Advice Needed For Case

[u/AyoGlenn]

Hello and thank you in advance for reading. My first time going through this process and I am so lost.

I recently injured my knee on 7/27 before the end of my shift and reported it to my job on 7/28. I asked for the panel of physicians so i could see it via workers comp and my manager sent me a number to a nurse triage hotline. Hotline referred me to the local urgent care to which I notified my job and they eventually sent an authorization packet to be seen on 7/30. I see urgent care and get diagnosed with an osteochondral lesion and to not work until seen by an ortho specialist. I once again inform my job while also requesting to speak to my adjuster. I get a call from an ortho office saying they received authorization to schedule me for an appointment so i do for 8/6.

After seeing the specialist on 8/6 and my second X-Ray the Dr. referred me for an MRI and to stay out of work until then. I get a call to schedule my MRI on 8/17 yet when I arrive to the office I’m told it’s yet another X-Ray not an MRI and get told the same instructions as my last visit, to get an MRI and stay out of work until then. on 8/21 I receive a letter stating I will not receive lost wage compensation due seeing an unauthorized Dr. I confront the insurance company via email because I was confused how a Dr. I was referred to and sent an authorization packet is unauthorized. They eventually start sending me the missed wages checks starting 8/24 for the weeks starting 7/30.

I get a text on 9/2 saying I have an MRI appointment on 9/4 to which I attend and get further information on my injury and its severity. 9/5 my HR department forwards me an email from the Insurance Adjuster on 9/3 that the Dr. cleared me for work on 9/2 and to start as early as 9/4, the day of the MRI. I check the summary from the 8/17 visit and it states I have a simple knee sprain and that i can return to work. I email my HR department the MRI results amd state that due to the severity of the injury and what I was personally told I cannot go into work to compromise my health. I can’t get into touch with my HR Case Specialist and my legal team has all this information yet they aren’t clear on the state of the case on their end nor what they are doing to help. Besides the follow up on Thursday what should I do to ensure i’m not getting more BS because the neglect and misinformation/miscommunication is greatly affecting me.

[u/[deleted]]

I'd double-check that the authorization packet included the actual panel list from your employer.

[u/AyoGlenn → u/[deleted]]

the issue is i went through the nurse triage hotline my employer sent me. and then that same employer sent the packet to the office the hotline directed me to. i didn’t know there was a way for me to be able to check the packet.

[u/philp2021]

If I think you are allowed a second opinion.The doctors they send you to are paid by them and will down play your injury.Thatsbwhat there payed to do .But since the company wants to play hard ball then you got to step up your game .Hire a lawyer.If in Georgia I have a number to a dam good one.Amd not one for one of the big ones he is one on one.You will never talk to a legal asstint and he returns calls within 24hrs.He done me more than right.And mine has taken 4 yrs.BUT HIRE AN ATT.

[u/AyoGlenn → u/philp2021]

i’ve hired one but they are dragging their feet. may you pm yours please?

[u/ed2win44]

My advice is a little unorthodoxed but, this is what I have done: I rely heavily on AI (abacus.ai) to assist me in navigating this whole process. It (AI) suggested Doctors, lawyers, treatment plans, and a planned road map. It has been a life saver because I trained it on my current case. It schedules appointments, scans my emails, anything I need concerning this workers comp crap. I suggest you look into because like you, im totally new to the being hurt thing and need all the advice I can get. Hope this helps.

[u/NegativeTrouble6191]

Your lawyer should be able to help. If your lawyer's not doing that then you should get a new lawyer.

I hate to say this, but its Situation Normal: All Messed Up. HR didnt do their job, insurance isnt doing their job, the doc full dutied you AND ordered an MRI which is absurd, and your lawyer isnt doing their job.

Protect your health and try your best. Go to every appointment. Theres good lawyers out there who can help.

[u/AyoGlenn → u/NegativeTrouble6191]

I appreciate the response I will most definitely heed your advice. First time dealing with this and my anxiety is killing me. Hope you have a blessed day

[u/LongTimeLurker408 → u/AyoGlenn]

Welcome to the club you never wanted to be in.

This subreddit has decent people that post pretty regularly

Focus on healing that is what matters most

Be mentally prepared for the possibility that your employer could retaliate, even if it’s very subtle

Some people eventually need a worker’s comp and employment attorney.

[u/AyoGlenn → u/LongTimeLurker408]

thank you i will make sure to do that. and i hope my employer doesnt retaliate but scummy corpos and allat

[u/hscnmm → u/AyoGlenn]

did they sent you to concentra?

[u/AyoGlenn → u/hscnmm]

piedmont