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Thread Title: Returning to Work
Created On Wednesday August 03, 2005 6:04 PM


jj
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Wednesday August 03, 2005 6:04 PM

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Off work since May 2005 due to a fall at work that injured rt hip (periformis muscle) and SI joint. Treated w/HMO doctor who is employer's occup dr for over 30 days. He recommended chiro for 3 weeks. Nurse Case Mgr did not like HMO doctor he was trying to send me back to work too soon, so we selected another doctor , pain management doctor to be primary physician, he is off of a panel. Can I choose a specialist or another doctor, since I have still have pain? I live in 100 miles from job.Total commute time one way is 2 1/2 hours+ each way depending on traffic. I tried going back to work for 1 day, by the time I got to work, in such pain could not work. Dr. took me off work again. Job is a office job sitting for 8 hours day; which exerbates the injury. Driving long distances also worsens condition. Have had MRI and Underwent SI joint injection, which does not seem to have worked. My employer has followed up via registered mail, they expect me to return to unrestricted full duty when released from doctor. Total commuting time each day RT is 4 hours per day and sitting for 8 hours each day all of which make my back/hip injury worse. Additionally, I take 2 50 mg Tramadol 3 x day, Relefin 50mg, Cyclobenzaprine 10mg at night. The medication says I cannot drive when I take the Tramadol, but in order to endure the pain, I need to take it. If my doctor releases me back to work to "restricted duty" is it considered "safe for me to drive", and if I quit due to the inability to drive long distances which makes may condition worse, what next?

Thank you

Edited: Wednesday August 03, 2005 at 7:25 PM by jj

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andyourlittledogtoo
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Wednesday August 03, 2005 7:23 PM

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Don't really have enough information to answer this correctly.

Are you saying you drove that long distance from home to work every day before the injury, but now cannot?
What kind of a panel?
Was it an MPN panel?

You certainly have the right to be treated by a doctor closer to home if you choose, and if the current doc is not meeting your needs you do have the right to change to a different doctor. If you are subject to MPN panel choices, you still can select any MPN doctor you wish. You may not select a doctor outside of the MPN doctor panel unless there is no one close enough (within 30 miles if I recall correctly) that is on the panel.

If you are not subject to MPN panel doc choices, and your employer is not in an HCO, after 30 days the employer loses medical control and you can select any doctor you choose.

TTD is due when the IW cannot perform the duties of the job they were doing when injured. I have not seen a situation such as you are describing so I'm not sure if there'd be a difference there, but if for instance you were required to lift 50 lbs at work and your doctor said you could go back to work no problem but you can only lift 20 lbs currently during your recovery (prior to P&S), or that you cannot drive as part of your job temporarily due to the type of medication required due to your injury, then it is up to the employer to determine whether they can meet that restriction or not. If they cannot, then you are temporarily disabled, period. It does not matter that you could perform lots of jobs for other employers if you found a job somewhere else, the fact is you cannot do that job the employer has for you now and the employer can't modify it temporarily while you recover, then you are due TTD. Usually this is all on the job. What you are describing is the commute, which the employer has no control over and which is made voluntarily by you to get to the actual worksite. I'm not sure whether being impaired from your commute would trigger TTD in the same way as being unable to perform the duties of your job. If the other professionals who post in this forum have experience or knowledge in this area I'd really be interested in the answer. That situation has never presented itself to me in my professional life. My gut reaction is that it would not be considered in the same way, as the commute is not part of the job itself but is your private responsibility in order to make yourself available to the employer at his own worksite.



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"For a long time it had seemed to me that life was about to begin, real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." Alfred D'Souza

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jj
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Wednesday August 03, 2005 7:37 PM

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Yes, I commuted to the Bay Area for the past 10 years. Once I sustained this injury, it is difficult for me to sit for long periods of time. When I drive, I can not sit up straight, due to my injury. I am hunched over the steering wheel which is uncomfortable and causes pain in my lower back. I can not take the pain medication prior to driving because it says do not operate machinery or drive when taking this medication.

Re: Panel Doctor. I originally treated with the employer's doctor who is part of an HMO (Kaiser). He was not helping me only providing me with medication. He referred me to a chiro for which I treated about 3 weeks. Then, the NCM suggested I get another primary physician, a pain management doctor, who was part of a panel approved by the WBAC I believe. What does MPN stand for? Is there a list of MPN doctors? If so where can I obtain the list? My question here is, can I change doctors, because I underwent an SI Joint Injection, which was very painful and still no relief. I would like to be referred to a Neurosurgeon. Can I request that? As to the commute issue, I can not do my job once I get to work, because I have to drive without medication. Once I get to work, I am in such pain from the drive I can't do my job. If I take the medication at work, it makes me sleepy and I can't lay down at work. I researched the SI Joint/Periformis problem and one of the major causes of continuing pain is sitting for long periods of time and driving long distances.

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andyourlittledogtoo
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Wednesday August 03, 2005 8:43 PM

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If your doctor says you cannot do the job itself while medicated or because you'd be sitting too long, and the employer cannot accomodate it at the job site, then you may still be considered TTD. It really depends on what the doctor actually restricts you from doing and whether the employer can find something appropriate for you to do.

MPN stands for 'Medical Provider Network' and it's new this year. Since you say you went to Kaiser I'm gonna go out on a limb and assume your IC is SCIF, unless you tell me otherwise. If that is not correct please tell me as I can't go into this too much as it's a conflict of interest. I will tell you that SCIF does have an MPN and if you were injured after Jan 20 of this year you are probably required to see an MPN doctor as long as there is one geographically close enough to where you live to be appropriate. There are rules about when the MPN is mandatory and when it is not and I can't go into this here. You can see a list of MPN doctors for SCIF at the scif.com website, as well as a brochure on what an MPN is and how to navigate within it vis a vis your claim. If you are subject to using an MPN doctor, then you can choose to see any doctor on that IC's MPN panel, once you have seen the MPN doctor the employer chose for you for at least one visit. After that one visit, if you need treatment and the injury is considered to be industrial, you can choose a new MPN doctor if the first one does not meet your needs for some reason.

If your carrier is not SCIF then I don't have info re MPN specific to anyone else. But the legal rules are all the same, it's just the panel of doctors that would be basically different from MPN to MPN.

I hope this has answered at least a few of your questions.

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"For a long time it had seemed to me that life was about to begin, real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." Alfred D'Souza

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