs, and I was afraid one was going over the bannister. I politely asked him to leave, and he didn’t like the idea.

The next morning, I called our national headquarters’ property management division and they told me to immediately get to a hospital and file a workers’ comp claim.

It took weeks for them to assign me to a doctor, but his first words to me were:  ” The good news is it’s our job to get you back to where you were before this happened.” If only I’d known.

In all that time, I haven’t had one day of physical therapy. I have had chiropractic treatment, which was a joke because they’d approve six treatments and I’d have to wait six weeks for another six to be approved. Oh, and three different approvals for accupuncture. The last was actually working…..but he’s in LA, and I’m not.

When I moved — San Francisco, LA, San Diego, LA, it could take up to five months to get new physicians approved.  So, with damaged back and legs, I was having to drive anywhere from three to 6 hours one way.

The good news was that I had been told that as soon as we got our AME’s (Approved Medical Examiners — someone both the insurance carrier and my attorney agreed upon) and they deemed me “permanent and stable,” we could solve the case. That was two years into the case when I went to dental (TMJ and broken teeth), psychological and physical AME’s. No settlement.

A year went by. Once again, AME’s with psychologal and physical. Both deemed me “permanent and stable” again. Again. We got a settlement hearing. Both their lawyer and my lawyer approved a settlement. But when they called the adjustor, she said they ” needed more information.” She did not say what additional information they needed.

The next year, same thing. “Permanent and stable.” No settlement.

Now, we’re waiting for Medicare’s approval for future medical. I was told 6 months. Then, I was told by my lawyer that he’d talked to “his guy,” and it was going to be mid-August.  It’s now mid-September. My lawyer called him again, and the news now is that they’re backed up and it will probably be February. Once we receive the future medical approval, we may have to appeal. If not, it will be two weeks of negotiation on our part, and two weeks of negotiation on their part and then, if we reach an agreement, I’ll get a settlement sometime in March or April. If not, more months to get a court date and start all over.

And how, prey tell, am I supposed to live until then?

All this for something that should have been ended at least 3 years ago.

I haven’t had any medical care since the end of May, and they’re jacking me over for my last expense account for mileage, etc. for April & May. It should have been here the end of July — now, they’re telling me mid-October.

They started disallowing one of my medications, Lidoderm patches, several months ago. “It’s too expensive.”

We haven’t even started the process of getting new doctors because I don’t know where I’ll be.

I just learned that it’s a black mark on an adjustor’s record if a claim is settled under their watch. WHAT? Are you freaking kidding me? No wonder everytime I come close to a settlement I get a new adjustor and have to start all over.

I understand there are people who abuse the system. I’m not one of them. But I’ve been trying to get out of this hell for the last 3 years. They’ve spent tens of thousands of dollars on care and AME visits (at about $5000 a pop) when all I want to do is get out. Out of the system. Out from under their thumb. Out from under being held prisoner because I can’t be too far from California. I want to have my physical care in my own hands — get some physical therapy, see a sports medicine doctor so I can hopefully start running again — maybe even swimming again. Because I’m damned sure I’m not going to get it under the care of Worker’s Comp.

Whoever invented this system should be shot — on the job — and have to go through the Worker’s Comp system.

But for now, I’m thinking of going to Sacramento, camping out on Governor Brown’s couch and sleeping in his parking lot at night, calling the press, and not leaving till I have a check in my hand.

And I’m being called a “moocher.” I don’t want to be. I want to work. I want the freedom to live my life as I want to. I should have been able to retire by now, but the times I’ve been unemployed between jobs, I’ve gone through my retirement and the proceeds from my house. And I’m being held hostage by California. I’m told “it’s hard” to find doctors out of state. Suck it up. Nothing we can do about it. And now, I have “pre-existing” conditions. I don’t know if going to my Medicare doctors for the things they’ve decided not to cover will hurt my case. Getting another physical AME will delay my settlement, but without medical care, I’m worse than I was a year ago.  With all due respect to the wonderful doctor who saw me that first day, it’s not their job to get me back to where I was before “the incident.” It’s their job to drag this out as long as they possibly can, and to hell with the individual involved.

So, I’ve been in a pissy mood all week. That’s why I’ve been so sucky with my blog. I promise to be better next week.

Until tomorrow, when I plan on being my perky, peppy self, take care of yourself. And for God’s sake, don’t get hurt on the job.