Does the workcover insurance company care about injured workers? Does your workcover case manager care about you? Most are just big mean ogres that wants to do everything they can to screw you over, and, as you’ll see, some times (read: often) their actions are so ridiculous, you have to wonder if they are really run by humans!
Workcover insurers & case managers – sometimes their actions are beyond ridiculous
We recently received an email from a really nice, honest 50-something truck driver who had never lodged a work injury claim in his whole life.
But not long ago this nice and hard working man unloaded his heavily packed truck and … he ‘felt his back pop’. He experienced excruciating pain. And what’s worse, he was about 200 hundreds kilometers away from home so he had to be admitted to a strange, more ‘rural’ hospital, without his friends or family around. He did initially try to drive himself through the pain, but it was so bad that he was worried he may end up crashing the truck, or worse, kill someone. So, he did the right thing for his own health as well as for his employer.
As the injured man lay in the hospital bed, the surgeon told him that he needed immediate, urgent surgery as the nerves (roots) in his back were badly compressed. He basically suffered from a condition known as cauda equina syndrome (CES), a condition that requires urgent surgical treatment. (People with cauda equina syndrome often are admitted to a hospital as a medical emergency. In patients with cauda equina syndrome, something compresses on the spinal nerve roots. These patients need fast treatment to prevent lasting damage leading to incontinence and possibly permanent paralysis of the legs.)
The injured worker’s surgeon told him that nothing else would relieve his pain or give him a chance for a normal recovery.
This happened on a Monday and surgery was scheduled for the Tuesday, the next day.
The injured worker called his employer who then told him to call the workcover insurance company (that Monday) in order to get approval for his surgery. Note that this injured worker did not have do this (under the legislation) as all emergency treatment does NOT require pre-approval from the workcover insurance company.
What the injured worker’s workcover case manager told him next just floored me. (Brace yourself!)
The workcover case manager basically told this critically injured worker that before he had the spinal surgery, she wanted him to find his way to his Capital City (some 200 km away) so that he could see one of their hand picked doctors for an “independent medical examination” to determine if surgery was really needed.
The truth is that the workcover insurance company (and it’s case manager) does have a right to request that you see an IME, but they can’t stop you from getting emergency treatment. But of course they (as many other workcover insurance vultures) didn’t care about that! They wanted this poor man to actually get out of the hospital bed and somehow get to the city some 200 km further to see some IME doctor. Undoubtedly, they were asking him to travel so far because the doctor they chose is a well known hired gun. If they really wanted an honest medical evaluation/assessment, they could have paid to have some local doctor (IME) go see him. But they weren’t (and often aren’t) about what makes sense or what is moral.
The disturbing news was that this most ridiculous request delayed his surgery by 2 critical days. However, the good news is that this poor injured worker did get the surgery he needed and does now appear to be on the road to recovery. But, this recovery could have been screwed up really bad by a delay! (or a denial!).
Even if there had been serious collateral damage from this surgery delay, I honestly believe that would not have concerned the workcover insurance company as long as they saved some money. It sounds cruel, but it’s the truth!
As an injured worker you need to be careful and really look out for yourself, because we can promise you that the workcover insurance company is and will not look out for you.
[Article dictated by WorkcoverVictim and manually transcibed on her behalf].