Once you get past the fact that you have had a devastating on the job injury and that you are going to be out of work for a long time, you then have to face dealing with Workman’s Comp. Even if they give you almost everything you need medically, the amount of time you spend making sure that you get your weekly checks on time, the prescriptions filled, keep track of your millage and so on can be a bit frustrating.
AIG was the workman’s comp insurer for F & H Trucking when I fell November 19, 2008. Having been a civilian contractor in Iraq for KBR in 2003/2004, I have seen how this company has treated some of the people I know when they were injured overseas. Some they took care of but many have had the fight of their life to be medically taken care of. My driver, Robert Rowe, on the night on August 21, 2004 was shot in the knee and until earlier this year, has been fighting with AIG to get the medical care he has needed. His fight started with being sent home to heal, going back before he was totally healed for fear of loosing his job, to AIG saying he needed to prove to them that he was shot in Iraq. Still walking around with several pieces of shrapnel in his knee, he has never gotten the physical therapy ordered in his settlement and received only a “few thousand dollars”.
To date, my dealings with workman’s comp and AIG/Chartis has been rather positive. Within the first two weeks of being released from the hospital, I was contacted by Arnissa, my workman’s comp adjuster. We talked about the fact that Dr. Waguespack’s office was 2 1/2 hours away from where I lived and I requested to find a hand specialist closer to home. Arnissa informed me that workman’s comp would rather I stay with the doctor that did my surgery in the hospital and that they would pay me millage for traveling back and forth. She said she would get in touch with Angela, a workman’s comp field nurse for the New Orleans area, for my medical care in the state of Louisiana and Debbie, the field nurse for the Mississippi Gulf Coast, for a doctor to fix my broken nose.
Arnissa asked me about my wages with F & H Trucking. The compensation rate for the state of Mississippi is 2/3 the Average Weekly Wage subject to the minimum and maximum in effect on the date of injury. Two-thirds of my income from F & H Trucking was more than the $398.93 maximum a week allowed for injuries in November 2008 and the millage pay was $0.585 per mile. This was a drastic cut in income for me. Arnissa got my mailing address and said she would send me the forms to keep track and get payment for all my millage.
Angela met me at my first appointment with Dr Waguespack two weeks after my release from the hospital. She sat in on my visit with the doctor, took notes, and told me to let her know if I needed anything. Even though it took me about an hour to bathe myself, I could not wash my hair and I needed help at home with personal hygiene at the very least. She said that she would get in touch with Debbie to get a Home Health Care Nurse in to help me a couple times a week.
It took about 2 weeks for my Workman’s Comp checks to get started. For the most part they have come every week, but once in a while they will be a week late. So far AIG/Chartis has not missed a week, but the inconsistency that the checks arrive can be a bit frustrating. For a few months they arrived at the house on Thursdays, then they started arriving on Tuesdays. Then, in the last few months, they have arrived any where from Tuesday to Friday and a couple of times not until the following Monday.
Getting millage pay is a bit complicated. I run the route on Google Maps or Map Quest to get the millage, they do not pay actual miles. I have to keep up with every time I go to the doctor. The form asks for the date, address of my house and the doctor’s office, what was the purpose of the visit and how many miles it was round trip. In the beginning, keeping track of all that was not a big deal other than I could not write, I had to get my Dad to fill out the form. I don’t sent this off every month, I usually wait till the amount of reimbursement is up around $700 to $800. Once I started Occupational Therapy (OT), it was a lot to keep up with. In stead of trying to write out every day that I went to OT, I would get the rehab center to write out a list of dates of visits and attach that to the millage form from AIG/Chartis. Once I mailed that form I am supposed to get the reimbursement check in 30 days. I have yet to get one in that amount of time, it usually takes about 45 days and I have to call Arnissa and get a bit nasty in the message I leave on her voice mail to get it then.
One of the biggest frustrations I have is getting Arnissa to return my phone calls in a timely manner. Usually it will take 2 or 3 voice messages left before she will call be back. Angela is almost as bad. I send her text messages through my cell phone because it is easier to get her to answer them, than it is to get her on the phone, but it can still take her 24 hours or more to answer those. Debbie is real good about answering my calls or text messages in a timely manner.
Getting prescriptions filled in the beginning was a bit of a pain. The doctor would write the prescription, I would take it to the pharmacy and it would be about 3 days before I could pick it up. It took the pharmacy that long to get approval from AIG/Chartis. This was the process for refills as well. A few months back, without any notice, AIG/Chartis switched to PMSI to handle prescriptions. I received a phone call out of the blue telling me who they were and what they were doing. They mailed my refills and 2 weeks before I was due for another refill, I would get an automated phone call asking me if I wanted to reorder the prescription. This was good. Now I no longer had to drive into town, drop off the prescription, wait 3 days to get approval and drive back into town to get my prescriptions refilled, they would be delivered through the mail to the house.
That was great till I messed up on reordering once or had a new prescription. There is no option to delay reordering the medication. You either reorder, or you cancel. A few months agoI still had plenty of the Vicodin and didn’t need to reorder so I choose to cancel the order at that time. The next time I saw Dr Waguespack, she gave me a new prescription for Celebrex along with a few samples of the drug to tide me over till I got my prescription filled. When I got home I called PMSI, punched buttons till I got a real person and told her I had a new prescription, and asked how do I get it filled. I was told to “put it in the mail”! When I told her that I needed the medication sooner than that, she told me to have the doctor cancel the written prescription, and fax them a new one, ordering the Celebrex. I asked if they could call Dr Waguespack’s office and get it, I was told “no, they could not”. This frustrated me and I hung up the phone. I sent Angela a text message telling her the problem with getting the prescription filled. The next day I got a text from her saying she would get a copy of it from Dr Waguespack and send it to PMSI for me. It was two weeks before I got the first bottle of Celebrex. Celeberex is a medication that you have to take for 2 weeks before it has any effect. So the samples Dr Waguespack had given me and that I had used up a week before I received the prescription in the mail, were of no use.
At that last doctor appointment I still had some of the Vicodin and didn’t get a new prescription for it. A month later when I did need to reorder, I jumped through the hoops of the automated system but I could not figure out to reorder them. Again, I sent Angela a text message. When she didn’t text me back within 24 hours, I called Dr Waguespack’s office, told them what I needed and asked if they could help. They told me to get Angela to come get the prescription for me and fax it in. I sent Angela another text message and tried to call her. No answer. I needed the pain medication so I called PMSI again. I went through the automated system again till I got a live person. I explained the situation. She told me I was talking to the wrong department, but that she would help me anyway. She got Dr Waguespack’s phone number from me and said that they would have the medication to me in about 2 weeks. Angela finally sent me a text message back that afternoon saying she would talk to the doctor’s office. I text her back informing her that I had gotten it taken care of myself.
Now, when PMSI’s automated system calls saying it is time to reorder my medication, I just reorder it weather I really need it yet or not. Since I try not to take the Vicodin unless the pain in my wrists get to the point that I just can’t stand it any more, I am building a rather nice stockpile of Vicodin. Since medication will keep for an extended amount of time, I guess this will be less I have to pay for out of my own pocket, later on, when they cut me off.
In my last post about dealing with Workman’s Comp, two weeks after seeing Dr George, I was still waiting for Arnissa to approve the work hardening therapy. Again, I took matters into my own hands and called Arnissa and left a rather tart message. Amazingly, she called me back that same day. She told me that she had just gotten the orders a few days before and had approved them. I thanked her for calling me back so quick this time and called the Rehab Center to set up my first session.
At the date of writing this story, I have been to 7 sessions, a little over 2 weeks , of the ordered 8 weeks and will not be going to any more. The mission of work hardening is to work a patient up from 2 hours of therapy, 3 times a week to 8 hours of therapy each visit. They take a description of what your job physically requires and your therapy is based on that. Even though 3 doctors have told me that with the injuries I sustained to both my wrists I will never pull a flatbed and never drive a truck again, my therapist has to go by that guideline and try to get me to where I can do the job I was doing when I was injured. I have had pain with every therapy session. Some of the pain was muscle pain from a year of non-use, but some was injury pain. My last therapy session was to be for 4 hours. I was sent home after just 1 hour due to the pain in my wrists. The head of the therapy department told me to call my doctor and see what she wanted to do, either not be so aggressive, or stop the therapy. Dr Waguespack’s assistant called me that afternoon and told me that therapy should not hurt like that and I should stop. I have now exhausted every means to get more use out of my wrists.
I have an appointment with Dr Waguespack on January 18, 2010. At that time I will give her the letter from the Rehab Center. It states that I could only lift 10lbs instead of the 20lbs that we thought I could do before and all other limitations they have seen though the work hardening therapy. At that time Dr Waguespack should give me a disability rating with my limitations and we will move to the settlement phase. With this milestone comes a whole other set of problems. AIG/Chartis could cut off my weekly checks, no longer send me medication, and refuse to pay for the doctor visits I will need for future pain management.
The Mississippi Workers’ Compensation Commission has a web site that gives all the information a person could need about the laws and regulations for the state. After spending hours and hours reading the laws governing Workman’s Comp for the state of Mississippi, I have hired a Workman’s Comp Attorney. I know I have had a much easier time dealing with Workman’s Comp and AIG/Chartis than many others have had, but the laws are very hard to decode and understand without some legal knowledge. In the next installment I will try to decode the law a little so you can understand what I am facing in trying to get a settlement out of AIG/Chartis on my Workman’s Comp case. It is very possible that even with the very low limitations on the use of my wrists, I could get less than $50,000. That settlement would include future medical visits due to this injury, future medications, and a lifetime compensation for the disability.