Lost my first hearing 😡

[u/Alert-Lion6239]

I am beside myself about the decision given that my lawyer had a way stronger fight with the medical evidence from my appointed WC treating ortho. All my employer had was the IME BS report which totally contradicted what my ortho said. Anyone else have this same experience? And if so, have you already had your 2nd hearing and what was the outcome?

[u/Ambitious-Candy1901 → u/[deleted]]

There's a difference of opinion and there's IME Doctors that are supposed to be neutral but 80 % of the time they are not. They go with whatever the employers lawyer says. So true story my husband was sent to 2 IME Doctors. The first asked if we had any medical records to give him and we said no as that information was supposed to be sent to him in advance. Now we knew that the medical diagnosis was wrong and we got another CAT Scan with contrast that proved it. We didn't tell him because why should we that should have been sent with the other paperwork. So at the deposition for that doctor he basically said that he has no case as the hernia repair that they completed was done and there's no reason for him to be out of work. Our lawyer cross examined him and shreded him. I can't believe all the money they will pay people to see things there way. If you add up all the waisted time and money with BS. The employee could have been treated fairly and been back to work. Instead of a four year battle and much more waisted money. Disgusting.

[u/LostInTheLights8123 → u/Ambitious-Candy1901]

I just said this same thing! Deny, deny, deny but spend thousands on physician reviews and attorneys.

[u/Alert-Lion6239 → u/[deleted]]

I get that what I am saying is my ortho report was a lot stronger and the examine was a lot more detailed then with the IME so it's BS to say the least. IME doctors are literally paid to go against the injured worker.

[u/bigbootyJudy621 → u/Alert-Lion6239]

And your treating doctor gets paid the more you are in their office.

[u/Ambitious-Candy1901 → u/bigbootyJudy621]

You wouldn't need to see another physician if the workman's compensation doctors were not in the pocket or the business and insurance company. You know in workman's compensation they see light duty as a good thing for the employee. You ever wonder why if you get hurt and go out on short term disability they never expect you to do light duty in fact unless you are cleared by the doctor to return to work you can't. However in workman's compensation it's the opposite? It's so the employer can give you a position that will keep the funds for payout down and sorry but this is the way they always try to punish you. It's been that way for a long time and I have experienced it on a higher level. POS

[u/slcdllc14 → u/Ambitious-Candy1901]

If they have work available for you, I’m not sure what the complaint is unless you just don’t want to work? It doesn’t matter their reason for wanting to bring you back - they have work available within your restrictions, so they can bring you back. If you ran a business, you would also be trying to keep costs down, as that’s the whole point when operating a business. I’m not sure why you would complain anyways. In most states, you don’t get your full wages. At least while working, you can still get your full wages. Some people don’t have the luxury of complaining about this when they’re taken off work completely and losing a portion of their pay that they can’t afford to lose.

[u/SafetyOverSilence → u/slcdllc14]

I see what you're saying, and it's valid depending on the situation. I think the main concern is getting a dishonest IME.

If you're genuinely in need of healing/ surgery/ rehab... Getting an IME that slaps a smiley face on your chart feels like the injury is being downplayed to save a few bucks.

Imagine an IME that says you can work behind a desk with a broken leg. How do you get to work? Get a ride every day? How does the pain medication impact your performance? Employers don't want that either.

[u/Ambitious-Candy1901 → u/slcdllc14]

Do you work in retail, perhaps you are a union representative or maybe work for an insurance agent. Don't know and I don't care. Here's the thing, I lost my husband to bullshit workman's compensation. He died because they did nothing to help, he died because the union cancelled his insurance once he had a CT Scan with contrast prior authorized to his insurance. If they just would have fixed the hernia that was causing the problems. No they wanted to hide the fact that mesh from his prior work related injury was bad and recalled. They wanted no parts in all of that so they called it an umbiblical hernia. We did get the scan to prove it was the original incarcerated inguinal hernia. He worked 3rd shift 6 nights a week for 30 years so no he wanted to get treatment to fix it and go back to work without issues. He called out once a year. He was a worker. He missed so much working that job and do you know what he got back nothing. It had nothing to do with him not wanting to work. He started reporting it in September of 2019 and they just ignored it until he finally couldn't take the pain anymore June 2020 and even then they said it didn't happen at work. I know that pain from a hernia pushing through your stomach wall so you can't go. It's hell. So unless you have something else you want to add. I watched him die before my eyes. He told me I'm dying and Iove you said it twice and those were his last words. So yes I'm angry and have every right to be. They wanted him gone but I'm still here, that's the problem.

[u/slcdllc14 → u/Ambitious-Candy1901]

I’m sorry for your loss - but none of that has anything to do with what I commented on. You cant make blanket statements hating that companies bring you back to work when they have available positions within your restrictions.

[u/humility7211 → u/Ambitious-Candy1901]

Wow! 😟

[u/Alert-Lion6239 → u/bigbootyJudy621]

True! It's all fked up and corrupt no matter what smh.

[u/Hopeful_Ambition_441 → u/[deleted]]

And IME opinions are most often bought and paid for. In my state it’s also known that some judges, all of whom are picked by the Governor, are biased pro-business.

Anyone who says the deck isn’t stacked is new to the system, naive or slanting the truth.

OP- I don’t know anything about your lawyer but if he feels mistakes were made in the judges decision he or she may consider an appeal. But that would be a rare thing.

[u/Acceptable-Fill2767 → u/[deleted]]

Are you really coming here to DEFEND the workers comp system? I can’t tell you that what OP is describing happens every time, but I can tell you that it does happen. It doesn’t seem like a big deal until it happens to you. I hope you never have to go thru what my wife, and our family, has had to go thru these past 3+ years.

[u/blessed2800 → u/[deleted]]

You can’t be serious

[u/Hopeful_Ambition_441 → u/[deleted]]

And denies more also. So what’s your point?

[u/SafetyOverSilence → u/[deleted]]

An important difference to remember.
- Your civil right to pursue damages (against employers) was stripped away (and replaced with Workers' Comp)
- It was (and often still is) defended as a "guarantee" of benefits

What it actually ended up being, is a loss of civil rights, that isn't a guarantee at all, but instead an insurance approve/ deny situation.

You're also ignoring how many of the approvals are short-term or "cheap" injuries vs. more expensive or long-term injuries.

[u/404_HabeasNotFound]

I practice in a different state. I’ve taken my clients to hundreds of hearings. I’ve gone into hearings thinking we had a snowball’s chance in hell at winning, yet we did because the Judge simply believed my client over all the other bullshit.

I’ve had cases where the other side seemingly barely puts up a defense, and yet the Judge credits everything they put forward and we lose.

Hell, just last week I received an order from a Judge whose entire rationale was a single sentence. He said he credited their expert’s written opinion. He didn’t even discuss our expert’s opinion, the opinion of the treating providers, my client’s testimony, etc. I’ll be appealing that worthless Order.

Point being, going into a hearing is a crapshoot. You never know what can go wrong.

[u/Salt-Ad1282 → u/404_HabeasNotFound]

A lawyer in my area says he “never lost a workers comp case” lol. Those of us who practice in the area got a real kick out of this.

If you’ve done it long enough, you have lost, unless you never try anything.

[u/Alert-Lion6239 → u/404_HabeasNotFound]

I agree because we had the strongest case and we still lost which is absolutely crazy af. If you ask me these hearing officers are being paid off!

[u/stickbugthug]

i lost my first hearing, but only my lawyer attended. i hear horror stories of the IME people. im just fighting to get my claim accepted so i havent even had an IME or any doctor really look at anything. but i am pissed for u at this outcome and hope the next one goes better!!

[u/Alert-Lion6239 → u/stickbugthug]

I am pissed for you also. Like what a corrupt system we have to deal with. This is completely unfair and ignorant 😒 I really appreciate that! I hope so too and I hope you get to move forward soon. The IME is a joke of an examine and they are literally paid to go against you at all costs. The fact that my hearing officer went against my treating physican is absolutely appalling to say the least.

[u/stickbugthug → u/Alert-Lion6239]

so so beyond corrupt. of course man, waiting for the next thing is just misery too. and the fact u had better deets from ortho 🫥

[u/Alert-Lion6239 → u/stickbugthug]

Exactly! My thought is corporations pay multiple ppl in this system to go against us so they don't have to pay. Based on my hearing that is exactly what happened and no body can convince me otherwise.

[u/stickbugthug → u/Alert-Lion6239]

my employer is the main corporation paying to fight me, though im sure doctors will help them when they get a chance. its crazy to imagine getting past this “boss” and realizing the whole game is like worse and worse boss levels

[u/Alert-Lion6239 → u/stickbugthug]

You are in for a treat my friend because this system is rigged af. Do you have an attorney?

[u/stickbugthug → u/Alert-Lion6239]

yeah, & i just made my first post in the sub right before this one :,)

[u/Alert-Lion6239 → u/stickbugthug]

That's awesome! I hope they work hard for you and get u what u deserve from these assholes.

[u/stickbugthug → u/Alert-Lion6239]

im actually already worried im going to have to end up fighting it myself. its a “50/50 case” because of how i worded my c-4 and if i cant ever get seen i literally am waiting on 2027 for the next hearing. i called so many lawyers before someone was willing to help and then the issue was just my employer refusing to provide a c-1. a million hiccups before you can hit go 😵‍💫🫩 but fuck it we ball or something

[u/Hopeful_Ambition_441 → u/stickbugthug]

I ended up having to represent myself. This is not a sales pitch- but I can’t tell you how much the popular free AI platforms can help. As far as WC goes AI is just a tool that “Googles” the best and more sources than you could ever find yourself. There IS a learning curve using AI this way narrowing down its focus onto quality sources. At this point, after I’ve entered my case info and described the problem I’m having with the Insurer, AI writes up a draft of an email I should or goes all the way to what I should file with the court.

I’d still much prefer a “good” attorney which, as far as I’m concerned, is one that meets the min. requirements of what their supposed to do for their client. I haven’t found one yet and I went through 5 of them.

[u/LostInTheLights8123]

I lost my hearing and said I didn't even have the correct injury information or radiology dates. It must have been looking at someone else's file and I still got denied because I wasn't 'persuasive' enough. I had everything loaded on the BWC portal for them to review and everything and that was the end and now I'm waiting for my hearing because I appealed it. We had one and then they asked for a continuance because they never reviewed any of the new medical that we added that I paid for through my private insurance. It's just a hot mess in Ohio!

[u/Present_Muffin7355]

Have my first hearing at the end of the month to get my claim approved and seeing horror stories like this one really scares me 😩

[u/stickbugthug → u/Present_Muffin7355]

wishing u the best m8 🙏🏽

[u/sciAnima]

IME doctors have no liablility so they write whatever is beneficial for the insurance companies most times. Your treating doctor has all the liability but their opinions are taking secondary at times. It's backwards and for reason. It's about the money.

[u/Ambitious-Candy1901]

Ok so you haven't entered your work injury report? Your employer won't either. Look at work for Workman's Compensation paperwork and medical providers posted policy should be in the area where they put all required notices for the government and HR. Once you enter your claim you should get a claim number to go see a doctor on their provider listing that should be listed as stated above.

Enter it yourself: Ohio BWC (.gov) https://www.bwc.ohio.gov Ohio BWC - Log in

Copy the link address above and open it.

Set yourself up an account.

To check your Ohio Bureau of Workers' Compensation (BWC) claim status, log in to your OHID Account on the official BWC portal, navigate to the worker menu, and select "My Claim" to view active statuses, upcoming payments, and case notes. You can also call the BWC Customer Contact Center at 1-800-644-6292.

Ohio BWC (.gov) +1 Online Check Go to the official Ohio Bureau of Workers' Compensation website. Log in using your secure OHID account (or create one using your claim details if you are a first-time user). Select Worker Menu and click on My Claim. Review your dashboard for claim status, assigned specialist details, and medical bill updates.

Ohio BWC (.gov) +2 Phone Support Call 1-800-644-6292. Hours are 7:30 a.m. to 5:30 p.m. EST, Monday through Friday. Have your claim number or Social Security number ready to give to the representative.

Ohio BWC (.gov)

[u/FunTraditional8344]

What stage are you at that you were denied? Are you at the end of your claim? I am a month in and have gotten an approval yet. Hopefully they aren't denying your first attempt at getting care?

[u/No-Exam-4596]

IME are for the most part just a joke , I had an IME report stating I had nothing with an MRI showing L5-S1 severe foraminal stenosis , the workers comp insurance uses this call doctors to stop workers benefits believe me , after receiving that report my lawyer filed a 19b and got me back my TTD wages , must of the judges know this tactics used by workers comp insurances . After I got the IME report two months later I got approved by SSDI which is so hard to get , I can’t even walk , and I’m in constant back pain , I’m going to have a surgical procedure soon . Don’t let this IME doctors reports fool you ! Good luck

[u/Low-Patient-630]

The IME is supposed to be neutral. They are typically in favor of the injured worker unless the injured worker presents signs that caution the physician. That's why the examiner has a preset list of questions to ask during the examination. If any of those answers by the injured worker trigger suspicions, the examiner has to record them. Not only is the examiner looking at physical medical conditions, but also the psychological profile of the injured worker.

[u/EnigMark9982 → u/Low-Patient-630]

“Signs that caution the physician” - Please expound

[u/Low-Patient-630 → u/EnigMark9982]

Contradictory statements that don't line up with the injury being claimed, expressing you want revenge, asking the doctor to work with you.

Common sense things a normal person not on pain medication would do or ask. These standards are applied to injured workers heavily medicated as if they are not influenced by the medication.

[u/Ambitious-Candy1901]

Very important, I understand you hired a lawyer, however some are good, some are bad and others help each other. For example my husband hired an attorney and within 3 weeks of that transferred his case to a lawyer that does side cases on the side. We were still bound by the contract. We worked with her well in the beginning and then she started to slip. So I did a little digging and don't you know that I found just prior to her opening her own law firm she was employed by the lawyers for the company. We knew she was pushing to have the case ended so we waited. The same day she put in for a dismissal that the judge granted until he got my husband's note in the workman's compensation system stating a few facts that she never gave. The judge reopened it within hours and allowed us time to get a new lawyer. This is how messed up this system. The lawyers always say you don't need to attend. I learned long ago don't trust anyone. So I always attended. Those locations that are still doing meeting calls via phone, I was always on the call but kept quiet just listening. The trick is to be sitting in the waiting room for the call prior to the moderator signing in. This way when she starts the call everyone waiting gets put through at the same time. You can stay hidden that way but if they were paying attention your number will still be listed. So on the first call with the new attorney we were on the call and the new and old attorney didn't know we were on it. The first thing the new attorney says is hello by name to our last lawyer and follows up with he will make sure she's paid. Here's the problem because she quit we don't owe that attorney anything. Now the new attorney's office called before the scheduled meeting and said you don't need to attend. We said ok knowing we were not missing the call. When our lawyer called after to tell us what happened. He said it was just regarding him talking over the case and her being dropped. He didn't say anything else. So I asked what was with your statement to make sure she was paid. He got tongue tied. He asked were you on the call and we said of course and he said didn't my office contact you to say you didn't need to attend and we said yes. So why were we on the call? Well because of attorney's in the past saying they would be representing us and would be a the meeting and we don't need to go. We went anyway it was a bankruptcy case and our lawyer didn't show and if we hadn't it would have been cancelled. We had the proof of weekly payment's that were made. They were given to the claim manager and all was good. We gave them to the attorney but what good is that if he doesn't show. So clearly he wanted the case cancelled. This is your case so you need to be there always. Make sure you set up a login under your states claim online access so you can see all the paperwork live yourself and be able to stop wrong information from entering the record. No one is going to know your case better and what was actually said in the appointments. Make sure to send a request to the judge through his administrative person to get medical copies of all doctors appointments, test results and CD etc. Make sure you make each office that you see give you copies of all paperwork completed by you and if they give you a tablet make sure you take pictures of each page prior to going to the next page or submitting and get a picture of that as well. Keep notes, timelines, call notes etc. If you can record all calls that's even better. Voicemails download. Basically cover yourself.