Saturday, 19 May 2012

Well, it's about bloody time!!

I know I've gone on and on about how the 'system' has been screwing me over my claim for compensation for the shoulder injury, right?

Well, my file was finally sent, with lots of documentation from my healthcare providers (physiotherapist, sports medicine doc and orthopedic surgeon), a couple of statements from two of my coworkers, and a plea from my nurses' union labour relations officer (who has been handling this appeal for me, bless her tenacious little heart!) to actually follow the workers compensation act and accept my claim. Both the physiotherapist and sports med doc saw me pre and post accident, as I had been complaining of an aching shoulder that would wake me up at night (but I still has full use of my arm). The physio and the ortho surgeon both said that in 20 - 30% of MRIs, certain shoulder injuries are not at all visible, and there is medical documentation all over the internet (in respected medical journals, etc) that uphold this.

My adjudicator at the comp board was consistently denying my claim based on the MRIs (and ignoring everything else) I had done pre and post injury. Because I had seen the sports med doc, he had ordered an MRI to see what was going on before doing steroid injections in my shoulder (which would have been the appropriate treatment at that time) but I had the accident the day after the first MRI. Comp ordered a second MRI to compare to the first. They said there was no change. The two MRIs were taken at different facilities, using different machines, and different views. Can you compare apples to oranges? But then, the ortho surgeon said he doesn't even care if there is an MRI. He determines the injury and need for surgery by the symptoms the patient has. And then he determines what needs to be done when he actually has the scope in your shoulder and can see the actual damage.

Did Comp take any of that into account? Nope. The second MRI showed almost "no change", therefore what happened at work was not the cause of the loss of use of my arm. Bastards!! The adjudicators are not medically trained personnel. They are just office minions. If an injury doesn't fit their 'cookie cutter' scenario... it gets stamped "Denied".

Thank the gods the Review Office is staffed with medical personnel!!!! It took them a week to make their decision. And that includes the couple of days it took to mail the file to them and for them to type out and mail a letter of acceptance to me!!! Obviously it was a no-brainer.

So now I am awaiting word from the Rehabilitation and Compensation Services office to let me know the financial end of things. I should be getting a fair chunk of change back. Which is a damn good thing, because I had a crown break off a couple of weeks ago and will be getting two dental implants to replace the missing teeth on that side of my mouth. And those ain't cheap, let me tell you!!! Costing me about what I paid for my (used) car. But I need them. I can't chew on that side, and I absolutely refuse to have a partial plate or dentures. I will go through the discomfort of the implants (both physical and financial) to have permanent teeth again!

I'll let ya, life would be very different if those Comp bastards had approved my claim right off the hop. I'd still have my house, my dog.... *sigh*

13 comments:

  1. Congrats on the comp review results!

    I have three dental implants and highly recommend them. Ja, the only downside is the cost.

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  2. yea! huzzah! whoopie! and congrats, sugar! xoxoxox

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  3. Sure you didn't break that crown from grinding your teeth in mental anguish from the medically incompetent? :)

    I tease, yet as someone who's just had her 4th crown put in, I understand the dent in the bank account.

    Just glad to hear that YOU are otherwise doing better and are settling in. Hang in there girl!

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  4. LX: Thanks! It's a big relief!

    And thanks for the recommendation on the implants.

    Savannah: :-D xoxoxo

    Hope: I've had seven root canals, 6 crowns (now 5) and a bridge. My mouth is worth a fortune! And about to go up in value exponentially. :-\

    Yes, I am otherwise doing well. Other than having to put up with urban rednecks who burn 2x4s in their firepit under the big elm tree in the back yard about 15 feet from where I live!! (One of the seniors across the street called the fire dept last night. The neigbours got a lecture about using seasoned firewood and not construction materials, and about keeping it a small fire and not torching the whole area!)

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  5. You've really been put through the wringer. Even so, the worst is behind you! Sad about the house and dog, though.

    Next stop: toothy grin!

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  6. Sometimes...mills grind exceeding slow!
    At least now you can stop banging your head on the wall!

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  7. Jonas: Indeed I have been through the wringer, but life goes on so I've learned to hike up my shorts and get on with it.

    Good thing the missing crown in towards the back. It doesn't show much when I grin... and given the size of my front chompers, I will always have a toothy grin!

    Dinah: Slow, indeed, and all because of one obstinate person. My forehead was getting a bit chafed from the wall... very happy to be stopping that!

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  8. Well, that's a relief. What happened to the great Canadian healthcare system I keep hearing about. Can you imagine what you would have gone through if you had been here in the U.S. Cold comfort, I know, but it's true.

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  9. UB: You are mistaking the healthcare system with the giant insurance monster. My surgery and all doctors' visits were totally covered by our healthcare. It was the insurance that the employer pays into for workers' loss of wages if hurt while on the job. Since their premiums go up with every claim paid out (as per typical insurance), they didn't want to pay for my lost income. Unfortunately the insurance industry demands proof of compensable injury (which is reasonable... to a point!) and they really make you work hard if you feel your case is right. A lot of people would give up in a case such as mine, which is what the employer wants. And yet, I personally know a couple people who take every summer off due to "back injuries" and they have no problems getting their claims covered. Go figure, eh?

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  10. I'm so glad your claim has gone through and you've got the decision you deserve.

    Such a shame it's taken this long to get it sorted. I'm sure you didn't need the extra stress involved, given what you've just been through.

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  11. As Roses put it - finally there's a decision.

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  12. Hi Ponita-good post! Everything will ends well, just take a little patient on things and put a smile on it. Thanks for sharing! =:-)

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  13. Now let the good times roll:)

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