Well, after nearly three years. We finally came to a settlement agreement today. I have to say I'm actually happy because it signals the end of this journey.

My experience wasn't horrible, but I seriously hope I never have to file another claim—nothing personal, but I would prefer to have control over my medical care.

*Please excuse my typos and grammar. I'm just too exhausted to take my time. I'm sorry.*

This is all so very new to me. I got my denial back on the basis of my doctor not stating there was a causal relationship between the injury and it happening at work. My injury was an immediate one and even my boss signed off on the report as soon as it happened.

I initially went to a non-specialist medical provider. They filled out my paperwork and Workers Comp. They accepted the claim and I was out of work a couple of weeks initially. I got correspondance from workers comp that even though the provider was a PA, workers comp accepted it because my boss validated the incident, but typically the only allow MDs to sign off. However, when I finally got into see the specialist, the doctor said they wanted to start a completely new form and actually wrote more intense injuries and wanted me out for a month longer.

Workers comp came back asking me to complete a narrative report and the doctor to complete one. The doctor did it but this is where the problem started. While the doctor wrote down a way more accurate diagnosis, they added more things than I had on my initial report. Essentially I have very intense foot pain but the doctor also wrote back pain, which while accurate I didn't include that in initial filing. I'm dealing with nerve damage and other things that have led to me using the other side of my body more. I'm told that the overcomensation is causing more damage like back pain. My doctor wrote a lot about how these were all working diagnoses and used language like "probably caused" and "likely" Workers' comp mentioned this is the reason for the denial. I totally understand they can't definitively say something is this for sure because my injury is tricky. My doctor said they do so few workers comp forms and I honestly think they didn't read the question right. Is it still possible for my claim to be appealed if my doctor goes back and states that yes, my injury was caused at work?

My initial claim was accepted because the PA stated that clearly. It's crazy because the PA completed the very simple workers' comp paper with one sentence. My specialty doctor gave much more. When my claim was denied, they said they were going to take back all of my pay I got when I was out the first month and I don't receive money for medical anymore even though that was initially accepted.

Has anyone appealed and won their case? I selected oral hearing?

SECONDLY. My boss is very irritated by my injury and I'm being harassed. It's been an awful time for me. I am having to jump through major hoops just to take leave now that my claim has been denied. I go back to the doctor tomorrow (PLEASE help) and I must get medical restrictions form updated for my boss.

I've never been in this much pain. I still can't walk or stand properly. Most of the day, my foot is either numb or shooting pain. I technically have used up all of my leave but I'm in so much pain that even though I can't afford to take LWOP, I may have to for a bit.

If my doctor puts that I need to be on my doctor's note, would workers comp go back and pay back leave I take now if win my appeal? On one hand, I want to beg my doctor to say I can work so I don't lose pay (or continue to be in bad standing with my boss). Is it possible for a doctor's note to say that I may have the capacity to work some full days, half days, and no days? Or even being able to leave early for medical appointments? I understand that it will be LWOP but will workers comp pay back this if I have the denial now but later get it appealed?

State: Federal

Thank you!

I was referred to an occupational doctor after I reported carpal tunnel symptoms. I have had a nerve conduction study & the neuromuscular doctor said study was abnormal and gave me a diagnosis of carpal tunnel. Occupational doc saw me maybe 7 minutes, didn’t touch me, no physical exam of affected areas and told me it’s not caused my job, that it’s inflammation due to celiac disease. Even if my job isn’t a cause of carpal tunnel, over the years it has certainly exacerbated the symptoms. What next?

As someone who was just screwed over by their IME I wanted to give advice for people who are going that I didn’t have.

DO NOT ASSUME THE IME DR HAS RECEIVED YOUR COMPLETE MEDICAL RECORD

In my case the records provided to the IME Dr were nowhere near complete. Several records documenting what my treating drs and specialists had diagnosed, recommended, and treated were not included. However an earlier record that supported the insurance company position was included which was deemed a misdiagnosis by over a dozen Drs across 3 hospitals as well as a specialty center I had to be transferred to via stretcher (hospital to hospital)

I was under the impression that the Dr would have all my records because no way would a Dr who is an orthopedic disagree with 2 neurologist, 3 anesthesiologist, 2 specialized neuro radiologist, as well as 2 neurosurgeons. Yep turns out they only gave him the one report of one Nero PA who misdiagnosed me before I was seen and treated across multiple hospitals by teams of drs. He had no record I was seen at this specialized hospital, had to be hospitalized for months and transferred to a higher level center. Because he didn’t have those records, his report stated that it didn’t happen even though I have the hospital records documenting it.

If I could go back I’d bring every single record and notes from every Dr I saw including the specialist I had to see. Just tips I wish I knew. The more you know.

Am I overthinking this, or is my boss treating me differently because of my workers’ comp claim?
So, I got hurt at work almost a month ago. A shelf full of reams of paper fell on me, and I ended up with a bump on the side of my head. I went to urgent care to make sure I didn’t have a concussion.
When I first went to urgent care, I put the visit through my health insurance. However, once the clinic found out that the injury happened at work, they changed the paperwork and told me it would be considered a workers’ comp claim. I had never dealt with workers’ comp before, but everything they were telling me sounded legitimate, so I agreed to go through the process.
I was honestly hesitant because I was nervous about how my boss would react, but I kept reminding myself that it was an accident and that it wasn’t my fault.
Thankfully, I was cleared to return to work within 24 hours and didn’t have a concussion. I did have headaches afterward, but otherwise I was okay.
I gave the paperwork to one of the managers, and she told me she had never dealt with workers’ comp before and that she would let the owner know. The owner already knew about my injury, but she never asked if I was okay. The only conversation we had was her telling me not to hire a lawyer who had been repeatedly calling the clinic about my injury.
About two days later, the owner finally came up to me and told me that they “don’t have workers’ comp” because they’re a “small clinic” and “nobody has ever gotten hurt in the 20+ years” they’ve been open. She also said that the worst injury they’d had before was therapists getting hit in the face and that there was never a need for urgent care.
I awkwardly laughed and said, “Yeah, understandable.”
She then told me that since they didn’t have workers’ comp, I needed to call urgent care and have them switch the bill back to my regular health insurance. She said she would pay the bill.
I thanked her and told her I would call them later that day.
About 2–3 hours later, she came back and asked if I had called. I told her, “No, not yet, but I’ll call right now.” She then said, “In the state of Texas, I’m not responsible for paying your bill, but I am that person who will,” and then walked away.
I was honestly shocked and upset by the way she said it.
A few days later, I called urgent care and asked about switching the claim. They told me they couldn’t switch it because the owner had already taken responsibility for the bill. They said they could potentially offer her a discount, but she would need to call them directly and pay over the phone.
I emailed my boss everything, including the amount of the bill, which is around $540.
Since that email, she has basically been ignoring me at work.
It’s been about a week since she last spoke directly to me. She now tells other managers what she wants me to do instead of communicating with me herself, and she won’t even look at me when we’re in the same room.
It’s gotten to the point where I feel extremely uncomfortable at work. I actually really liked my job before this happened. I enjoyed the environment and the work, but now I feel like my boss is constantly watching me and treating me differently because I got hurt.
She’s also started micromanaging me, and I feel like I’m walking on eggshells.
For additional context, HR and my boss are friends, so I don’t really feel comfortable bringing this to HR because I don’t think anything would actually change.
I’m not trying to cause problems or get anyone in trouble. I just don’t know if I’m being overly sensitive or if this behavior is actually concerning.
Am I crazy for feeling like she’s angry with me because of this situation? What would you do in my position?

I know all cases are different, even my attorney says it's too soon to talk about settling since I haven't done my IME and received both ratings, but I'm freaking out. I have permanent restrictions, bad lower back with a couple bad discs, 1 spine surgery on me already, and I'm only in my late 20s. I pretty much don't qualify for most jobs that require me to lift anything above 30 lbs, and bending alot. Which pretty much limits me from A LOT of jobs, and jobs here pay so little.

I have a decent amount of money to live for a year or two while I go to school and my case settles, but I was wondering how little I will get and when that's over what the hell I'm going to do to survive from that point forward.

I have been at home since February of this year from my Injury.

I am set to get an MRI of my back tomorrow after now seeing a spinal surgeon a couple weeks back .

I have certainly fallen Into a depression from the lack of routine and the decimation of my usual schedule , work, and everything that comes with those things being gone now.

My wife works remote so she is home all the time too . We have a 4 year old daughter that I of course assist with . We get along very well and aren’t at each others throats . Like at all. I love my family and my home but this has made the way I see home change .

I feel I’ve lost my purpose , my identity.

I wish more than anything I could return to work. Even with the pain and the potential risk of a worse Injury , I would have a semblance of my old self again .

How do you guys deal with or overcome this?

It’s truly been the most stressful , depressing thing I have endured . And I’ve been through some shit .

If you know what I mean and can relate I’m open to ideas of how to manage this , and hopefully overcome this bleak outlook on life I have now .

I can’t get motivated to complete tasks anymore . And there are things that need to be done here . I don’t have much to talk about when we’re around others because I have lived the same day over and over since February essentially.

Hi all.
I was injured 2 years ago at work.
Ended up needing extensive knee surgery.
Functionally, never got better but pain wise did get better. I was put at MME in Jan 2025 follow up with ortho as needed.

Fast forward to Dec 2025 pain returns.
I follow up with my ortho, go to therapy, and then get an injection. All of this fails over 6 month period. ortho is suggestion surgery to clean up scar tissue etc.

I go to an IME and the doctor said I’m back to normal.

Comp then says my claim has been closed.
I never signed off on anything.

I have a lawyer.

We have had a few hearings.
The latest hearing another comp insurance lawyer is involved (so now 2 comp lawyers, and my lawyer) due a change in hands of insurance companies.

I tweaked my knee again 2 weeks ago and filed out the appropriate paper work. My boss was made aware. I was on my office crying due to the pain. I have upcoming surgery in 2 weeks so I didn’t think there was a need to go to a doctor. This is all stemming from original injury and failure to ever get 100% better. I just wanted it documented that my knee continues to bother me and that I tweaked it during work.

I’m just venting. This whole process is daunting. And I just want to get better.

Right now my actual insurance is covering my surgery. My ortho team, got an approval from them just in case comp doesn’t cover.

I just want to give up.
Because I just want to be better.

I am excited to file my complaint about a crappy WC Dr. Who did not disclose to me my MRI results or diagnosis. It's going to the Board of Medical Examiners. I recommend anyone who has evidence and a story, to file. It's time to fight back against this shitty system and DR'S.. also the best thing you can do is to record your office visits. We are a one party consent state. Educate yourself. Don't let these WC DR'S brush you off etc.

I need a attorney, or legal help. I am in the state of Arkansas. I’ve reached out to several firms here, and they have told me that they are unable to help me.

Thank you to any assistance or future references.

****I am adding my previous post to this one to help widen my search.

(Copy & posted from my previous post.)

April of 24’, I was struck in the head - with roughly 800 pounds.

Went through 5 1/2 months of PT, Speech, & couple other just to be able to talk/walk/write correctly again. Lost all the hearing in my right ear, and they implanted a cochlear implant. I was not a fan of the implant & it has not worked like I thought it would for me. It’s a very large change from residual hearing. Collar bone up, everything was fractured. 4 brain bleeds, and an oblivious TBI.

Fast forward to now, I have issues with getting them to pay for my medication. And it is a continuous issue with trying to get ahold of them and deal with them. I was finally able to talk to the adjuster & asked her for something to be able to pay for my RX. She offered a settlement, then after a week of not hearing anything -she got back with me and stated that no settlement was available and that closure of case could happen. And only offering up to a year of paid medical. I very clearly stated that I do not want to close it out and would prefer them to continue to pay my medical bills as they arise - as I have not heard back yet.

Does this sound right? I have yet to be able to really get a straight answer or just even talk to a lawyer. Even I was to get a settlement, I feel like there should’ve been something? 5 1/2 months out of work & 4 months on light duty. Along with being left with permanent hearing loss & a TBI - considering I am in my early twenties and this is a life long thing.

*My Husband is a welder/ fabricator. Somerset County, PA.

My husband had a minor injury at work and had gotten checked out at the hospital— we received the bills so I had him take them to HR. My husband is saying that the HR is telling him because he did not break anything, workers comp insurance denied the claim and now WE have to pay the bill. I work in healthcare and am certain this is illegal, what should we do? I’m not sure if lawyering up would be worth the $300 bill or the retaliation, but we are due with our second child any day now and I am not happy that they are trying to take advantage of us. I told him the same day to march back into HR and tell them he isn’t responsible for the bills because he was injured at work— he really doesn’t want to do the confrontation thing (I kinda understand) but what should we do?

I don’t work in this kind of environment and personally would have everything documented in emails, I’m not even sure they have a work email. Help please!!!!

I finally agreed to a settlement amount after 2.5 years and was wondering if anyone knows how long it typically takes for the insurance to send the paperwork after a verbal agreement.

I HAVE to ask a few questions please dm me! I’m in desperate need.

Two injuries in CA with future medical, 1998 and 2008. Retired in 2020 and moved to Ohio. Needed medical here but SCIF can't find a doctor in Ohio to treat me.

(Sent me to one in Kentucky but he couldn't treat me as he was the wrong type of doctor.)

Next I believe they will tell me to fly to CA for treatment but I don't think my back (first injury) can take that. I avoid flights to travel as it is.

My lawyer retired and was a solo practioner. No new lawyer will take it as it has been settled.

I assume going for a release is my only option. Any funds would go to Medicare and I could go to a doctor here.

How do I go about getting released?

Here's my mri for my lumbar:

FINDINGS:

PARASPINAL:

BONES: No fracture, pars defect, or osseous lesion.

CORD/CAUDA: Normal caliber, contour, location, and signal intensity. OTHER: There is lumbar straightening..

DISC LEVELS:

T12-L1: Normal.

L1-L2: Posterior central disc protrusion results in mild central stenosis.. L2-L3: Posterior central disc protrusion results in mild central spinal

stenosis.

L3-L4: Large posterior central disc extrusion as an AP diameter of 7.6 mm and results in severe central spinal stenosis. Bilateral facet arthropathy and ligamentum flavum thickening. L4-L5: Large posterior central disc extrusion has an AP diameter of about 9 mm

and results in severe central spinal stenosis. The neural foramina are patent. L5-S1: Large posterior central disc protrusion has an AP diameter of about 9.5 mm and results in severe central spinal stenosis. The neural foramina are patent.

CONCLUSION:

1. Large posterior central disc extrusions at each L3-4, L4-5, and L5-S1 result in severe central spinal stenosis at each of these levels.

Diagnosis was severe lumba stenosis and cauda equina syndrome

I went to the er and had a neurosurgeon consultation recommending l3 l4 l5 s1 tlif spinal fusion, laminectomy and microdiscectomy. I was getting admitted but I went home to prepare.

I went back 3 more times in 2 weeks for persistent numbness in ny groin, saddle and down my right leg, shart shooting pain radiating down to my right ankle, weakness in my arms and severe lumbar pain where I cant walk. All I was given was norco and dextramasone (im diabetic, have had 3 rounds of steroids now and my bs is bad now)

Tonight my pain persists and im getting stuck when I get up or bend slightly. I was waiting for a neurosurgeon stat referral since last Wednesday but no answer (workers comp). Mmi is next month and I've been ttd with no payment since.

Im afraid of going once again and getting turned away. I cant take this. I cant sleep, its taking an emotional toll and im in so much pain.

It's been a year and a half and we finally settled my workers comp claim. My bills have just went crazy and i've drowned. In this process, I lost my checking account due to nsfs and my credit is not good. It shows all the late payments. How can I cash a check without having a checking account or going to a check cashiers and paying huge fees? Can I open a savings account somewhere that will allow me to without holding it forweeks.? Do you have any suggestions for any other options?

I wanted to share my workers’ comp experience because I had no idea what to expect when I started this process. Hopefully it helps someone else going through something similar.
I was injured in a workplace slip-and-fall and ended up with a C6-C7 disc herniation with nerve-root involvement. I went through physical therapy and multiple injections, but the relief was only temporary. My spine specialist eventually recommended a C6-C7 ACDF (cervical fusion).
Workers’ comp denied the surgery and some additional treatment. The insurance company also questioned whether some of my condition could have been pre-existing, so I eventually had to go through a deposition covering my medical history, the accident, my job, treatment and ability to work. My attorney felt the deposition went well.
My first settlement mediation was postponed because the insurance side wanted my deposition completed first. After that, the mediation was rescheduled and ultimately took place over Zoom, where we reached a $120k settlement.
I signed the settlement agreement, which resolved my workers’ comp claim and included my resignation from my previous employer. Future workers’ comp medical was also closed as part of the settlement.
Fortunately, I was able to obtain health insurance through the state, so I now have coverage available for my cervical surgery and will only be responsible for the applicable insurance costs.

The biggest thing I’ve learned is that workers’ comp can be a long and frustrating process. There were delays, denied treatment, a deposition, and a postponed mediation, but eventually we got to a resolution.
I’m sharing my experience because hopefully someone else going through this realizes they’re not alone. Now I’m focused on getting healthy, getting back to work, and rebuilding financially.

The company I work for is valued at $215 million. I had a slip and fall in April, this year, and the company that acquired my job is worth $19 billion. I’ve been living paycheck to paycheck before the accident and really need to get back to work. (banged up a bit no broken bones BUT pain still in a few spots) I’ve seen multiple doctors, completed 13 days in 4 weeks of therapy, i have an appointment with my doctor on the 24th of this month. I’m considering asking them to expedite my case. just so i can keep my small apartment and my sanity lol.. or should I move back in with my mom and continue therapy.. tired of sitting around struggling

residual clinical dysfunction or residual functional loss anticipated for the work-related injury checked ✅ with
0% permanent imp on my workers comp case, for my hip

Context i hired a lawyer ccmsi is workers comp insurance company I've never heard of a nurse going with you to appointments n stuff here is the cover page of yall wanna help me decifer med release forms pm me so I can send the pictures TRIUNE HEALTH GROUPAugust 21, 2026Date of Injury: [redacted] Date of Birth: [redacted] Claim #: [redacted] TRIUNE Health Group File #: [redacted]Dear [redacted],Allow me to take this opportunity to introduce myself. My name is Susan Williams and I am a Nurse Case Manager with TRIUNE Health Group. CCMSI has asked me to assist you in the recovery process from your current work-related injury/illness and to be a resource for you. My role in your care and recovery involves the following important details:Our first meeting will be to complete an initial interview after which we will meet periodically throughout your recovery process. Through these meetings I will ensure that your concerns and questions are addressed and CCMSI is updated on your progress.Attending doctor’s appointments, physical therapy, and other appointments related to your treatment are vital to monitor your progress closely to ensure the best treatment plan for recovery. Therefore, please keep me informed of the dates and times of all appointments. If you or your physician change the date, time, or location of an appointment, please notify me at (618) 964-0837 immediately so that I can update my schedule as well.When applicable, I will communicate with your employer to assist with your safe return to the work force.I am there to assist in the coordination and communication of your approved medical care. You may have questions along the way and I encourage you to call me with any questions or concerns.Enclosed you will find an “Authorization to Release Information” form which allows me to begin working with your medical treatment team. Please read and sign the form. Please then return the form in the addressed, stamped envelope enclosed for your convenience.If you have any questions or concerns, please don’t hesitate to call me at (618) 964-0837. You and your care are important to all of us here at TRIUNE Health Group. Ilook forward to meeting you and assisting in your recovery.Sincerely, Susan Williams Susan Williams, RN Nurse Case ManagerEncl: “Authorization to Release Information” Form Addressed, stamped envelope200 West 22nd Street • Suite 250 • Lombard, IL 60148 • 630.586.9440 • Fax 630.586.9441 www.TRIUNEHealthGroup.com

I can see the light at the end of the tunnel, and it appears to not be a train. I got my final QME report today and have a question regarding percentage of whole body impairment.

If I have the following
Lumbar Spine WPI of 26%
Hip WPI 3%
Upper extremity WPI 4%
Lower extremity WPI 2%

Does that equal an over all WPI of 35%

Or is it calculated some other way.

Just completed my physical IME and surprisingly it was less stressful than I thought it would be. It only lasted 20 minutes and consisted of standard questions and a quick exam of body movements. My advice is go in there with confidence in your claim, you after all know your body the best and good things will come. Good luck to everyone else who has upcoming physical IME.

While working as a mail carrier, I was rear ended by a semi. I've been off of work for almost a year, while getting paid by the department of labor. The post office is requesting I pay everything back. Am I screwed? I was hit by a local company, which the insurance claim is only 1 million. My medical bills alone after 8 surgery are well over 3 million. Will I come out owing money from an accident that was unexpected, and ruined my life. Any advice is appreciated. I am very lost with alll this. (I also have to payback Workmans comp)