Thursday, October 9, 2008

At it Again

My brother sent me an email today asking me how my knee surgery went.

It didn't. As I told you the insurance company sent me to an IME. I haven't received his actual report yet, but basically he determined that yes I have a torn meniscus and yes I need it scoped. However, in his opinion a person with a tear such as this certainly wouldn't be able to do physical activities like work and exercise therefore although the insurance company isn't denying the fact that I "aggravated" my knee, called in the claim, and went to the clinic doctor twice before seeing my own orthopedic surgeon who ordered the MRI that the tear must have happened after I called in the claim and told the clinic guy that I felt like it was torn which he actually put in his dictation report. Hmm, I should start playing the lotto more often if I'm able to predict that 3 weeks after telling someone I think my knee is torn that I actually tear it.

So anyway, yesterday I had my restrictions lifted with my own orthopedic surgeon so I could take my"unable to perform physical activities" butt into work. I can't sue them until I'm on disability and having the surgery even though I need it now, but can't afford it so I can't take off work to have it. Back when we picked vacations early in the year I took next week off as a payoff for one of my vacation weeks and am scheduled to be off the following two weeks. I've asked my boss if I can work through the 2 weeks that I'm scheduled off to save enough money to have the surgery in January. Then in January I told him I would have to take all 5 weeks of my vacation together and have the surgery. BUT, if I am allowed to work through my 2 weeks of vacation, I will instead have the surgery just prior to Thanksgiving and give them a ___ you so sorry I won't be able to work peak this year and will hopefully be recovered by the first of the year or at least by the second week. Then while I'm off I can file an appeal against their denial for workers' compensation. I almost feel bad about tricking them... oh wait, no I don't. Unfortunately for them I take really good notes and have lots of documentation regarding my injury. I don't see how they have a leg to stand on when it comes down to it. In addition I will be trying to sue not only for the workers' comp benefits but for pain and suffering and mental anguish that I've endured through this. I'm not sure if that will fly, but I'm certainly going to try. Screw them; I did nothing wrong other than go to work and twist my knee while working and the stress that it's caused me has been enough to cause at at least temporary increase in anxiety and despair.

Of course with all insurance companies they are looking for an "out" so they conjure up some crap by twisting what the doctor has to say based on questions that they ask him but that he doesn't ask me. The guy never once asked me about my ability to do my job or other physical activities and I'd have to guess that conveniently no where in his report does it state that I told him that I could do things, but the next day I would be stiffer and more sore feeling in the knee. They do this because they figure by the time the person pays for the surgery using their own insurance and pays for the lawyer fee that it isn't worth it to them monetarily to file an appeal. However, I don't like basically being called a lying, deceitful person who has filed a "false" claim which no doubt creates in the minds of my supervisors and peers regarding my integrity. Therefore like many things we fight for in life, we do it on the basis of principle.

I had Marianne my surgeon's assistant fax a work note which lifted my restrictions so I could return to work since the insurance company was denying my claim. When I returned to work, my boss asked me if I would be ok to do the job. I told him I would but it wouldn't last long. He asked how long is long a few hours? I told him no, I would make it a few weeks before the symptoms started bothering me again I would guess at which time I would start taking some Ibuprofen.

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