Tag Archives: diary entries

When injury is used as vengeance

There is no doubt that many injured workers are mistreated. They do not receive approval for diagnostic tests (i.e.MRI, CT etc.), treatment is intentionally delayed by the workcover insurance company, procedures are denied or cancelled, prescriptions are rebutted and financial compensation (i.e. weekly payments, reimbursements etc.) is not sent.
The injured worker, in a dependent position, grows resentful and also feels powerless…

When injury is used as vengeance

After months of enduring these frustrations, the injured worker (most often male) feels that the only alternative is “to get them like they have been getting me.” That is, they simply refuse to recover, refuse to consistently comply with prescribed or suggested treatment modalities, refuse to settle and refuse to “move on” and “let go”.

The injured worker -wrongly- feels  that this passive-aggression (at times active-aggression!)  will balance the scales and make others suffer as he feels he has.

This type of injured worker often sees the “system” simply as his workcover insurer, his employer, his case manager and his treating doctor(s).  What’s more, after a while, the “system” will include friends, family members and even websites and blogs! The injured worker can only appreciate his own plight and does not see (nor particularly care) about administrative, clerical or “opinion”-related “problems”.

Often, however, there is an acceptance that passive-aggression has become the injured worker’s sole recourse…and many people close to such an injured worker will just “put up” with the constant aggression, until it becomes unbearable! The passive aggression escalates, the injured worker is so resentful and vengeful that he (she) starts taking it out on friends and family, who in his (her) opinion are somehow “pro-workcover” because they don’t always agree 200% with his/her extreme opinions, and whilst they’re only trying to help the injured person in their recovery.

Often the most important questions or findings is “what are the injured worker’s grievances that occurred after injury” rather than the seeking of obscure reasons for continued (often excessive) complaints.

Educating the injured worker as to why delays occur is usually in-effective. Equally ineffective is trying to rationalise your opinion an actions as it will further instigate and antagonise him/her.

All that can be done , or is left, is base administrative decisions, judgements, opinions and even clinical decisions solely on objective findings.

Underlying personality disorder and pain

While pain and depression are common and expected among injured workers and can be managed with appropriate pain clinic and pain specialist consultation, there are some injured workers who suffer from an underlying,  severe character pathology (aka. personality disorders). Those represent an extreme challenge.

A study (Burton et al., 1997), found that up to 25% of the patients in a traditional multidisciplinary pain clinical have symptoms of borderline personality disorder (26% histrionic personality disorder and 22%  of narcissistic personality disorder)
Another study (Polatin et al, 1993) reports that up to 5% of the injured workers in these settings are antisocial, having a pervasive pattern of disregard for, and violation of, the rights of others. Deceit, violence and a pattern of job, marital and legal problems are also often typical of this group.  These are referred to as “Cluster B” or “dramatic” personality disorders.

Most of us dread interaction with borderline injured workers who tend to be impulsive, have unregulated emotions, and are unstable in their relationships with family, friends, lawyers, and even their medical practitioners. Histrionic people are attention seeking, markedly overly emotional and melodramatic. Narcissistic people lack empathy for those around them, have endless need for attention and admiration and see themselves as special with a strong sense of entitlement.

Psychological methods of coping – which were barely adequate prior to injury- now become grossly maladaptive in the presence of pain and the attention provided by others, including friend, family and support “blogs” / “websites”.

Compliance is spotty at best. Equally as problematic is that dramatic personality disorders are disruptive and damaging to  therapeutic settings. The antisocial has a continuous potential for violence, and the histrionic’s aggressive demand for attention can never be adequately met. The narcissist needs to remain disabled to generate attention and will fly into a rage when they are forced to comply with rules (that they insist do not apply to them). The bordeline’s create an atmosphere of chaotic moods and demand the “impossible” to attempt to achieve emotional stability.

These type personalities will not only disrupt other injured people , but they will also fatigue and deplete professional and support staff, friends, family and support groups.

The key will always be to recognise these personality disturbances as having existed for almost all of the patient’s life and not mislabel them as the result of pain itself.

Why are we writing this?

Being heavily involved with injured workers, incl. support “group”, blog, forum etc., we have come across a (very) few injured workers who have turned their anger, rage, frustration and ‘vengeance’ against us! Initially we could not understand why any injured worker would “take it out” on us, on a blog, support group and/or the blog administrators; especially not after having gone to great lengths to try and help the injured person.

It is only later, through discussions with our own psychologists and psychiatrists, that the above picture emerged. Meaning that there are injured people with underlying personality disorder.

We believe that there are some carers, friends, spouses, partners, relatives, moms, dads, GPs and even other injured workers out there that relentlessly “cop it” from such unhappy injured workers, no matter what they do or say. This can cause feelings of hurt, defeat, abuse, depression, guilt, inadequacy in those who try so hard to offer support. We therefore believe it is important to be aware that some injured workers do, with no fault of theirs, suffer from underlying problems, including personality disorders and that those ought to be identified and treated.

One such person emailed us the following (excerpts)

An injured worker posted what we believed was inappropriate “advice” and we said so; in response we received:

“By [our blog] providing false hope, chin up, keep going, advice, it just digs them further in the hole that is inescapable”

Following our decision to hide some forum posts from the preying eyes of workcover et.al (posts only viewable by those who register, registration is instant and free).

“… regardless of how much you enable people to feel better through having a support group, the end result will not be people getting fairer outcomes, rather, the game will evolve to take advantage of the fact you’re organising to play their stupid administrative games, and the people who now don’t join in the support group get even further hung out to dry… ”

Is that how the forums are gonna run, anyone who doesn’t say what you want them to say, just boot them off?  I thought it was workcover who acted like that….”

“You’ve got a nice little support group going, and they’re busy attacking me for having a problem with politics, and voicing that opinion.  Meanwhile I get stuck with no support from anyone.  Toughen up, get back to work ya lazy prick….”

Following numerous comments from injured workers that this person’s advice was inappropriate:

” I’m talking politics, and people are misinterpreting my words as personal attacks or someshit.  The socially-correct thing for me to do is dilute what I say down so I don’t say anything, but fuck that shit…”

“No need for a lynchmob, or threats of censorship”

 

Personality Disorders explained

Personality is merely a term used to describe the sum total of characteristics that make us each unique. We each have a personality which is our style of interacting with our world.

There are, however, “personality disorders” in which the individual has developed a pattern of maladaptive ways of interacting that results in some degree of occupational and social impairment.

People with a personality disorder do not feel that they necessarily have a problem. They do feel that there is something wrong with everyone else.

The individual may, for example, have a paranoid personality disorder. Such individuals, when injured, expect the worst and look for it continually. They hire a lawyer to protect themselves and end up not trusting the lawyer. They anticipate betrayal from family, friends and doctors.

They live in a world where they are defending themselves against others whom they perceive undermines their authority. They attribute to others the very characteristics that actually may define themselves. They believe that others are scheming against them. They feel that they will have to defend themselves, and they cannot readily relinquish control to others.

Communicating with those type of personalities can be very difficult; most say to peep conversations brief and always directed toward the point/topic. Do not respond to accusations because defending yourself will have no positive impact. Anticipate that you will not be trusted no matter what you do (and be prepared to document all of your actions).

Be certain that others are aware of this pattern of behaviour so that he/she can assure that s/he does not fall prey to the same chaotic interactions.

Be aware that you will not be successful in changing a personality disorder, but you can learn to anticipate how someone with, for example, a paranoid personality disorder does respond.

And, by the way, a personality disorder cannot be caused by injury.

Personality disorders are interesting, but since they cannot arise from injury, why would we care if an injured worker has one?

The interest is in attempting to return a patient to baseline functioning…how they were before they were injured, says the psychiatrist.

If they have a personality disorder of which you are unaware, your efforts to return them to what you consider to be “normal” will ultimately fail.

Thus, if they are pathologically dependent or pathologically avoidant by virtue of a developmental personality disorder, and you are unaware of this, you can exhaust yourself in an attempt to restore them to a level of functioning which they have never had.

Additionally, if they have even more dysfunctional personality disorders such as paranoid, or borderline, much of what you believe is arising from injury is actually the way they have (poorly) functioned for much, if not all, of their adult lives.

Think of personality as a foundation upon which our lives are built. A personality disorder can then be considered a weak foundation for the development of adequate social and occupational functioning.

Another Example

An injured worker is verbally abusive and physically threatening to several people. He appears to have no boundaries. It is highly probable is that he suffers from longstanding Intermittent “Explosive Disorder”. This could be determined by determining if he has had recurrent physical confrontations and destruction of property when provoked. Such individuals often have a history of domestic violence recurrently in their lives.

While depressed people can be irritable and overly responsive, and they may even launch into brief verbal tirades for which they feel guilt and remorse, those with intermittent explosive disorder,for example, simply do not tolerate disappointment or frustration.

“I have seen this occur when a patient is offered a settlement amount that was not what he expected” says the psychiatrist we interviewed.

Some injured people will attempt to cover their explosiveness and assaultive behaviors by stating “I was depressed” to avoid responsibility. Also, they may quickly learn that to try to claim it as due from injury may increase the perceived financial value of their claim.

Conclusion: sometimes, no matter what you try and do to help your injured friend, spouse, family member, colleague etc, nothing will work. Sometimes you may find that YOU are the one being abused, attacked and ‘mentally assaulted” for trying to help. It is NOT your fault. Don’t blame yourself, don’t feel guilty. Chances are that your injured friend suffers from a personality disorder- aggravated by his/her injury.

[Post entered by w/C Victim3 on behalf of W/C Victim]

Shortlink: http://workcovervictimsdiary.com/?p=5273

 

 

2011 for a workcover victims diary

A workcovervictimsdiary.com is wishing all its readers a healthy or healthier, prosperous or more viable New Year!

╭━━━╮╭━━━╮┈┏┓╭━━━╮ ┗━━╮┃┃╭━╮┃┏╯┃┗━━╮┃happy ╭━━╯┃┃┃┈┃┃┗┓┃╭━━╯┃  new ┃╭━━╯┃┃┈┃┃┈┃┃┃╭━━╯year ┃┗━━┓┃╰━╯┃┈┃┃┃┗━━┓ ┗━━━┛╰━━━╯┈┗┛┗━━ to all injured workers!

The year 2011 was a fairly decent year for me – relatively speaking, that is. Let us count the ways:

  • I did not hear of any new law(s) that took away more rights of injured workers;
  • I only had to write 6 or 7 complaint letters
  • I only had to attend the ACCS for concilliation on two matters
  • My requested surgery was only delayed by two months
  • My 3d Medical Panel assessment for permanent impairment rating was only suspended
  • I only had to increase my anti-depressive medication
  • I only had to increase my pain medication
  • I received help from a very good pain specialist
  • I only have severe end stage osteoarthritis and complete rotator cuff failure and only need a total reverse shoulder prosthesis, it’s not like I am dying or anything
  • I only had a heart attack and serious cardiac failure during my last, recent surgery but am recovering well
  • I finally started this blog (on 19 August 2011) and it’s going very well!
  • and I adopted Bobby, my boy eclectus parrot

Still, I hope that 2012 will be a better year for me, and – undoubtedly- for all of you (injured workers) too!

Goolgle Analytics for a workcovervictimsdiary.com

Analytics for the past month (30 November-30 December 2011)

The blog continues to increase its popularity, with 672 visitors, 6050 page views and 32% new visits this month alone! The Twitter followers have also dramatically increased and we have now over 500 followers! Not bad, considering that the blog was started on 19 August of this year!

View full report for November here

Analytics of workcovervictimsdiary.com since its inception (19 August-31 December 2011)

Yep, 2809 visitors, a whopping 29374 page views and an average of 12:48 minutes on the site per visit -amazing!

View full, detailed report for 19 August to 31 December here

Hottest content

 

Thank you all for being part of the journey!!! Happy New Year!!!

 

To all who work for workcover insurance companies….

2012

Given that a new fresh year is about to start, how about some fresh new ideas for improvements, inclusions to this blog? What would you like to see on this blog?

So far I am planning the following:

  • some serious national petitions and letters which will be powered on change.org and disseminated via twitter and facebook + begging for your signature in a link under each post (!)
  • more visibility of the blog, including through work behind the scenes on search engine optimisation and, with a bit of luck, through the media (we’re working on it)
  • sharing of more real stories and “paper” evidence (documents)
  • …. [here is where you can add your ideas/wishes]

What would you like to see on this blog? Don’t be shy! All and any ideas welcome!

Xchanging denies taxi travel based on the misuse of selective medical information

Well, well, I had just about recovered from smashing my head in with that baseball bat regarding the most unpleasant dealings with my complaint raising issue with WorkSafe, when I – today – miraculously – received – at last (!) – a very nauseating rejection letter from Xchanging, denying me taxi transport to and from medical appointments.

Xchanging’s rejection letter is dated 24 November. This means that either WorkSafe has in fact had a little chat with Xchanging regarding this matter (following my complaint of 24 November), either that my personal letter to my case manager dated 21 November has had effect (for once), either that my complaint to Xchanging’s Customer Service of 24 November – and which has not even had the courtesy to send me my requested read-receipt request (email) and/or acknowledgement that they have in fact received my complaint- has gone into panic mode and quickly “internally’ addressed the need for my Case Manager to quickly send me the well overdue rejection or acceptation letter, so that they can address my complaint in their usual pathetic manner along the lines “we notice that the matter [taxi travel] has been addressed – implying why the f*ck I am complaining for”, right?!

Anyway…. Let’s move on to the really disgusting bits here.

Request for taxi travel to and from medical appointments

The medical request taxi travel to and from medical appointments originated from my treating GP. He requested taxi travel in July this year (bloody half a year ago) based on “a grossly painful and unstable shoulder” and based on a “change in circumstance” which was well explained. This is about the fact that my defacto not only works 70 hours or more per week, but he also started traveling a lot interstate on business. So defacto is no longer able to play taxi for me every other day or so, which is quite understandable. On average defacto is interstate 3 days per week, sometimes 5 days a week – which literally means that I am stuck at home on my own, with no transport and, also with no assistance in terms of house hold and personal hygiene help. It might sound disgusting to you, but during those periods I cannot even shower nor change my tops, and let’s not even mention the rest.

Whilst I still somehow need to get around for grocery shopping, pharmacy pick up of medication and similar trivial matters, I do have many regular medical appointments. On average two a week, sometimes more. I still need to get to those, right. Public transport? That’s a big issue for me, not only because I live in the sticks. There is only 1 bus (at 15 min walk or so) which only goes to a big shopping centre. From there it’s another bus or a walk to a tram. From there it’s a walk to the train station, then another tram, another walk etc. See what I mean. Also public transport has been proven dangerous for me, not only is the inherent jarring and jolting “a great source of pain” for me (as an IME wrote), but on a few occasions that I have attempted to take public transport I have been bumped into by busy people (slightly and not so gently!); on other occasions I have been in situations were there were no seats available and I had to somehow try to ‘hang on’ not to fall… You can just imagine how that feels when your arm is literally hanging out of its socket.

Usual run around from Xchanging

Following my GP’s request for taxi travel, my case manager of course started emailing me let me know that “my GP had actually not provided clinical justification… [by writing that I had a grossly painful and unstable shoulder] and there is nothing to say that I can’t drive a car or take public transport”.

Email received on 2 August from Xchanging

 

Hi [my name],
As Worksafe has strict guidelines now with regards to provision of taxis we may need to arrange a further physical assessment to address any further requests for taxis other than the approval we have  given for the 4.8.11.
The requests provided by the GP were not really sufficient and he hasn’t actually provided clinical justification for providing taxi travel.
There is nothing to say why you couldn’t still travel on public transport to appointments.
regards

So I had to go back to my GP (at Xchanging’s cost) for another consultation just to get another letter which explained in BABY language why I need taxi travel. The letter was along the lines of … need taxi travel because has grossly unstable shoulder, the arm hanging out of its socket, which is extremely painful…can’t obviously drive a car, which would be dangerous…is taking an illegal amount of narcotic…has not been medically allowed to drive for at least 2 years…public transport would risk further injury because of bumping, etc etc. I kid you not!

Of course this was not sufficient evidence for Xchanging, they rang my treating surgeon (who told me all about it) and apparently tried to sent him a 2 page long  fax “questionnaire” about the taxi travel. My surgeon told me that he had personally spoken to my case manager and that she was ‘quite something’.

On 8 August Xchanging decided to send me to an IME psychiatrist and the IME is specifically asked if I need to travel by taxi or not in relation to my work-related condition. The IME supports taxi travel.

REPORT:

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On 9 August I receive this email from Xchanging

We have faxed a request to your treating surgeon to provide information with regards to taxi travel and are waiting on a response.
The issue with taxi travel will be addressed in due course.
We are currently arranging a further physical assessment considering it has been 12 months since your last assessment.
We will contact you regarding your availability.
On 11 August I get this from Xchanging

To date I have not received a response from [your surgeon]

WTF? Give the man a f*cking chance to respond, will ya. (I know that he personally spoke to the case manager around this date)

However on 17 August (after they spoke with my surgeon) Xchanging emailed me this:

[my name], you will need to advise me how long the appointment will be for at [facility for MRI] so I can advise the taxi company.
Could you also provide me with their address as well so there is no confusion.
We will approve this trip but this is not to assume that Xchanging is approving taxis ongoing. These will be assessed on an as needs basis.
We will make a decision [re taxi travel] once we have reviewed both the physical and psychiatric assessments.
 So, as you can clearly see, Xchanging ALLOWS me to travel by taxi and in fact have paid for quite a few trips to MRI’s, a pain specialist,to my surgeon, IME’s, bone scan etc.
On 25 August Xchanging even OFFERS me taxi travel, wow
Dear [my name],
Mr [doctor-IME] has called to advise he cannot consult on the 1.9.11 and due to the fact he was not available for some time we have arranged an appointment with Dr [doctor IME 2] on Tuesday 6.9.11 @ 10:30am.
Please advise if you require a taxi so I can advise admin to arrange.
regards
Reason for sending me IME 2
You will be sent a new letter with all Dr [IME 2] details.
He is an orthopaedic surgeon and based on all the information you have been providing Xchanging regarding your shoulder we believe it is necessary to have the shoulder assessed based on your feedback alone and my conversation with [your surgeon].
regards
Clearly, here is already PROOF that they DO NOT believe what my surgeon tells them (and what I tell them) – it was about the shoulder infection by the way and the need for further tests + surgery + need for taxi travel etc.
On 6 September I attend IME (2 – Orthopedic surgeon) as requested. The specific question was asked whether I really, really, really needed taxi travel to and from medical appointments. IME supports it BIG time!
REPORT:

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On 12 September I receive this email from Xchanging – take note – very important when you will read the rejection letter
We have not  received report from [Dr IME 2] as you only saw him on the 6.9.11.
We do not have a report from [GP] only 2 referrals dated 26.7.11 for Taxis and Home Help Services.
The last report from Surgeon – Mr [surgeon] was dated 14.2.11 and I have not received any other reports.
I do have on file a copy of MRI results dated 10.8.11 on Mr [surgeon] letterhead.
I will organize taxis today.
Regards
Interestingly, the case manager lies her socks off (you’ll see) but one such a fat lie is that she claims to have on file a copy of MRI results on my surgeon’s letterhead – shows how illiterate she is, for it was the bloody request form for the MRI, silly(!) and not the results!
On 13 September I receive another formal taxi approval via email
Dear [my name],
Please find attached a copy of your taxi approval.
Regards
On 19 September it’s official, my taxi travel is finally approved by Xchanging
Dr [IME 2 – orthopedic surgeon]  report has been received and a copy will be forwarded to you under freedom of information.
Dr [IME 2] suggests that you require taxi travel and now that we have a decision regarding transport we usually book taxis at 3 monthly periods so we will need you to identify how many trips will be required over the 3 months period, the name and address of the treaters you will be seeing.
If you could please provide this information as soon as possible so these can be organized.
Regards
A week later, folks, Xchanging DENIES me the taxi travel again, in-spite of their written approval of 19 September, and I even received a glossy ‘welcome package from the Cab company”!!!
On 27 September I receive the following email from my case manager from Xchanging
Dear [my name],
Please be advised that Xchanging is still awaiting further medical information, and I am therefore unable to approve taxi travel at this time.  On receipt of the relevant medical information, I will provide you with further advice by email.

Should you wish to contact WorkSafe to lodge a complaint about any aspect of the service that Xchanging has provided to you, you can do so via their email address which is service_division@worksafe.vic.gov.au.

Regards

And this really royally p*ssed me off because they did not give me any notice and I was literally left stranded (I was due to undergo a radio active body scan the following early morning and had nobody to take me there!!!!). Also, NO explanation was ever given to me for the reason for the “need for further medical information“. Besides, where on earth is that information supposed to come from? They sent me to two IMEs of their choice to assess the bloody taxi issue, my GP requested it, my surgeon clearly supported it (he told me so and said that he had spoken at length with my case manager)… So what the f*ck is going on here?

If that’s is not enough to drive anybody to breaking point?

The Xchanging waiting game

Since 27 September (two months ago) I have been waiting for that “additional medical information” and an outcome of said taxi travel to and from medical appointments. For those (additional) 2 months I have been STUCK without transport, I have annoyed the sh*t out of my defacto and my old neighbour (who’s 84) to get a ride here and there, and I have had to cancel a few medical appointments just because I cannot get there!

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So on 28 September I emailed my surgeon and asked him again if he would consider supporting me for taxi travel (as I thought they may ask him for more information and he may have forgotten about my case). My surgeon, as you can see, clearly writes “no worries [my name], I’ll get onto it”

I have on numerous occasions written to Xchanging to ask them to please (and not so please) enlighten me on the progress of the taxi matter. I mean 2 months waiting for additional “info” is a bit rich, or? Xchanging has remained silent until TODAY.

Xchanging denies me taxi travel – I receive a rejection letter on 25 November!

Here is the letter – you can read it for yourself and draw your own conclusions….

It’s the second page only but the letter just start with a “usual” very offensive “….Xchanging has determined that we are unable to approve the reasonable costs associated with taxi travel as it is NOT NECESSARY AND/OR REASONABLE FOR YOUR WORK RELATED CONDITION

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My seriously injured opinion about Xchanging

It is clear to me that we all know (including Xchanging) that my GP supports taxi travel, those two IMEs support it (in fact the orthopedic surgeon IME STRONGLY supports it).

That my surgeon supports it is in fact evidenced by the fact that Xchanging approved taxi travel after they had spoken to my surgeon and after they had received his “faxed questionnaire”, right?! Why would they otherwise even allow me taxi travel in the first place for many weeks?

Xchanging was then hoping that the IMEs would NOT agree with my GP and surgeon and they were praying that they would say that I really did not need to travel by taxi. That’s is why they sent me to those IME’s, right?! Also, between brackets I already had an IME report of December 2010 stating that I needed taxi travel (but obviously that did not count anymore for Xhanging). I also had been previously granted taxi travel (indefinitely) in 2006 by Allianz (see complaint letter) but when my employer changed over to these leeches I had to start the process over….

Then Xchanging decides that “nah, we’re not going to believe these IMEs now” and go on a most likely fictitious “report” from my surgeon dated “11 August” and AFTER which they decided to send me to those IME’s, right, mate… See what I am saying? Interestingly they tried their best with trying it on with the IME shrink by requesting a “follow up report”…Why a shrink? What has he gotta do we taxi travel assessments? Unless you are psychiatrically so dangerous that you have to wear a “silence-of-the-lambs” type of face mask, …

In addition and perhaps most importantly, since that said “report from my surgeon” of “11 August”, my shoulder condition has considerably deteriorated, and Xchanging knows that. For example, I was only sent for an MRI on 18 August, where it was picked up that I had ruptured tendons, that the ball of my shoulder is out of its socket upwards (end stage stuff and very serious) AND that I had suspicious looking lesions consistent with infection. Only after that MRI was I sent for blood tests, bone scan, radio active scans, all suggesting the infection and that’s also when the request was made for the surgery to take biopsies and do a debridement (this will be next week).

And before this MRI of 18 August I had NOT seen my surgeon since at least February… Hence why my GP requested the taxi travel, as I see my GP at least once a month. I only see my surgeon for SURGERY related stuff, hellooooo!

So what Xchanging is doing is either lying and making up an entire fictitious report (I have asked for a copy of said report FOI) – remember here comes the important bit from above where Xchanging clearly wrote to me that they had NO reports from my surgeon since February and they told me this on 12 September, but yet here they refer to a report of 11 August? Yeah, mate….sure…

Or, either, should everything miraculously have been an “oversight”, then why did it take 2 months for “further information” that they already had on file?

Or, either and worse, how can you explain that these leeches go the other way round – assuming this is all true — they are using OLD reports as evidence and new reports as non-evidence, how does that work? But even older evidence (IME December 2010 does not count as does my granted indefinite taxi approval since 2006 from Allianz not count).WTF.

And I have no f*cking doubt, had my surgeon supported my taxi travel (which he does but anyway), and the IME had said NO, they would of course have denied me taxi based on IME’s opinion, right.

They just CHOOSE what SUITS them, and here is THE evidence again.

I feel S-I-C-K !!!

Yeah, folks, of course I am going to appeal this crap at conciliation.

Can someone understand this?

 

Oh boy, oh boy,oh boy, bang, bang, bang, bang…..and so I am blogging at 1 AM in the morning 🙁 🙁 🙁

 

 

Complaint page 9 - click to enlarge

About WorkSafe complaints: F-off approach

Following yesterdays post about Xchanging sending the debt collectors in my neck, because those pathetic penny-pinchers have been refusing to pay for a most reasonable medical blood test, prescribed by my treating upper limb specialist surgeon on 24 August and undertaken on 5 September, for the sole purpose of evaluating an infection in my shoulder.

Miserably failing to settle this trivial matter with my case manager from hell – who by the way remains SILENT on all matters I raise in writing -I spent half a day crafting and dictating a lengthily complaint letter to the WorkSafe complaints department.

By lunchtime I managed to email my complaint (attached in a PDF file) to  the Advisory_Service@worksafe.vic.gov.au , WorkSafe’s official complaint email address.

My complaint raised two issues, namely the refusal or stalling of the blood test account, and I also took the opportunity to raise another nagging matter, that of an approved – in writing- taxi travel, which was ‘suspended’ a week later based on Xchanging’s need “for further medical information”. It is worth noting that I was sent to no less than two independent medical examinations for the purpose to “objectively assess” my medical need for taxi travel to and from medical appointments (and both IME reports strongly support that need). My own GP and treating surgeon also support, of course, the need for taxi transport. Xchanging’s “need for further medical information” was conveyed to me well over two months ago, and by-God, I haven’t got the slightest clue of where they intent to get that “medical information from” either. They certainly have not asked for any medical information from my own treaters and Xchanging has also not requested that I attend any other IMEs….

My WorkSafe complaint summary

This is the content of my email to WorkSafe -The original formal and very detailed complaint was sent in a separate attached PDF file (as well as other evidence).

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My WorkSafe complaint: full document

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Complaint page 11 - click to enlargeAbout WorkSafe Complaints

Anyhow,… I was most shocked, horrified and seriously sickened when I received the following email from the WorkSafe complaints department in response to my complaint this afternoon:

WorkSafe’s response number 1

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As you can see, WorkSafe clearly does not even READ my complaint but goes on to state that my complaint relates to a complaint made in September (since when??? I last complained on 4 November regarding the denied surgery and included the blood test account and taxi travel which were NOT addressed!).  And what is this story about a “rejection” and wanting to “have a decision over-turned”? For f*ck’s sake, are these people illiterate or what? What does the summary of my email complaint say, what does my full complaint state huh? Is it that badly written? Chinese? Especially considering that I clearly mention that I had raised these issues in an email to WorkSafe on 6 November (and not heard back as yet!)

Extract of email sent to WorkSafe on 6 November 2011

click to enlarge (just an extract for the taxi issue is also in it...)

My response to WorkSafe’s email

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WorkSafe’s response number 2

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Clearly same sh*t, different email, f*cking -hands-off-pass-the-buck and WorkSafe tells me to ring Xchanging, WTF? Xchanging is NOT responding! They’re NOT f*cking answering any of my letters or emails, so what am I supposed to do?

Shows you what WorkSafe complaints process is about – certainly NOT about protecting injured workers and their miserable little rights – no, they actually dig you deeper in the sh*t, I tell you… it’s hands-off/piss-off approach/ suck-it-up,…. well, see and judge for yourself.

WorkSafe does obviously not read my (and your) complaint, they make some quick whatever unfounded ‘story’ up that does not make any sense at all referring to complaints I (you) have not made and making false accusations that you are requesting to have “decisions overturned” or implying that you are fraudulently coercing the agent to settle an account (helloooo, even I know that the ACCS deals with this sort of issues), and/ or say you gotta sort the matter out with the insurer (but what’s WorkSafe’s complaints department for then?)…

I have no decisions from Xchanging, that’s the problem! I can’t even get a bloody rejection letter out of them for taxi travel SO THAT I CAN APPEAL THE MATTER AT THE ACCS!!! The morons just ‘suspend’ my taxi travel based on “waiting for further medical info” for yonks and in fact they could make me wait forever like this (consider that the request was made half a f*cking year ago!). Xchanging has not given/issued me with a rejection letter for the blood test account, no explanation, no nothing, just the usual stall, delay tactic until I become so desperate that I am going to have to borrow money to pay for it myself and then, out of sheer desperation and poverty, claim it on Medicare, thereby committing Federal Fraud as Ben (our very lotal reader& great commenter) said yesterday.

Tell me,  is my letter badly written or what? I mean English is my third language (I speak and write 4 languages fluently and a couple basically) or am I missing something here?

For f*ck’s sake where is our protector, supporter, ‘arbitrator’, mediator? What does WorkSafe stand for? In particular what does their “advisory service” (aka complaints department) really stand for?

According to WorkSafe’s flashy website, Worksafe:

view site

So, I had no option but to sent this same complaint letter to the most pathetic, corrupt “Customer Service” from Xchanging (aka Complaints department) via email and cc’d WorkSafe for the f*ck of it.  See what’ll happen…

Sh*t, f*uck I am so angry! Has anyone got some Valium that can be emailed stat?

PS Sorry for all the *swearing*

Related post: Worksafe complaints: there is no process

Xchanging sends the debt collectors

I am furious, frustrated and about to take a baseball bat to my head. Xchanging, well, I guess my case manager from hell, has been refusing to settle a blood test account since 5 September, and as a result I have now received a final notice of the -now long overdue account- stating that if the account is not paid within 7 days (I have 3 days left) the matter will be referred to the debt collectors, yohoo!

As you can clearly see from the request form for the test as prescribed by my treating surgeon, the blood tests were requested for “acute pain and swelling of  R shoulder“. This basically means that we were -and still are- very concerned about an infection in that shoulder (osteomyelytis) and for that bloods are needed to that we can monitor the progress of the infection with infection markers (such as the white blood cell count etc.) Right… So what is there so obscure about this account that Xchanging refuses to pay for it?

As you can see from the final notice account, the bloods were requested (prescribed) on 24 August 2011 and the test was done on 5 September 2011. Interestingly the test was done on the same day as the technetium bone scan I had done, and Xchanging had no problem with paying for the bone scan (also to look for the infection).

My case manager from hell also has a copy of the bone scan results which shows significant crap going on in the entire R shoulder and nowhere else in my body – so to try and pinpoint the blood test on an ‘infection’ elsewhere in my body would be , at the very least, very deceitful. (Mind you they tried it n to deny me the surgery!)

bone scan results: note scan done on 5 September

And, if that’s not enough evidence, Xchanging (my case manager) has also sent me to an IME (Orthopedic surgeon) the day AFTER the blood test and the bone scan. In his report, the IME describes in detail the status of my shoulder, upper limb, elbow, hand, fingers and there is no mention whatsoever of any infection in the finger or anywhere else, but the IME describes a “grumbling infection in the R shoulder”.

Xchanging refuses to pay again for reasonable and necessary medical care

So, tell me why is it that Xchanging refuses to pay for a blood test that:

  • was prescribed by an upper limb specialist surgeon
  • for the sole purpose of evaluation infection in the shoulder
  • but they paid for a bone scan to investigate the infection
  • they paid for a gallium body scan (after some fighting) too for the purpose
  • they recently, after a 2 month delay, finally approved my surgery for biopies, clean out of infection
  • but hey, they refuse to pay for the blood tests -obviously an “unnecessary medical treatment?”

Have a look at this:

my red shoulder

swollen & reddened

Nice, huh… Especially if you see how the redness is progressing / has been progressing over the past 2 months,because Xchanging has been unnecessarily denying and delaying my surgery and treatment. Because of that I have now developed a fever, excruciating pain …I can’t even describe it, I have lost over 6 kilos over the past month and really don’t feel all too good. Thank you, Xchanging! Maybe – should I believe your sick opinion- it’s only a case of psychosomatic disorder and a bit of VALIUM cream may just help, can you send me some to try please 😉

This morning I had to have some more urgent blood tests done to further look at the infection markers given that the shoulder has worsened again over the past few days and I am not sure that I can hang on until next week for the scheduled surgery. I should have the results tomorrow. This time we had no option but to cheat the system and bill Medicare out of FEAR that the bastards would refuse to pay for this account as well – isn’t that terrible and unfair to the tax payers?!

In any case, what I wanted to get off my chest is that, yet again, here’s a beautiful example of another delay, deny, stall process on the part of Xchanging, who, like all other workcover insurances, is required under the law (the Act) to pay for all reasonable medical care and treatment/procedures. Now you tell me the reason(s) why a blood test to evaluate the infection markers in this shoulder is not reasonable!

We all know that any infection, especially a joint infection can potentially spread to the blood stream and make you septic (that’s what they call septiceamia) or blood poisoning and that’s a very serious matter, from which you can die if not treated promptly, hey! But who cares?!

I did include the blood account issue in my complaint to WorkSafe on the 4th of November… haven’t heard a whisper as yet….

Any suggestions?

I have sent a letter off again to my case manager demanding immediate settlement of the account. I have told her that if I do not hear from her my tomorrow lunch time I would, regrettably contact WorkSafe again as I do not want the debt collectors knocking on my door for an account for which I am not responsible.

Why must we deal with such a trivial crap when we are under stress already… I mean I have enough on my plate at the moment with this infection and my upcoming surgery of next week (provided we can wait that long) and dealing with the fear and the consequences of such an infection….

 

My workcover case manager is making me sick

A few days ago, I posted “can I put a restraining order on my case manager“, and while the answer is YES, it doesn’t mean that your horrible workcover case manager will refrain from harassing and bullying you in a different way. In my case, we successfully put a “restraining order” on my case manager about 12 months ago – she was not allowed to contact me directly and all correspondence was to go through my solicitor and/or medical practitioner and direct contact with me was prohibited unless prior approval was granted.

Well, what can I say… Whilst this nutter of a workcover case manager ceased to phone me (up to 10 times per day), she soon found another way to make me sick by emailing me  constantly and several times per day on my personal email address. This in-spite of having emailed her personally that she was not to contact me via email (all contact was to be via letter) and that all her emails would be deleted unread.

In a way it’s good she persisted on emailing, because the contents of her emails can now be used as evidence of her disrespectful, uncooperative, dishonest, incompetent, harassing, demeaning and obstructive behaviour. On the other hand she is making me sick and I start feeling nauseated just opening my personal email inbox.

Some specific examples of my case manager’s emails

  • attempting to cease my psychology entitlements whilst I just had been referred to a psychiatrist (by my psychologist) for severe depression after I had been illegally sacked by my employer
  • stating that “I did not need to see a psychologist or psychiatrist because I could talk to her (WTF!)
  • ignoring the ACCS ruling entitling me to have as many psychology sessions as required (as per the Act) and in fact refusing to pay a psychology bill of over $700 (when confronted by the ACCS she stated that it ‘had been an oversight’
  • sending me to a vocational assessment whilst certified unfit for all work by my GP, psychologist, orthopedic Surgeon, Psychiatrist and independent psychiatrist
  • not providing me with a list of three choice service providers for occupational rehabilitation and making a direct appointment with her provider of choice
  • overriding a previously approved special orthopedic brace – i.e. we received approval for a brace requested by my treating orthopedic surgeon, purchased it (very expensive) and then one month later received a letter that the brace was not approved – again when confronted my case manager simply said that ‘it was an oversight’
  • ceasing my physiotherapy entitlements ‘because I am not improving” and failing to realise that when you cease physio on a severely damaged joint, the remaining muscles and tendons will also start deteriorating – which happened to me (for which I now have to undergo major surgery number 7).
  • making me wait 28 days to write a 2 line approval letter to the radiology facility where I was to undergo an MRI (the radiology facility insisted on having an approval letter),whilst 1) the request for the MRI came from my treating specialist (no prior approval is needed for an MRI in that case) and 2) my GP had sent an urgent fax as a follow-up requesting PROMPT approval for the MRI as I was in a very bad shape
  • when she was told that my injury had significantly deteriorated (MRI,report from surgeon and request for major surgery-approved by her!) she stated that “she was not interested in my physical condition, but only my psychiatric condition”
  • my case manager – whilst aware of the severe deterioration of my injury (request for major surgery etc) sent me to a shrink for an independent assessment because she needed to assess ‘my ability to engage in rehab and return to work…’ (WTF?)
  • my GP requested taxi transport as well as  my orthopedic surgeon but whilst my case manager allowed 1 taxi travel (to an IME) she stated that I should not assume that this (taxi transport) would be ongoing…. as she first had to have me assessed psychiatrically and physically before making the decision whether or not I would be allowed to travel by taxi. WTF – given that she had spoken to my orthopedic surgeon and has all the clinical evidence on file, including recent MRIs, emergency x-rays, requests for major surgery and the explanation from my surgeon on what was going on with my injury
  • why did I not tell her on the day that I had to go to the emergency department with a dislocated joint that I was going to the emergency department – WTF
  • sending me to a physical IME because she needs an “objective assessment of my injury” (of course by an IME who has no expertise in the field of this type of injury) after ‘having spoken to my orthopedic super specialist”… Can you make sense of that?
  • stating that there ‘is no reason why I could not drive my car’, whilst she had just received the emergency department x-rays (showing dislocated joint), MRI results and requests for major surgery… WTF?

Anyway, there are lots more examples… but just recalling them makes me fully sick. Is your workcover case manager also treating you like a criminal or a piece of s**t?

I have now instructed my solicitor to ‘deal with her’ and have her immediately replaced, for I will not tolerate this kind of treatment any longer. Life is hard enough as it is at the moment and I don’t see why I should be constantly insulted on top of it all.

[dictated post – apologies for spelling mistakes ]