I HATE self insured worker's comp

Pro1driver, thanks I will tell you what I drove and how I was hurt. I deliver "new truck's" piggy back (drive away). I was undecking a load of truck's in North Carolina during a pretty good storm it was very windy.
I was taking my lifting strap off of the front axel, by leaning over the front tire with the hood up. A big gust of wind slammed the hood shut striking me in the back of the head and neck.



I was put MMI July 7 for my original allowed claim: head contusion, and Cervical sprain.
The Dr then set me up an appointment for a FCE test

I will get the result's from this.......this week. Right now we are awaiting the results from my last IME exam. When we recieve it, if it say's the condition should not be allowed them my lawyer will file a motion for the condition to be allowed.
They tell me that a self insured company is suppose to be alot better. I don't know if I believe that or not while dealing with mine for the past 8 month's.:smt065
But I am sure I will prevail as I had a eye witness to what happened. He was standing right beside me when it happened.

 

Ok I thought I might update this thread... BTW I STILL HATE SELF INSURED WORKER'S COMP!

Well the results from my FCE report are that I am NOW on FULL BODY restriction's.........light duty status.

I finaly recieved my IME report from a STUPID DR from back in June.
Man what a QUACK! He said my injury was not work related, and that an infection (Tumor) in my ear I had removed caused my injury!

Now my employer's lawyer jumped on this right away, the same day the report came in he puts in for a hearing to terminate my Temporary Total Compensation.
We (my lawyer and myself) knew this would happen soon after I was put MMI by my DR for my ALLOWED claim of cervicle sprain.

Now my DR on May 8th put in a C-86 form to have Herniation added to my claim, but they have not excepted it yet.

Why does a company who pays W/C insurance want to fight a employee so much?
Why don't they just go ahead and fix ME! This is going to cost them thousands upon thousands of dollars only to end up paying for it anyway!

I have a file that is 4 inches thick that has come off the BWC website from my case. I also add to it with photo's of the truck and Activity Logs saying what I have not been able to do since my work injury.

How can a DR go home and sleep at night? After examining a person who has just about had his head ripped off by the hood of a BIG truck, and putting in his report that this is NOT how the injury occured and this SOB only saw me for about 10 minutes TOP!

It really p*sses me off that he is allowed to write a report of LIE'S and have it on FILE!

This IDIOT got all of this from NOT LOOKING at my MRI CD I took with me, he stated in his report that to view the CD special equipment was needed.................what special equipment you only need a computer to view it, I have looked at it several times.

I went thru his report and THANK GOD I took my wife with me the day of the exam, as we went thru the entire report and marked all the LIE'S he wrote and put what really happened.

We now have a hearing scheduled for the 14th actually in 3 days. My DR has responded to the IME report I recieved so now we have a defense against them terminating my Temporary Total Compensation. My company does not offer ANY light duty work.

I recieved a letter from my company's Lawyer's yesterday. They said they had recieved my FCE report from my DR and it stated I was MMI as of 07/07/2006.....as of this date they said they were NOT paying me anymore Compensation.
They state now I have a over payment of $1300.00+ and that they expect it to be paid back according to BWC guidlines.

This came about at the same time that my Lawyer requested for them to do a wage recalculation as he had found that they had shorted me $300.00+ per week since the last week of Feb.-06 they owe me alot of money. Their excuse was they had not recieved any information as to a request for wage recalculation requested in March by my lawyer.

So I guess we will see after the 14th were I stand as for either liking my company and referring driver's to them....or whether they end up in the bad section of this forum. Stay tuned! This almost is just like a soap opra.....:smt065

 

The bad thing is my company is Self Insured so my company says what is what....This has been going on now since Nov.29,2005 back in Dec-2005 I was released to return to work on light duty........My company has no light duty.
So I have sat on my ##* ever since...and will continue for a few more months I guess.
A thing about lawyers...no way I could have handled this with out one..He has done everything, and always has time to take my call. I even have his cell # so he has been great 9 months I have olny given him $475.00 so I don't think that is to bad.

 

Just another update:

I had a hearing on 09/14/06 and one week prior to this hearing my lawyer calls me and says we will lose this hearing for sure. Don't get upset about it, it is because the DHO (District Hearing Officer) is a idiot.
Well we did lose the hearing.
What ticks me off is, back on Feb.07 2006 I was seen by a IME (Independant Medical Examiner) Dr. his job was to see me for 10 minutes and see if I really needed a MRI or not. Of course he said no, just because that is what he is paid to do.
Well my company decided to go against this Dr's wishes and allow me to have the MRI.

Well 8 month's later at the hearing on 09/14/06 the company's lawyer produces ANOTHER updated report from this same IME Dr, which I have not seen in 8 months. Also he only spent 10 minutes with me period.
They (company lawyers) produce a 16 page updated IME report. The first report was 10 pages long.

Anyway after reading thru this BS the very last part states that there is nothing wrong with me and that I am able to return to work. WTF? I have not seen or talked to this idiot in over 8 months, he has no clue.

Well the DHO agreed and denied everything....

Well we filed an appeal, and will go in with both barrells loaded this next time which will be probably the end of this month.

One thing we did accomplish was a wage recalculation of my weekly temporary total compensation check.
After careful review my lawyer asked me what they were paying me per week. I said $304.42 per week.
He said that is wrong, they were suppose to be paying me $604.84 per week.
So the company was ordered to pay me over $5000.00 two weeks ago. They paid me from the last week in Feb. to July 7 2006.

Now when we get back to my hearing at the end of this month. They will have to pay me from July 7 to End of October $604.84 per week.

Just goes to show you how crooked company's try to be, and I swear I believe the ones that say they are self insured are more crooked than the others.

On a funny note: Have you seen the movie The SantaClause 2? The part of the movie where Tim Allen is very heavy set, but has no beard and his hair is tan color?
Well that is exactly what my company's lawyer looks like..

 

Sorry, no I am not any better yet. Still fighting with the company to make them except the new claim.
I sit all day and eat pain killers, and go to 2 different dr's every 2 weeks for ultra sound massage.
Surgery has been discussed, but we have to get the company to except the claim before this can be put into motion.

 

Thank you Keelady for those kind words I really appreciate it.

Thanks but I am doing ok (Knock on wood) just needed to vent a little. My first hearing I knew before hand that I would be losing it, my lawyer has delt with this DHO before. We do not have to deal with him again.

8 hearing's wow! Mine will only go 2 more times then it will end up in District Court if it goes that far.
Good luck with your case, I wish you the best outcome!