Workers Comp Help
Torn ACL and meniscus from job injury
My knee was dislocated while working under a conveyor on a wood chipper, resulting in a torn ACL and miniscus late in June '99. The supervisor wasn't present til after the injury, and was drunk when he finally did show up. Two co-workers were helping me stand, he arrived and asked if I could walk. I said I didn't know but I would try and he left the site immediately, saying to get back to work. He never reported the job injury. This was just before the 4th of July holiday weekend, and in spite of doing what I could to ice, elevate and take med's for the pain and swelling at home, it didn't get better, so I called to let the supervisor know I couldn't return to work that Monday.
First dr. I saw (on my own) was no help, and I still didn't get any better, so I went to the company and filed the W/C injury report. At that point I didn't know how severe the injury was, I just knew I was in a lot of pain, it wasn't getting better and I needed to see a doctor. The secretary made another appointment for me with a doctor of their choice, whom I saw three times, and was then referred to an orthopedic surgeon for evaluation. It took 2 months to get the surgery scheduled. Meanwhile, the W/C carrier controverted the claim because the drunk supervisor covered his butt for not filling out the injury report within 72 hours by saying I didn't get injured on the job! My co-workers sent statements of what had actually happened, so the insurance company eventually allowed the claim, but said I was a "part-time" employee at 72 hrs. minimum a week...! They have been just about that "reasonable" ever since...
It took several months to get TTD benefits, and then they based it on a "similarly employed" person's hours, who actually worked about 1/2 of the hours per week that I put in, and who, sadly, has since passed away from cancer. Also, the company I worked for when injured went bankrupt a few months after I was hurt. To encapsulate... I had the ACL reconstruction surgery, miniscus repair and debridement, did physical rehab at home and was making normal progress when the insurance company decided it wasn't fast enough and sent me to physical therapy against my surgeon's advice. They made me do weights - totally against my doctor's protocol - and threatened to cut off my TTD benefits if I didn't "cooperate" in P/T. They continued forcing the weights on me even after being contacted twice by my surgeon's office saying it was too soon for weights due to the extensive miniscus repair.
When I protested, I was told that my surgeon's methods "weren't 'scientific', and they knew what they were doing"... From that time on, I've been unable to straighten my leg or bend it as far as I had progressed to on my own at home up to that point, let alone all the way. I had severe swelling and a lot of pain, so I was put on Celebrex (PLEASE, EVERYONE STAY AWAY FROM THAT DRUG!!!) My heart freaked out, pounding wildly and I almost passed out in pool therapy and on other occasions, so I was taken off it, but I have had ongoing palpitations and pressure in my chest ever since. Subsequently, I was rushed to the ER, paramedics thinking I was having a heart attack.
And still no progress with my knee. It's been 21 months of pain, physical limitation, frustration, stress and financial hardship. I believe the insurance company pressured my doctor into doing a stability rating and disability rating last September, and of course they cut off all benefits at that time.
Because I had filled in as a bartender on a few occasions to help out family friends in a bind who owned the business, while still working full-time during the days, for a total of about a month over the previous 5 years, I was denied retraining benefits because "there are bartending jobs available about 250 miles from my home". They think it's realistic to commute almost 500 miles a day for a $7.00 per hour job... This statute needs to be modified to reflect the actual logistics of a state the size of Alaska. To commute within your home state in Rhode Island is certainly not the same as up here...!
Prior to the hearing to appeal the retraining benefit denial, I was so frustrated I finally retained an attorney. We lost the appeal, but I saw my surgeon and asked if there was anything he could do to get my leg working well enough to go back to my work as a heavy equipment operator, since I wasn't able to do the heavy physical demands of my previous work the way I am now and I'd been denied training for any sort of lighter duty employment. How could they just dump me like this with no way to support my family and myself?? The surgeon examined me and said he felt the miniscus repair had failed due to the weights I had been made to do in P/T, and scheduled another operation to remove scar tissue and take out the damaged cartilage which had resulted.
The insurance company now refuses to authorize the operation! My attorney says I could go ahead and have the surgery and we'll litigate, but if we lost I'd be liable for the cost. Alaska National Insurance has done anything they could to starve me out by cutting my TTD benefits 7 months ago, withholding or denying reimbursements I had coming for mileage expenses, per diem, medication, etc., and by postponing hearings repeatedly just to drag things out. Meanwhile, my savings have dwindled...
But I am determined, I am right and I will ride this out to the end. I know there must be a special place in hell for insurance adjustors like the one I am dealing with! I just want - and need - to get back to work and get my life back! This has dragged out for so long... It's bad enough to be injured doing an honest day's work, but the added strain - physically, emotionally and financially - that the insurance carrier has unnecessarily piled on is outrageous and without conscience in my opinion. There should be some prevention or at least consequence for this economic brutality.
Hang in there! Maybe I am naive, but somehow I still believe things will work out in the end. Faith, patience and tenacity...
**P.S. Just since writing this, I finally received authorization for the surgery... A start...