Thursday, July 15, 2010

Denied!!

I got a call last night from our HR department.  My SAIF claim had been denied.

Most people will be surprised to hear this.  I think it goes back to the doctor I saw at the Urgent Care.  For whatever reason, he doesn't like worker's comp claims.  I had to press him into letting me get an MRI, and then the ones he ordered didn't even use the dye to check for things like a tear in the rotator.  His wording was, "Well, that's expensive."  Why the heck should he care?  If worker's comp wasn't going to cover it, I still have good insurance - I was in pain!  This doctor was also pretty rough on my arm and kept telling me to "relax" even though I had no control over the stiffness in the shoulder.  I could NOT move it on my own.

Yes, it took me a while to file a worker's comp claim.  I fully believed my shoulder was bugging me because of muscle tightness brought on by stress.  I work in a stressful environment, and about this time we learned Lee would have his hours dropped to 20/week AND we found out Trevor had screwed up at college and was likely going to lose his financial aid - so yeah - I was stressed!

I tried 4 sessions over 4 weeks of acupuncture.  A little relief, but then I got worse.

Then I went to the chiropractor.  Again, a little relief, and then it got worse.  At the last visit, he really manipulated things around, and it was very painful.  At this point, he said he couldn't do anything more for me, as I probably had something wrong in the joint.

I had to think really hard to remember what I might have even done to injure my shoulder.  During my work day, I wasn't doing much physical activity, other than morning stretches & carrying stuff like my bag/purse and stuff like that.

At home, I really only ride the exercise bike, probably to the detriment of my arms, since I took the arm attachments off to be able to use the bike while I play World of Warcraft at my raised computer desk.

I finally realized I HAD hurt myself on a day at school when we were moving books & computer equipment back to the warehouse.  We knew we weren't going to get any other students, and we didn't need all the extra stuff.  We also knew we'd be changing locations and everything would have to be moved anyway, so why not get a jump start on that?

The actual injury occurred when we were lowering a heavy box into the back of my van.  The lifting technique was all good, it was the lowering & releasing when I felt a twingy-pop thing in my left shoulder.  I shrugged it off though, and I seemed to be okay.  Well, soon after that the tightness started, and just kept getting worse, no matter how much I babied my left arm.

So that's why I even went to the Urgent Care in the first place.  I should have gone straight to a physical therapist, but I think I needed to see the regular doctor first for worker's comp anyway.  Once I had the MRI's done & the doctor saw them, he told me there was nothing wrong with my arm.  I still don't get it.

He did prescribe me some meds, which I used while we were in Canada.  Once we got home, I got a referral to a physical therapist.

Flash forward to today.  Physical therapy is working.  The therapist thinks it's a tear which caused my shoulder to freeze up.  He thinks the chiropractic manipulation sped up the 'freezing' process, which he now thinks is already on the 'thawing' phase.  So I'm doing my exercises & I still intend to see the orthopedist next week.

On the claim - I know I can file an appeal.  I did find out, however, that I can still get sick leave, since I was contracted to work over the summer in the special needs room - where I can't work since it's not safe for the kids or for me to lift them.  I have a substitute in place, and I have lots of sick leave hours, so that's all good.

I have also gotten a couple of checks from SAIF before they denied my claim.  I just put them into my savings account, in case they might ask for them back.  I don't know - I've never dealt with worker's comp before.  I found out to appeal, I need to hire a lawyer.  It's supposed to be mostly covered, except the stuff like phone calls & travel expenses & such.

Now I'm wondering since I can use my sick time, and I've got insurance, if I should appeal after all.  If the medical costs come out to be about what I got in the checks from SAIF, it's a push anyway.  I have 60 days to file the appeal.

I'm going to wait until after I see the orthopedist before I make any decisions.  While my shoulder seems to be doing better with the physical therapy, I still want to be sure I'm expected to completely recover before dropping the worker's comp completely.

2 comments:

keeka said...

I am sorry to hear that. I just hope the injury isn't one that will continue to cause pain whenever you do anything unusual. My shoulder is doing ok but I am seeing my doc anyway due to the issue I had with you with my meds.
So since I am going anyway, I will ask. I mainly want to find out if I can go to the spa and get my massage! I don't want them to say, "well, let's find out what is doing this first". It has been better, but I was just traveling in the car for the last few days so... Anywhoo, hope you are better and good luck to Lee!

Lynda G. said...

I don't know you but I happened upon your blog through Blogger's NEXT BLOG button. So much of what you say here, I can relate to. I want you to know that although it is not commonly done, when I could not move my arm with a frozen shoulder, my doctor put a few shots of cortisone into the shoulder muscles. It was SO much better! It took a day or two and I could move it again and there's been NO problems since. It saved me painful physiotherapy (which I could have done after) and I was back to work right away. Something to consider. GOOD LUCK! :D