Injured worker’s weekly pay cut off based on biased pain doctor’s report


In this sickening story an injured worker who was diagnosed with Chronic regional Pain Syndrome (CRPS)/aka Reflex Sympathetic Dystrophy (RSD) following bilateral carpal tunnel surgery had her workcover claim suspended after attending a pain clinic, where the pain doctor basically did not even examine the injured worker but went on to write a report to workcover that s/he does not suffer from CRPS)/RSD.

Injured worker’s workcover cut off based on biased pain doctor’s report

The injured worker’s story

I suffered at work from ironing for about 4-5 hours a day , I was a private housekeeper for one couple, and I did everything from cleaning floor to ceiling doors cleaning balconies bed making shopping cleaning bathrooms washing ironing.  Everything needed to look after a massive 5 bedroom penthouse. I worked 45 hours per week.

Over time my wrists started getting really sore and my thumbs also.

As soon as I started complaining to my employer about my pain and ever increasing workload , the nasty employer appeared and bullying from her and her assistant started.

It got to the point over 4 years my hands felt like they were on fire. I ended up having bilateral carpel tunnel syndrome. I went on workcover and had both hands operated on at once.
After surgery my healing was slow and pretty soon I was in agony , after months of this I was diagnosed by my surgeon and a pain specialist with chronic regional pain syndrome.
I was advised to get legal advice which I did.  As soon as I got a lawyer everything changed.
I was advised by the workcover psychologist to go to a pain clinic at the hospital I had my surgery.

I went to  the leading doctor there who was steely and cold to me , he kept asking me about why I had a lawyer (what did this have to do with the clinic ? ) anyway he was so nasty to me he didn’t examine me just said you r waiting my time you won’t get better so we can’t help you.
He then sent a report to my doctors saying I did not have chronic regional pain syndrome and next thing I know workcover ring me on my due payday and say as of today you will no longer be paid . You are stable now you’re no longer considered as having a work related injury and are no longer covered by workcover.

Apparently after receiving the report from my pain clinic doctor who didn’t even examine me , my doctors signed letters stating I do not have CRPS and no longer needed treatment . By now I’m on 3 highly addictive pain medication and am told to just stop taking them.
So I no longer get therapy for my now useless hands. No more pain relief. I can’t put petrol in my car as I have no grip strength to squeeze the trigger to put petrol in. I can’t lift anything heavy including my own grand kids . Shopping is near impossible let alone shampooing my hair. Opening doors or jars or bottles . I am in constant pain. It seemed everyone’s opinion of me changed as soon as they all knew I had a lawyer.

I was left with no income with 5 mins notice because my pay gets put through at 1 pm it was 12.55 when I got the phone call from workcover cancelling my account. How am I supposed to work with useless hands ?

Thank you for sharing your story with us, again highlighting how workcover insurers will jump on just about anything to discontinue your weekly pay, medical treatment or your workcover claim. Whether a biased IME’s “opinion”, or, as in your case, a biased report/letter from a “pain doctor” who did not even examine you.

In addition to that, RSD/CRPS is not always easy to diagnose as it can flare up and “disappear” for days or weeks, and many doctors still do not understand the condition well. One of aworkcovervictimsdiary’s authors in fact suffers from this painful condition, and has been told, for example, by a biased IME that she did not suffer from the condition as the blue discloloration of her limb was due to being “immobilised in a sling” – WTF! Another biased, geriatric IME wrote that she did not suffer from this debilitating condition as the mottled and blue/cold limb was due to “keeping the limb dependent” (hanging next to body) – WTF. Interestingly the limb was in a sling at the time of the exam, and was blue, mottled and cold, and certainly not hanging “dependent”. On other occasions the injured worker’s limb would be of normal colour at an exam precluding the diagnosis of RSD/CRPS, only to turn a vicious purple when leaving the examination room. This condition is usually unpredictable in symptomatically (which vary) and there are also various stages of the disease.

Only specialised pain doctors are able to properly diagnose and treat this condition.

You can read much more about this painful and debilitating condition on the website

If WorkCover advise you that they intend to terminate your weekly payments, medical treatment expenses or workcover claim, you should refer the decision to the dispute resolution service in you state, i.e.  to the Accident Compensation Conciliation Service in Victoria. It is your RIGHT to appeal any decision made by your workcover insurer. You also have the right to seek a second medical opinion, paid by the insurer!

In Victoria, one of the most common methods of resolving this type of dispute is to refer the issue to the Medical Panel (via conciliation). When a matter is referred to the Medical Panel, it is often important to be in a position to demonstrate that in the absence of treatment, your condition will worsen. It can sometimes be useful to have a discussion with your treating doctor about whether you should have a brief break in your treatment, i.e. physiotherapy or pain management treatment to determine the effect of its termination on you. That way you will have evidence that ceasing you medical treatment is absurd and that it should be reinstated.

Whatever you do – please appeal the decision!

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3 Responses to “Injured worker’s weekly pay cut off based on biased pain doctor’s report”

  1. I’ve had a hip injury sustained by manually loading soil bags onto a pellet that was incorrectly placed (with only one side accessible).  Doctors took a long time to diagnose my problem, I actually worked for 8 months in pain, being told “it should go away”.  I had to resign after being declined any time off, even though I had 2 weeks owing.  I didn’t want a workcover claim, but months passed and the injury persisted.  Many specialist later, over a 4 year period, I finally get a diagnosis correctly (instead of waiting months just to hear “I don’t know”).  And now I have a referral for a surgical remedy (arthroscope).  Just before the insurance company could approve it, I receive a letter saying my claim has changed companies.  Months pass with the new company proving very difficult, eventually they send me for further independent medical exams.  My latest report states the injury was not sustained from the workplace and is due to my structure.  I have been in constant pain for over 4 years since a specific incident at work.  My specialist is extremely renowned, and knows the IME I saw, and told me I’ve simply been messed around, I’m now lost in the system.  All medical expenses are to cease next month, I haven’t been paid since 2011, I am unable to claim newstart due to my partners earnings, I’ve been rejected from disability support.  My work capacity is extremely limited, and finding a new vocation, part time and less physical,  has proved too difficult.  One of my mistakes has been saying I want to work, this allowed the IME’s to state “has the ability to return to work”.

  2. There are many things the Workover can’t legally do, yet the Claims Management does them all, because they can get away with it. Even when the process proves the Injured Workers Claim, the Insurers will look for every opportunity to deny treatment and cut off income. This is how Injured Workers end up with so-called “secondary injuries” that are excluded from their workplace injury claims.

    Where are the lawyers with any integrity in the Workover? Are there any? If there were they’d be well on the way to campaigning to have all this INJUSTICE removed from this cruel law.

  3. Also, If the workcover agent rejects the claim it should provide written notice of the rejection. They can’t just give you a quick call and cease payments!

    For example, according to the online’s claim manual (VIC):

    Unless stated otherwise, if agents suspend, terminate or alter a worker’s weekly payments it will generally only have effect:

    ·         if written notice is given

    ·         after the expiry of the required notice period.

    Workers are entitled to know the reasons for the decisions made about their weekly payments and have the right to seek internal review, conciliation or external review when they think a decision is wrong.

    Agents are to inform workers of their right to apply for conciliation or review.

    workcovervictim3 May 14, 2013 at 10:30 am