Workers Comp Help
Workplace Lumbosacral Injury
I'm at my wits' end.
It's been five years now since injury.
Now recently have had stroke(s) and need medication to be taken prior to scheduled surgery to prevent further stroke(s) now that after a long battle Argonaut finally conceded for me to have the surgery recommended 4 years ago -- and now further endangering my life by their refusal to accept responsibility for ensuing medical problems related to my frustration and stress, pain, et cetera.
An Orthopedic surgeon recommended surgery to correct L-5/S-1 condition based on MRI of '98.
Argonaut sent me for 2 second opinions -- their choice of doctors, of course -- who disagreed.
After years of sending me to physical therapy, doctor of physical medicine, doctor for pain management, the last two doctors both recommending I see a surgeon, Argonaut's refusal, I was caused to make my second trip to California -- first to a QME who acknowledged the back problem, but really lacked information and films previously done in order to assess my medical condition related to the back but did find me MMI with significant impairment (also addressed my knee injury which resulted in my back injury, the back injury having occurred during physical therapy while still in California at the time of the knee injury (which the orthopedic surgeon debrided and recommended a knee replacement but stated due to my age, 54 at the time -- I also mention previous orthopedic surgeon also recommended knee replacement -- but I elected to wait upon the advice of the orthopedic surgeon who recommended the back surgery because he stated that I would likely need more than one knee replacement and although he believed I needed it then and was willing to do the surgery, recommended that I wait a little longer if possible -- and my back condition all the while worsening.
I did receive some relief of pain with the knee condition, and my primary complaint at that time was my back pain -- my income was diminished to less than half the amount, causing me great financial distress and hardship -- Argonaut then ignoring the recommendations of new treating physician of their choice (not orthopedic) but doctor of physical medicine, who sent me for epidural injections and that doctor stated I needed to see a surgeon -- Argonaut looked the other way -- and the doctor of physical medicine who found me MMI since he couldn't help me -- recommended I see an orthopaedic surgeon and actually gave me a hand-written prescription to see a neurosurgeon -- again denied by Argonaut -- who then without my knowledge of the inferior qualifications, an "arrangement" between my attorney and the insurance company which has just now come to light, sent me
Then for the second time I caused to go to California and without explanation to me, it was arranged by my California attorney for me to be examined by an "Agreed Medical Evaluator" which I have just recently found out was arranged between my attorney and the insurance company -- and that report was not at all favorable -- but I relied upon my attorney's assurance that this doctor is "a great diagnostician" and that he had known him for 25 years -- still not knowing he was not an orthopedic surgeon -- I complained to my attorney about the inaccuracies in his report and opinion rendered in conflict with that of an orthopedic surgeon -- who of course is more imminently qualified to make such determination -- and this AME in addition offered "gratuitous remarks" which are prejudicial to my case.
After advising my attorney I had a friend in the legal profession direct me to some of the statutes and labor codes -- since I feel the "push" was on for settlement -- without any relief of my pain and stress -- contacted the insurance company and I was offered a greater amount of settlement offer -- but still no permission to see the neurosurgeon.
About a year later, Argonaut finally agreed to let me see the neurosurgeon who concurred with the orthopedic surgeon based on the '98 MRI regarding surgery. I also have a problem at L-4/L5 which has been vaguely addressed -- and there has been some mention of a multi-level fusion -- which I can't remember now which document addressed that -- but I believe in one of the letters from the attorney for Argonaut -- but, the records and films reflect what they reflect -- and I have been caused to suffer such pain, stress, anxiety, depression and frustration that while awaiting the results of a new MRI study which Argonaut refused, causing me to endure additional pain, stess, et cetera, by the time I saw the neurosurgeon who had the necessary studies and tests, I had a stroke and now cannot have the back surgery because of a newly discovered congenital heart problem which must be treated first, and although I am 57 years old and the condition had never manifested itself until my mo!
st sedentary point in my life -- having performed heavy duty work all my life as an electrician -- has now come to light in that I had a stroke just less than a month before my scheduled appointment with the neurosurgeon (who finally was granted the approval for the back surgery by Argonaut) but too late -- and now I have suffered another stroke just December 6th, 2002, sent to the emergency room at the direction of my new treating physician's office staff, in that my physician was out of town, however I was advised his partner was then at the hospital and would be notified I was coming there -- and after being evaluated by the ER doctor was hospitalized from December 6th to December 11th, 2002, and upon discharge from the hospital given a prescription for medication to prepare me for the heart surgery which is in the neighborhood of $6000.00 per month -- and which needless to say I have not been able to obtain -- and now I'm advised my attorney is leaving private practice to become a judge.
This leaves me without an attorney, without medication, without hope, and not in a position to keep my scheduled surgery for January 28 or 29, 2003 for the heart repair so that I don't have another stroke and perhaps can live and have the long-needed back problem remedied and a knee replacement, since now I am experiencing increased pain in the knee.
If there is anyone who can suggest what I might be able to do -- since I am in limbo -- at at great risk for another stroke or worse -- and feel that I have been abused and that the stroke is a direct result of all that I've had to endure for the past four years since the recommended back surgery and Argonaut's refusal to adequately treat my condition which was clearly known to them, but found every diversion possible, and now according to my attorney who is too busy to help me, says the "stroke(s)" would be hard to prove related to the work-related injuries -- is just as guilty of wrongful, willful neglect as Argonaut in their refusal to allow proper medical care and treatment, which had I been allowed the surgery 4 years ago, at least even if I had the stroke(s) which occurred recently, had they occurred in the normal course of life, I would have the pain alleviated and the surgery behind me.
I directly attribute the stroke(s) to Argonaut's neglect which caused the stress and ultimately rendered me in the position of being at risk of death.
I believe this is criminal on Argonaut's part and think they should be responsible for my current condition and resulting problems or perhaps even death.
As you can imagine, it would be nearly impossible in this letter to mention all the problems I've had with the insurance company, as well as my attorney, and am relying on memory for the chronology of this -- but I think it is, although convoluted, accurate.