I have severe CTS and been trying to make an appointment with a Dr. Auerbach who is listed on the RSI-LA website and is in my area.
http://www.geocities.com/la_rsi/treatmnt.html
I called his office several days ago and tried to make an appointment but was told that since I was on Workers Comp they need an authorization first.
(more)
So it took me two days (with persistence) to contact the WC case manager and he said that first I needed an authorization from my own doctor who is handling the case. It took me two days to get hold of her and she said I needed to make an appointment with her so that puts us at 1/2/07.
I have an appointment on 1/2/07 at 8:30 AM for her to complete the paperwork to authorize WC to authorize Dr. Auerbach’s office to make the appointment.
So now that this is in progress and to avoid further delay, I called Dr. Auerbach’s office to set up the appointment and they ABSOLUTELY refused to schedule me until they had the paperwork from WC first. Absolutely, given all my reassurances that this would be in place before I appeared in front of the doctor.
This is discrimination.
I have my own insurance, which is now no longer accessible to me since (as Dr. Auerbach’s office informed me) it’s against the law for them to bill my insurance for a work-related injury. Apparently being injured at work now presents new and special barriers to receiving desperately-needed medical care.
I begged and begged and begged them to make the appointment, assuring them that now that the process in place I would cancel at the first sign that WC wouldn’t authorize. Dr. Auerbach was totally available as of 1/4 and the day was wide open so it’s not as if he’s swamped with patients and I would be bumping someone else.
So now apparently work-related injuries put people in a special class of suffering human beings who can’t make doctor’s appointment without the authorization of a bureaucracy festooned with red tape strategically placed to delay and hinder the medical care that they so desperately need.
Excellent, Governator! Well done! Your corporate sponsors must be showering you with campaign contributions for dismantling what little was left of worker’s rights and protections in California.
What a pain in the neck! Hope you get in soon and get that taken care of.
Our stupid dental insurance (glad to have it though) is so bad about paying that I can’t get in to a dentist until we are “on the monthly list” for that specific location. If the list hasn’t come out yet for that month, even if are in horrible pain, you’re completely out of luck. They will not see you.
Some dental insurance! That is horrible. Things just seem to keep getting worse in our tragic so-called health care system.
Gross and disgusting! Between WC and dental insurance UGH. Josh’s new dentist doesn’t even bill insurance. I have to pay upfront and then bill for reimbursement, he does things this way and doesn’t even have an opening in his scheduling because I guess he’s good at what he does. Obviously though he’s sick of being jerked around by insurance companies.
agh!!! Frustrating is right! I wish there was some way to get the masses to protest against our tragic so-called medical system. It just keeps getting worse and worse and people seem to accept that it has to be that way. I kept my dental plan when I retired from UCLA since it’s a good plan… at least so far. My son is still covered too since when I retired he was classes as an “adult dependent relative” and he is still living at home.
Sounds like you are trapped in the shift the payment game. Everyone wants to make sure that the costs go to someone else. I think the doctor is simply avoiding get caught holding the bag.
This is what happens when medicine is profit making. The insurance end takes over and they run the show. My mother, a life-long Republican, is facing a similar problem, now that she is on Medicare. The little boutique hospital in Dallas where she use to go for medical attention will no longer see her. I don’t care if we have the best doctors and hospitals in the world (that’s another argument), it doesn’t matter as long as we have this lousy insurance system driving it.
Was in the same boat when my traumatic brain injiry occurred. Fifteen years later and after traumatic brain injury (tbi) rehab, I still only have roughly 90-95% use of my right arm due to nerve damage from the brain injury. After the traumatic brain injury, I had about 50% use of my right arm and was in EXTREME, CONSTANT pain, which was why my PT was approved. However, the tbi rehab was not. I had to sue to get that approved/paid for and the attorney fees were hefty.
Not new–that’s been the case since way before 1991.
Two days is quick. Getting approval for a referral from your own doctor to a specialist is SOP for WC claims.
Like I said earlier, not new. I find it ironic that no one ever complaints about WC until it happens to them. Welcome to the club.
Not necessarily. There is a LOT of fraud involved in WC claims. As a result, WC carriers assume fraud until proven otherwise. (“Oh my aching back–I can’t work.”) Good luck w/an injury that doesn’t show up on a diagnostic. (In 1991, I believe that the technology for a PET scan was still on the drawing board, if even that. My diagnostics were contradictory.)
Please explain to me what is so unreasonable about filling out required paperwork.
for his work-related physical: either go to the work-approved clinic or have our personal physician perform it — but if he goes the personal physician route, we’ll have to pay out of pocket. But after months of the run-around between the two we’ll eat the cost and have Dr. S. do it; the reduced stress which is probably what’s kept his blood pressure up will be worth it.
And thanks to the union, employees can specify their personal physician for treatment of work-related injuries, and they’ll be covered under workman’s-comp; as soon as he gets rehired he’s going to do the paperwork.
Yes, there’s a lot of fraud in WC cases — I’ve heard the horror stories from the spouse and many of his colleagues. But there needs to be a way where companies can crack down on those who abuse the system, while at the same time making things as easy as possible for those who truly are in need…
And may the Deity-Of-Your-Choice protect you should you have an illness that gets classified “mental”. If that happens, take all the normal hassles and triple ’em, then take the normal payments and cut ’em in half.