This entry is part 6 in an ongoing series of semi-irregular posts detailing my frustration with Workers Compensation and the wonderful world of rotator cuff surgery. In case you haven't been keeping up: Part 1
| Part 2
| Part 3
| Part 4
| Part 5
| Part 6
(YOU ARE HERE) | Part 7
| Part 8
| Part 9
| Part 10
| Part 11
You knew there was going to be another part, didn't you? I certainly did. Because why should anything be over when it's over?
So, first things first: Story time!( This is long, but it does at least tangentially relate to the rest of the post. So you should probably click it. )
Why did I tell that story? It will soon become obvious.
So. Back in October, we left our intrepid hero (me) with physical therapy appointments, finally. After a long, drawn out battle. I had my first six PT appointments. They seemed to help. I had a lot of exercises to do, and they all hurt like heck. But I did them.
And after six visits, it still hurt like heck, but there was a bit more mobility. But Some Company had approved "eight to ten," so we still had a little wiggle room. So we scheduled six more, and I went back to my doctor to get another order for PT, which he gladly gave me.
Fast forward to the tenth PT visit. Melissa told me that Some Company had told them they weren't paying for any more visits after the sixth one, because they had only approved eight to ten. (Don't think about this too long. I did, and I lost 7 IQ points, permanently. But I still remember Gilligan's Island episodes. Can't ever
get rid of something that doesn't matter. But I digress.)
I pointed out that they had said "eight to ten," and that six is not equal to either eight or ten, based on my many years of mathematics. I mean, I'm not a nuclear physicist, but this is fairly easy math. But apparently not for Some Company.
We cancelled my last two appointments until they could straighten everything out, and Melissa said they had also sent in my doctor's request for six more.
I spoke to Jane in HR about the whole thing, and she once again got everyone involved, and Some Company said that they would, indeed, pay for ten full visits. Once we explained the math to them. And I don't even mean that facetiously. Jane had to actually say, "You said 'eight to ten,' and he had six, after which you refused to pay for any more. Six is not 'eight to ten.' He's had four more, and by your own agreement, you should pay for them."
But still nothing about the approval for the remaining ones my doctor felt were needed.
Then I got The Letter. <ominous chord>
In The Letter <ominous chord>, I was informed that a doctor I have never met in my life reviewed my case and decided that since I "had returned to work at full duty" (which I never left, I might add), further therapy was "not medically necessary," and that they would not
be covering the last two visits, nor would they be covering any subsequent visits. Further, my case was closed, and that was the end of it, as far as Some Company was concerned.
I . . . might have exploded. All over anyone in audible distance. I . . . might have used some of those words I didn't use in 8th grade. I might, indeed, have invented a few new ones. And I might have marched, letter in hand, to HR.
The next email from HR — after Jane talked with Some Company and others — was that Some Company would
be paying for the final two visits. They I would request my PT for a referral to an orthopedist. And we would go from there.
So, I asked the PT for a referral.
Crickets. When I finally got hold of them again (another week went by because I thought maybe they were mailing it), they said they didn't do that, and that Melissa was no longer employed there, and who was I again? I would have to talk with my regular doctor.
I went a few rounds on the phone with his office staff, as well, and basically found out that I can't trust his office staff to give him messages.
Finally, in frustration, I contacted HR again and got them to send me a list of 'approved' orthopedists. I picked one and made my own damned appointment.
Which was yesterday at 3 pm.
The first question he asked me was, "Has your elbow been x-rayed?" I said it had not. He made some remark under his breath that I didn't quite catch, and then sent me to get an x-ray.
They x-rayed my elbow. And developed the film. And put it up on the light box.
And from all the way across the goddamned room
, I could see . . . something.
He called me closer. "Do you see this little dark line right here?" He pointed. I said I did. "That is the sign of a healed compression fracture. That's why your elbow has been hurting."
He said that fractures like this "always heal" and that the treatment is basically to keep using it as normal so you get full movement once it heals. But it would continue to hurt for 3 to 12 months. I assured him that I had been using the arm as normally as I could given the pain. He said that was good.
Well, that's nice to know.
He then wanted to schedule me for an MRI of my shoulder. Which meant I had to call Some Woman at Some Company and get that approved. I called, and it went directly to her voice mail.
Much amaze. So expect. Wow. I didn't even bother leaving a message.
A few minutes later, as I was checking out and the receptionist was getting ready to call Some Woman themselves, my cell phone rang. It was Some Woman! OMG! First call I've ever gotten back!
Alas, I was so shocked that she had called me
that I didn't manage to answer. But we knew she was at her desk. So the receptionist ("Martha") called her and got on the phone with her
The conversation, edited to remove the back-and-forth between me and the receptionist, went something like this:
Receptionist: Hi, this is Martha at Orthopedists R Us. I have one of your clients in my office, and we need to schedule an MRI for him. . . . [Kaa] . . . his right shoulder. . . . He made the appointment himself; there was no referral. . . . He says he got our name from a list of approved medical professionals from his workers comp representative at work. . . . Martha . . . Orthopedists R Us. . . . [Kaa] . . . his right shoulder . . .
And it went on. Then, Some Woman apparently said she'd have to call back and let them know where to send me for the MRI.
Martha said she would let me know if and when Some Woman called her back. [I should note here, for the record, that the doctor and the nurse and the receptionist were all scandalized when I told them about the sixty days Some Company made me wait before getting PT. Apparently, that is not
normal. My mishandling of the initial doctor visit is probably what it all stems from. Had I gone to an orthopedist from the get-go . . . but hindsight is 20/20.]
That was yesterday at 4 pm.
Another part of Jane's email from work says this: "Katie (the My Company workers comp program manager) will oversee / ensure that Some Woman is facilitating the approval in a timely manner."
What that said to me was that someone is now watching over Some Company and Some Woman in particular, and that I may finally get some reaction from them on a timely enough basis to do something about.
What? Why are you laughing? That's not very polite.