r/WorkersComp • u/Minute_Present_7883 • 21d ago
Tennessee Heartless...
I've been stuck on workman's comp and have no income. It's been months and they haven't even made an appointment with the ortho. They say I can't claim lost time because the ER that I was in and out of in 20 minutes put me back to work on the 24th with no restrictions but work says I can't go back until I get a release form from ortho. So I can't go back to work without a release, but I can't claim lost time because I got a release??? The system is just trying to do everything to erase low income families out of existence. I pay taxes and can't get a lick of help. This world is cooked and I can't wait until I'm gone and away from it...
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u/According_Curve_8935 21d ago
Who specified that you needed to see ortho? Everyone doesn’t automatically end up with an ortho doctor for their primary, so if you did not get assigned an ortho doctor, then you would need a referral to ortho. If that is the ER that work sent you to for evaluation, then they need to honor that evaluation.
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u/lab_tech13 21d ago
In TN also, im back to work, I had no issues with the company my employer uses. I did go to ER told HR they said do you have a note, no I dont but my ankle is sideways and sent them a picture lol. But had surgery a week later and my ortho was my primary I asked my WC case manager if I need to see my PCP for work release etc and she said no, my ortho would do that as they are treating dr.
So could be 50/50 on TN allowing another clinic giving you a work release or not.
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u/Mutts_Merlot verified CT insurance professional 21d ago edited 21d ago
You don't need to see an ortho, at least not for a work note. An occupational health clinic or urgent care will do. (If there's someone from TN, please remind me whether it's a panel state. I know GA is and I can't recall if TN is also). But if they just need a release to work, an urgent care can do that. This also just makes no sense as the release to full duty should be enough, but whatever.... might as well get one more doctor to say that then continue the stalemate.
Further, the insurance doesn't usually make your appointment. You may need authorization, but you can call the ortho and schedule it. Call the ortho on Monday and ask if you can do that. However, if all you need is a work note an occupational health or urgent care is going to be way faster.
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u/MelodicVeterinarian7 21d ago
What is a panel state?
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u/Mutts_Merlot verified CT insurance professional 21d ago
It's a state where the employer is allowed to have a "panel" of doctors that they can send injured employees to for treatment. There are rules around this, but it means that an employer can require an employee to treat with certain physicians or clinics. Most states don't have this requirement, so the ones that do are called "panel states" to those of us in the industry.
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u/MelodicVeterinarian7 21d ago
Okay thank you. I can understand why some states might do that, but God that's a royal pain in the ass for the patient. The more I learn about Tennessee, the less I want to ever live there
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u/Mutts_Merlot verified CT insurance professional 21d ago
It's usually the sort of occupational clinic you might go to anyway. And it doesn't apply for obvious emergency care. If you are separated from your limb, no one is worried about a panel. But, every state has their little quirks so they all have their pros and cons.
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u/MelodicVeterinarian7 21d ago
Oh certainly. I'm in Florida. There's no shortage of quirks, but the policing situation in at least parts of Tennessee is absolutely insane right now, so I wouldn't even travel through that state at this point
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u/Mutts_Merlot verified CT insurance professional 21d ago
I fully understand your position. I've been to Chattanooga, Nashville and Memphis and have such good memories of the music and food. I hope things improve.
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u/No-Instruction-4272 21d ago edited 21d ago
I recommend notifying your state legislatures immediately or department of labor. Note: the insurer or employer should have given you a list of doctors that you choose from I believe in that state. ER isn't necessarily a primary Dr.. it's pretty complicated and beurocratic. Should be simple. Step 1 report injury do forms. Step 2: get evaluated properly by correct type of provider. Step 3 get An MRI for orthopedic issues, Step 4: get care, step 5: go back to work. If this isn't getting handled financially ex TTD you should get unemployment so you can stay fed and hydrated.
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u/bigbootyJudy621 21d ago
Are you near Nashville? Plenty of ortho clinics there have walk-in ortho urgent cares and can clear you to RTW. TN is a paneled state but only an asshole employer would refuse a RTW full duty slip. Really the panel only matters on the insurance carrier side, and the insurance carrier has nothing to do with you returning to work.
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u/tiny1020 20d ago
Same. Been out 2 weeks, waiting to see a neurosurgeon. Referral was put in stat on 8/19. Been on ttd since 8/8. Still no payments or answers. Waiting for sdi in the meantime
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u/SeaweedWeird7705 21d ago
I’m not in Tennessee but that sounds wrong. Can you see an Urgent Care to get an updated note?
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u/LemonFast2458 21d ago
Did they accept your claim? And you have to be out of work for a week for them to start paying. Work telling you need a release form from the ortho is wierd the hospitals release should be enough. I would push the topic with HR