“I feel that my story should be out there stating that I have been unjustly done by both the WorkCover Insurer and the Medical panel”, writes injured worker “R”. In essence “R” suffered a back injury and a hip injury, the latter discovered some months after the accident. The insurer accepted liability for both his back and hip injury, and even paid for “R”‘s first hip surgery. However the insurance company refused liability for further hip surgery, based on both an IME and a Medical Panel opinion who indicated his hip injury was not caused by his accident at work…Go figure!
Another injured worker unjustly done over by workcover
Work Cover Injury
By injured worker “R”
My original injury was for a lower back acceptance injury which happened back in [month] 2011 at my work place. After at a later stage of having surgery to my lower back in having a Lumbar Fusion I also noticed that I injured my right hip as well, which wasn’t recorded on the Workcover Accident/Injury form as the injury didn’t get picked up until late [month] 2011 to which my back surgeon found the right hip injury as well.
As all my doctors where telling me that it was all coming from my lower back injury that I had sustained.
I had surgery to my lower back but kept having right hip soreness. I went to see an Orthopaedic Surgeon which was for my right hip and did find that I had a Labral Tear in the right hip and therefore wrote to the Workcover Insurer to get this approved for surgery to fix my problem. I was then sent to see their so called Independent Medical Examiner (IME) which said that it would be recommended that I have surgery to the right hip to fix a labral tear I had.
Now the Work Cover Insurer accepted for me to have the surgery to the right hip, which I had. Unfortunately the surgery didn’t go well and went from bad to worse in having the surgery and I then opted to have it reviewed by another surgeon who recommended for me to have a Total Hip replacement which the WorkCover Insurer didn’t want to pay for it and sent me to get reviewed by yet the same IME doctor who recommended that the first surgery didn’t seem not at all appropriate to be paid for by the Workcover Insurer and then indicated that I didn’t need to have a total hip replacement and it’s only done to old age people and that the hip wasn’t hurt at my workplace accident I had.
Now this is the same IME Doctor that accepted the first hip surgery to be done, and they opted to pay for the first surgery to the right hip.
I went to a Conciliation Conference to have the decision overturned but to no avail and therefore got sent to a Medical Panel for an Opinion.
From there the Medical Panel agreed that the right hip was not injured at my workplace accident I had. I already had the surgery to the hip to have the replacement done before going to the Medical Panel as I had no option to have the surgery as I was losing strength and dragging my right leg and getting worse by the day.
With all this that was going on I had been confined to using a Four Wheeled Walking Frame due to my injuries I had to my lower back and now my right and left hips. With the weight that I had gained this had put extra strain to my shoulders as I was using my upper body to take the weight off my back and also my hips. With that I suffered to have a Rotator Cuff Shoulder injury to my left shoulder which also requires surgery to fix the problem I have with my left shoulder.
Now in saying all this I got two Medical Reports from my Surgeon that states that my injuries are a result of my Work related injury I suffered at work and therefore I required surgeries to my right hip and left shoulder. But the Medical Panel nor the Independent Medical Examiners didn’t agree and they made sure that these injuries wasn’t a result of my work related accident I had which is totally nonsense, as we all know that they are all working with the Workcover Insurance Companies and write what the Workcover Insurance companies want to hear.
Why did the WorkCover Insurer accept the first surgery to the right hip as I received an accepted letter by the Insurer to have the first surgery to the hip, which to me is saying that they are accepting the right hip as part of my work related injury and now not willing to accept the hip replacement surgery?
I assumed that if the WorkCover Insurer accepted the first surgery to have the labral tear fixed and now because I needed the hip replacement not willing to accept this now.
I already had the surgery as I needed it and my lawyer told me to go ahead and have the surgery as we were thinking that it was going to get accepted at the Medical Panel but it wasn’t to be.
I feel that I can go somewhere to get this dealt by and over turned by someone even though I went through the Medical Panel.