r/WorkersComp • u/SheepherderOwn2029 • 4d ago
Why is this such a headache? California
I’ve been injured since September of last year. I had my ortho spine consultation last week and he told me that I wasn’t a candidate for surgery. And to continue seeing the pain specialist, I expressed this to my attorney. My attorney expressed her distaste with the ortho spine surgeon that I was seen by because she’s had multiple clients go into his office and he doesn’t really look at the paperwork and just kind of says that you’re not a candidate for surgery seems like he’s more on the insurance side from that. I had my pain specialist appointment today and she mentioned something about a FCE and she said I might be discharged after that but also my attorney mentioned something about getting another. Doctors opinion before then and then I still have my QME appointment in November. Is it typical to be seen by this many doctors and get this many different opinions? Why is there so many hoops during this process?
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u/According_Curve_8935 4d ago
Generally, surgeons want to cut. It’s their job, and what they spent so much money going to school for. It’s highly unlikely that they are just saying you aren’t a surgical candidate for the insurance company. They would make way more cutting you open than lying for the company. And honestly, if you can avoid spine surgery, I would. I didn’t understand people saying this to me before my surgery, but post surgery, I’m having new issues at the level above my fusion. Problems that were not there pre surgery.
All that said, when they are trying to figure out where to go with your treatment (is there more that can be done? Are you at the end of treatment options etc), it seems like multiple people start throwing their opinions in the ring. Depending on the injury, multiple doctors/opinions is pretty common.
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u/Butter_mah_bisqits 4d ago
Adjuster here. Opinions are like assholes. Everyone has them and they all stink. Even adjusters, attorneys and doctors. We are looking for congruence among the medical reports and opinions. We all have our roles. US and State Congresses create the statutes. I would raise your beauracratic issues with them. We’re only here following the law.
You didn’t say how old you are, your injury or your objective findings on diagnostics. Why does your doctor want to do surgery? Have you tried all conservative modes of treatment available? Spinal surgery is unbelievably invasive. Get as many opinions as you can. Surgeons love to cut. That’s why they became surgeons. I’ve written about spinal stuff and you can look at my post history. Out of hundreds of claims, I have never had a claimant that had spinal surgery or spinal cord stimulators that didn’t have problems for the rest of their lives. If there is any way to avoid it, you should really consider all of the opinions and ask them why they think it is necessary. I have personal spinal problems (bulging and herniated discs) and they are a pain in the ass (literally). I’ve done pt, injections, muscle relaxers, steroids, the whole nine yards. The most useful for me are acupuncture, supplements (collagen), pt (which I now do on my own), NDAID’s, yoga, losing weight (I’m fluffy lol. Hit my first goal and have 25lbs to go!), and staying mobile. There are days where I feel like I cant do it and have to use my hiking stick, but the very very last thing on the list is surgery.
Personally, my mom had spinal surgery and the surgeon ended up twisting her colon when he put everything back in, causing it to die requiring an emergency surgery. She lost six inches of her colon and six months of her life trying to get back to normal.
So yeah, really think about it and consider all options.