Workers Comp Help
The Cancer Screener's Story - Ruptured cervical disks and double carpal tunnel-tendonitis
The Cancer Screener's Story
My name is Joyce. I have been a Cytotechnologist (a screener of Pap smears, looking for cancer and pre-cancerous cells) from 1977 to 1996. I worked for the federal government between 1981 and 1996. Beginning in 1994 I developed some severe neck pains as a result of hanging my head over the microscope in a static posture for eight hours per day. I also developed pains in my wrists and hands but did not make too much of that because the pains in my neck were much more severe. In March of 1995, I finally went to my doctor who identified my problem as "muscle strain", even though a standard X-ray demonstrated osteophytosis, spondylosis, cervical stenosis and significantly narrowed cervical disc spaces. He did not perform an MRI, I think, because he was skimping on services.
He sent me to a worker's comp doctor, who diagnosed the above-mentioned findings as well as carpal tunnel-tendonitis; and, following a cervical MRI, (done eight months after the initial x-ray) he also diagnosed two ruptured disks with mild spinal cord compression and possible nerve root entrapment. With this final diagnosis, he took me off work. I was placed on "conservative" treatment and was told that surgery was not necessary and that many ruptured disks would heal on their own.
The federal government, meanwhile, chose to accept only the diagnosis of "muscle strain" and refused to admit the more serious conditions discussed above as elements of my claim (even though they tacitly acknowledged them by paying for their treatment). This is where the nurse-case manager entered the picture. Her sole goal was to get me back to work with or without my doctor's approval.
If I may digress at this point for a moment, I would like to mention that throughout this process I felt juvenilized, treated as a malingerer, accused of having bad work attitudes, and forced to undergo an unwanted psychiatric evaluation. I was also placed under increased pressure to meet productivity goals at work; and I felt that I could not take physician-ordered breaks and necessary time off for physical therapy. I might add that the persons who are the most conscientious and stick to their work task the most in this profession are the most likely to accrue these types of injuries. Enough digression -let us return to this nurse case manager!
This nurse-case manager scheduled me for a functional capacity evaluation over the head of my doctor who told her I was not yet ready for this test. She presented me to the examiner with a diagnosis of "trapezius muscle strain". When I told the examiner that I had two ruptured disks, he was quite surprised and did not believe me until I handed him a copy of my lab report. I then asked, "Who presented me for this test with the diagnosis of muscle strain?" The nurse case manager did, and he automatically assumed she was correct.
Although my evaluator strongly recommended against returning to my former job (after my valid test) and my workers' comp doctor concurred, this nurse case manager ordered me straight back to my former job on a trial basis. Of course, she indicated that it would not likely succeed because of my "negative attitudes"! It did not succeed because of my neck pains and my pains with hand and arm movements. My case was a bit unusual because I worked under the direct supervision of doctors who could identify my obvious problems: they recommended that the experiment be discontinued and that I be sent for rehabilitation.
My rehabilitation effort consisted of going to college and earning a Master of Arts in Counseling Psychotherapy degree which I began at the age of 52 and graduated from at the age of 54. I used the software program, Dragon Dictate (I am now using Dragon Naturally Speaking) during my school time because I could not type due to my carpal tunnel-tendonitis. This does sound like a tremendous opportunity, and I worked very hard in spite of being in severe pain. I achieved academic success but experienced difficulty finding internship opportunities due to my stiff posture and activity limitations. When I requested extra time to complete the program because the pain was overwhelming me, I was denied and told I must finish the within the two year time limitation.
Graduation, however, marked the beginning of my real problems. It is a well known fact in most states including Colorado that a counseling graduate must work for a minimum of two years under a licensed counselor (often as a volunteer paying for professional supervision) before obtaining a license of his/her own. I, however, was required to find full-time work, breaking into a super-saturated field at the age of 54 with obvious disabilities and a known history of having been a workers' comp claimant. In addition, I was unable to perform the physical aspects of jobs which were supposedly identified as "sedentary", including physical control, "take down" of unruly clients and other material management of their environment. The very stiffness of my posture and movements due to my inherent disability was also perceived as an obstacle to my being a desirable employee. I was, incidentally, forbidden by the federal government to seek any part-time work, which is often a means!
by which a new graduate breaks into this field. I was denied permission by several major employers to use Dragon Naturally Speaking as an accommodation for my disability in regard to typing. I now realize that this supposedly premium rehabilitation plan was a step-up for heartbreaking failure.
Undaunted by my inability to obtain a professional position, my government-assigned vocational counselor/job developer required me to apply for jobs such as nurse's aide, psychiatric aide, housekeeping aide and as asassisted living attendant, as well as for jobs as residential assistant to mentally retarded adults, and for jobs as day care attendant. I knew that these jobs were well outside my physical restrictions; however, I was required to apply for them regardless of working conditions or educational objectives. Of course, I was looked down on as being "not willing to accept that type of work" when I was merely commenting on its physical nature and my inability to perform it. I actually searched all over my locality and the nation as a whole well for suitable positions.
The end result was that this vocational counselor stated that he could not find suitable work for me: however he contradicted himself by saying that work was available. My workers' comp payments were severely reduced because of his statement that "work was available". This "available" work consisted of highly physical jobs which did not relate in any way to my educational objectives, and which both I and the potential employer knew I could not perform.
I have been emotionally devastated by this whole process, and have undergone severe stress. I had been highly motivated and excited by the opportunity to embark on a new career in the helping professions, and I had worked very hard to achieve my goals in spite of the presence of constant severe pain. I was given only half the time I needed to achieve this goal, and was then required to embark immediately upon a full-fledged career, despite significant obstacles to employment. My income has been essentially reduced to poverty level; and I am experiencing the natural progression of increasing disabilities caused by the conditions which I described above. I have been forced to sell my beautiful house and live in severely reduced circumstances. I need a "mobility scooter" with a van in which to carry it, but I cannot afford these things. There is no medical care available for me because my case has been closed. In my case, the workers comp system has achieved its goal of saving money while leaving me physically, financially and emotionally devastated. I can only hope that my story somehow promotes reform of our workers' comp laws.