Just not sure where to turn......

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Just not sure where to turn......

Postby Taz480 » July 2nd, 2009, 10:38 am

PLEASE, PLEASE FORGIVE ME IF THIS IS A LITTLE LONG. I DONT KNOW HOW TO ASK FOR HELP WITHOUT AT LEAST EXPLAINING MY SITUATION.

I was injured on job on June 24, 2008. I have an annular tear in my disc at L4-L5, AND a bulging disc(same disc). My doctor told me it would heal in 6-12 months. It is now July, 2009 and a recent MRI has proven that no change has taken place. Originally, I was diagnosed with simple lumbar strain, you know, wait it out a couple weeks, here's some low grade percocet, it'll go away. After 3 weeks I told my doctor it's not going away and his crap percocet doesn't help. That prompted the first MRI which revealed the truth. I had already been on light duty for a month which made my boss "thrilled"(he's a jerk, anyway. backstabber, manipulator, etc.) After those MRI results, I finally got some good pain meds and was put on light duty for 6 months. Well I'm sure you can imagine how "happy" my boss was now. I was a machine operator and there was 1 machine that was perfect for me with very little accommodation. Unfortunately, economy hit our little company hard and like a lot of places, when cut backs happen, guess who goes first. Yep, the light duty people. So here I am, light duty, no lift more than 20 pounds, no bending, crouching or stooping. My restrictions technically prevent me from tying my own shoes. Who the hell is going to hire me? Do I put that on the application? Besides a very deep and long depression, enormous stress and horrifying financial problems due to the cut in income, I have battled those questions for 8 months, now. I feel like I'm sneaking around. I have had my unemployment the whole time and only feel like I'm eligible because I only look for work in jobs that are not hard labor which I have no experience in. Every week I read the claim question, "Are you physically and mentally able to perform the work you sought last week?" and answer YES because the type of work I seek are positions that I normally wouldn't seek and I pass by the positions that involve lifting and stuff. I mean the economy is bad enough and my situation just cuts that even more in half. At the same time, I never could get wages from SAIF because technically I was still able to work and never went without work at least two weeks as required by SAIF. I live in Oregon and I just am not sure what to do or where to turn. We have things like Injured Worker's Alliance and Ombudsmon for injured workers but it's all miles and miles of reading and documents. If I even had the attention span, I would still never know where to start. Just curious what my options are in simpler terms. Thanx!!
Taz480
 
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Joined: July 2nd, 2009, 9:56 am

Re: Just not sure where to turn......

Postby yourbestfriend » August 21st, 2009, 8:19 pm

Taz480 wrote:PLEASE, PLEASE FORGIVE ME IF THIS IS A LITTLE LONG. I DONT KNOW HOW TO ASK FOR HELP WITHOUT AT LEAST EXPLAINING MY SITUATION.

I was injured on job on June 24, 2008. I have an annular tear in my disc at L4-L5, AND a bulging disc(same disc). My doctor told me it would heal in 6-12 months. It is now July, 2009 and a recent MRI has proven that no change has taken place. Originally, I was diagnosed with simple lumbar strain, you know, wait it out a couple weeks, here's some low grade percocet, it'll go away. After 3 weeks I told my doctor it's not going away and his crap percocet doesn't help. That prompted the first MRI which revealed the truth. I had already been on light duty for a month which made my boss "thrilled"(he's a jerk, anyway. backstabber, manipulator, etc.) After those MRI results, I finally got some good pain meds and was put on light duty for 6 months. Well I'm sure you can imagine how "happy" my boss was now. I was a machine operator and there was 1 machine that was perfect for me with very little accommodation. Unfortunately, economy hit our little company hard and like a lot of places, when cut backs happen, guess who goes first. Yep, the light duty people. So here I am, light duty, no lift more than 20 pounds, no bending, crouching or stooping. My restrictions technically prevent me from tying my own shoes. Who the hell is going to hire me? Do I put that on the application? Besides a very deep and long depression, enormous stress and horrifying financial problems due to the cut in income, I have battled those questions for 8 months, now. I feel like I'm sneaking around. I have had my unemployment the whole time and only feel like I'm eligible because I only look for work in jobs that are not hard labor which I have no experience in. Every week I read the claim question, "Are you physically and mentally able to perform the work you sought last week?" and answer YES because the type of work I seek are positions that I normally wouldn't seek and I pass by the positions that involve lifting and stuff. I mean the economy is bad enough and my situation just cuts that even more in half. At the same time, I never could get wages from SAIF because technically I was still able to work and never went without work at least two weeks as required by SAIF. I live in Oregon and I just am not sure what to do or where to turn. We have things like Injured Worker's Alliance and Ombudsmon for injured workers but it's all miles and miles of reading and documents. If I even had the attention span, I would still never know where to start. Just curious what my options are in simpler terms. Thanx!!


I hear your pain, but need a few details. Is your claim still open? I don't understand why you were laid off and not receiving time loss. Workers' comp does not require you to be disabled for 2 weeks before you receive benefits.
yourbestfriend
 
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Postby Taz480 » May 3rd, 2010, 1:12 pm

***Sorry this is so long. I didn't realize it was so long as I typed.

Oh my gosh, I can't believe I found this. I completely forgot I posted this. I was just here looking for answers on the same claim like I was when I posted before and stumbled onto it. Please forgive me, I forgot all about it. I had alot going on at that time.

Well a lot has happened since then and now I am again in sort of the same situation I explained in the latter half of the first post. Shortly after I posted that, SAIF wanted me to go to some clinic in Portland for a month, PRA, Progressive Rehab Associates. When I explained to my claims adjuster that I needed to be home to seek employment to still qualify for unemployment benefits she informed me that SAIF would pay me Time Loss. When I asked why they weren't paying me Time Loss back in October of 2008, after a short pause and a long "Uuuhhhh....", she replied that they should have been and apparently I just fell through "the cracks". Great!!

So as of the beginning of August, "09 until recently, I was receiving Time Loss benefits pretty close to what my unemployment was in dollars.

Now they have denied my claim and I get nothing, no more Time Loss, no permanent partial disability, nothing. Some months ago, I remember getting a letter from SAIF amending the acceptance of my claim from the original lumbar strain to the torn and bulging disc. It also mentioned something to the effect of me also having some sort of disc degeneration which I assumed was because of the disc being injured. I learned recently and was unaware at the time that that was SAIF covering their butt. One of the IME's they sent me to decided that the disc degeneration or degenerative disc disease was pre-existing and that I am now medically stationary. I know that the only doctor who is allowed to determine if I'm medically stationary is my own physician but apparently the IME sent that report to my primary doctor and I don't know if he just skimmed through it, missed part of it or really does agree but he concurred and that qualified the same as my doctor deciding that I am medically stationary. And since he concurred with the IME who said that the disc degeneration was pre-existing, SAIF denied my claim after almost 2 years because the job related portion of my injury is no longer the major contributing cause of my "PROBLEM".

As far as I know, there was NO pre-existing anything. I have an attorney now but he seems skeptical but is going to try to get me something. He said I should have come to him months ago but everyone I spoke to said don't bother getting an attorney until I have a Notice of Closure because most of them will tell me to just come back once I do.

I don't care about the system. I don't care about large sums of money. I don't want a free ride or hand out from anybody. All I care about is the immense pain I live with 24 hours a day, paying my bills and debts, providing for my family and not losing the roof over our heads we recently acquired. We were homeless for about 9 months including when I posted the first post last year. I really thought what would happen in my case was..... doctor would find me medically stationary, claim closes, decent disability award, find me eligible for retraining, finally get some sort of degree in computers like I've been wanting for a few years anyway to get a good career in a field that is never going to go away and also would not bother my back, and get on with my life. I've worked on computers for 9 years, all self taught, no degrees.

Now, because they denied my claim, all that is out the window. So now I am back to where I was a year ago. My Time Loss stopped a couple weeks ago and i am on what's left of my unemployment on the first tier of the EUC. And thanks to the good old legislature boys, as of April(now May), I am not allowed to advance to any other tiers of the EUC extended unemployment insurance benefits. Great, huh?!

I have about 6 or 7 more weeks of payments and that's it! So on the days i don't wake up totally depressed, I'm scrambling to find a job and in basically the same situation I was in in the first post except no more unemployment. I don't know what to do. We spent 9 months homeless. We just got this 2 bedroom apartment. we are struggling just to pay the rent and electric. Besides that, there's still the car payment, insurance and other bills. My wife isn't supposed to and really can't work. She has a worse back than mine and is in the middle of battling Social Security for SSI and SSD. The economy is a little better than it was a year ago but not out of the woods yet. Whatever few jobs are out there, only a smal few I could actually do and almost all am not qualified for. Almost every job U see requires some sort of lifting and/or twisting. Even washing dishes requires certain repetitive lifting that is against my work restrictions. Most certainly anything I may find will be minimum wage and even if it's 40 hours, it will only pay me almost to the dollar the same as my unemployment and time Loss benefits I was getting which is still not enough. I'll take whatever I can get but who's going to hire me? I am already injured, already on light duty and already a liability to employers. As i said, there isn't much out there to begin with. Whatever jobs are out there, only a few I can pick from and out of that few, no one's going to want to hire me. In 7 weeks, ALL income is GONE!!!!

I wake up every day hoping like hell the pain isn't so bad that I can't get out of bed. If I DO make it out of bed and I'm not depressed, I still go look at jobs and there's next to nothing out there and almost all of them I can't do because of my back. I don't know what to do. There has to be more benefits i should be getting. My attorney is appealing the denial AND the claim closure but even he wasn't sure how well we'll do. He feels it might be best if we just try to get a settlement which will be substantially lower than if things had gone the other way. And even if we do settle, all the extended medical coverage, awards, retraining, aggravation rights.....all gone!!

Again, sorry so long. I didn't realize it was getting so long as i typed but there's not much i don't want left in. thank you for reading.
Taz480
 
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Joined: July 2nd, 2009, 9:56 am

Postby Webmaster » May 3rd, 2010, 2:11 pm

We hope things work out for you. In case you're not clear "medically stationary" means that more time or treatment isn’t likely to help you get better. It's pathetic that an insurer is allowed to throw a worker under the bus when other types of insurance must treat a person, even if it's for the rest of their lives.

I hope you've read our "Critical advice for injured workers" linked from the home page. Stay in contact with your attorney regularly and don't talk to SAIF. They're not supposed to contact people with attorneys but routinely do.

I'm especially disgusted about workers' comp. today. The Statesman Journal wrote yesterday:

"On Monday, Gov. Ted Kulongoski will lead a ceremony in the Capitol galleria to commemorate the 20th anniversary of a revamping of Oregon's workers' compensation law."

Kulongoski led those changes while insurance commissioner for his good buddy, then-Governor Neil Goldschmidt. Kulongoski is now celebrating their efforts that have damaged or completely destroyed the lives of many tens of thousands of Oregonians and their families.

Between 1998 and 2003, Goldschmidt was paid about $1 million by SAIF for lobbying. Since it doesn't appear he did a whole lot, it appears to be a reward for when he was governor. So who will be next on the gravy train?

Try to keep your spirits up although I know from first hand experience it's difficult where WC is concerned.
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Postby Taz480 » May 3rd, 2010, 3:14 pm

Ya, Im aware of definition of medically stationary. Thats basically where I am. I knew it would come and I don't care, I just want what's rightfully mine. Im not asking for anyone to hold my hand or set me up for life. I just want to go back to work nd pay my bills, ya know? I'd even go back to my old employer at time of injury if they had a position that paid the same and didn't hurrt my back. Although, they're about gone under anyway. Talked to an old co-worker a couple weeks ago. They're down to almost no employees and running about 1/10 capacity compared to when I worked there and when I worked there we were already on a skeleton crew, lay offs, etc.

I had planned to go to Pioneer Pacific College anyway and was gonna pay for it myself with financial aid and was even willing to work part time while going to school but it's very difficult and also that was when my wife could work full time. I just want the disability award which I wasn't even going to view as an award, I was going to split it up and use it as income while waiting on them to find me eligible for retraining. I just wanted that and the Time Loss while going to school. once I get/got my Associates Degree or some sort of degree, and able to make $70K-$130K a year, SAIF can kiss my you know what and I'll go on with my life.

EVEN if I had to pay for my own schooling AND had to work a part time job during, I just want some money to pay the bills until that's all set up and I want my medical still paid for and my aggravation rights. There's a good possibility that part of my back "PROBLEMS" really are pre-existing and if that IS the case I certainly would not expect SAIF to be held responsible. But I don't believe any of my "PROBLEM" is or was pre-existing. And besides, regardless of who is responsible, there should be some help somewhere for someone who can no longer work in the fields they have experience in as long as they are willing to learn something new and better themselves and their education to compensate for their situation........you'd think!

So.....I guess unless my attorney can get something done, all I have are two options. Either find a field I can do with my back or the schooling needed to achieve that OR if I simply CANNOT work anymore, go after Social security for 3-6 years like my wife has been going through. I still feel I deserve some sort of compensation for the loss of functionality and 24/7 pain and loss of quality of life. I don't do ANYTHING the same anymore.

I will remember to report back this time when I hear something.
Taz480
 
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Joined: July 2nd, 2009, 9:56 am


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