posted
I posted this on Medical questions a day ago and got a response from TinCup. Thank you. Was wondering if anyone else in support might have advise.
Hi folks, I was diagnosed in Sept. with Lyme disease. It was a job related illness, i am a biologist for the federal govt. My claim was approved and i have been on worker's comp. since about 3 months ago. WC has not approved my LLMD, and I absolutely trust him and feel i am am capable hands. I do have to travel to Dallas, as I live in Corpus Christi. The reason for the travel is there are no LLMDs any closer than Dr. ? who is workers comp certified. Now OWCP wants me to go for a second opinion in San Antonio to an internist. I have already been to an internist here in Corpus Christi (CC).
In fact, all 4 CC doctors said that i did not have lyme as the titres test came back negative. I know it will come back negative with someone who has had it for a year and a half.
One doctor even told me there was no Lyme in Texas.
So now, WC wants me to go for a second opinion to see if i have Lyme. They provided me with a doctor who works in San Antonio, (travel) and is an internist who specializes in bariatrics.
Now the WC letter states...."If you desire, you may have a physician of your choice present at the appointment. Your physician may observe, offer opinion, and discuss the exam, with the physician to whom your are being refferred, although at my own expense. Now you all tell me what doctor is going to take a day off of work to visit with this doctor that someone else made an appointment for me?
You know i just dont know where these people get off. I did all the homework, found the closest worker's comp. certified doctor who is highly recognised as one of the best LLMDs in Texas.
Yep, i have to travel to Dallas, but that is first and foremost because my present doctor i feel is the best for me, and the only doctor in Corpus Christi that knows anything about Lyme disease is our veteranarian.
My first Dr. in Houston diagnosed me after having 7 bands present, this is 2 above CDC's, the head of the lab and i talked and he said definately i had it, and then now the doctor i am going to now is treating me for it after agreeing with the first doctor and looking at the test results.
How many opinions do i need?
How about this for grins. I will scan my tests results from the lab and if there are any doctors who have lyme experience reading this, you tell me what you think.
If any doctors want to go for a drive to San Antonio on March 2, and go to an appointment with me at 3:30 pm, to this second opinion doctor who has absolutely no experience with lyme, I will take you for lunch at the Riverwalk, and pay for your expenses.
If i sound like i am griping, i am and i am sorry, but this is absolutely ludicrous and totaly unsettling to know that i may not be able to keep this doctor or lose compensation benefits.
If you find a doctor you absolutely believe that God sent him your way, and worker's comp. wants you to go for a second opinion after already approving the work related illness, what do you do, give in, or fight?
I believe I will fight. Anybody want to fight with me?
Loretta Schanen Pressly (lemonhead)
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Posts: 156 | From Corpus Christi, Texas USA | Registered: Sep 2004
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Linda LD
Frequent Contributor (1K+ posts)
Member # 6663
posted
Loretta,
I am so sorry you are going through this.
I'm happy you did get workman's comp.
Just don't let the bast*&ds get you down.
Your Tennessee Cousin, Linda
Posts: 1171 | From Knoxville, TN US | Registered: Dec 2004
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
WELCOME To LYMENET
Here's more goodys! A typical response to newcomers.
Hi and WELCOME! Get a LLMD or at least Dr that is willing to learn about lyme. Borrelia Burgdorferi is a clinical diagnosis, based on symptoms and on your response to treatment. Good Luck, bumpy road ahead.
( No you don't always see a bite and if there's no bullseye the only way your going to be able to tell is (symptoms) and (((Maybe))) WB or lyme dot blot 3 day urine banged with abx's to free your antigens up for the test. ) See this ( . )thats the size of the larva stage tick... Next nymph size... ( * ) Next is adult ( o ) to ( 0 ) Pretty small????? HUH
posted
DC, they cost a lot and I am on comp now, and my husband is retiring after 34 years in the same job, and his dad needs help now, so he is taking care of him. Also i take 250 worth of supplements a month. If i do get a lawyer hopefully it will be after all else fails, but i am not changing my Dr. Thank you, but i am still praying that the big man upstairs will help me out. I am getting my guns loaded for this second opinion by gathering as much information as possible to give to her. Hopefully, i can get Dr. H to take a visit with me to this doctor's office on MARCH 2, 2005 AT 3:30 PM, Dr. Maria Jirka, internist with specialty in bariatrics. Lord, I know i need that too, but a bariatrics specialty doctor assessing an already diagnosed Lyme patient??? Dr. H are you listening? I'll buy you dinner on the riverwalk. I have never used a lawyer in my life, and am scared this is not going to work out. Help anyone. PA GS protege of Dr. H, can you come? Loretta
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Posts: 156 | From Corpus Christi, Texas USA | Registered: Sep 2004
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Linda LD
Frequent Contributor (1K+ posts)
Member # 6663
posted
Loretta,
You can take the cost of your suppliments off on your income tax. Keep those receipts!
Linda
Posts: 1171 | From Knoxville, TN US | Registered: Dec 2004
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minoucat
Frequent Contributor (1K+ posts)
Member # 5175
It's unbelievably frustrating, but I've found that if you keep fighting, and demonstrate that you have all the documentation and will go to court, you eventually will win.
Also, we found a wonderful lawyer who gave us a consult for free. This is his general practice when doing (in our case) disability claims, which he takes on contingency -- but with the advice he gave us, we were able to reassemble our info, highlight all the pertinent stuff, and win our case. But even an hour with a good lawyer might be well worth the investment.
I used many of the forms listed on the site above.
posted
Thank you all for replying. I have made a few calls here and there. I do know that I have to go to the second opinion doctor. Oh well. I did talk to the claims examiner and she said that the second opinion doctor and my doctor that I have now should confer if there are any different findings. Now I hope that is true. You know maybe this is just a regs. thing, but i dont quite believe so. I do know that 3 doctors (LLMDs) have seen my test results and definately diagnosed me with Lyme disease. Also, if workman's comp. denies the claim, I will be able to have my husband's insurance company to fight for me. I did my work and am now leaving it up to God, because I have to. Thank you all, Loretta
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Posts: 156 | From Corpus Christi, Texas USA | Registered: Sep 2004
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posted
Hi Loretta, I'll fight with you!! I also work for the federal govt. and I'm currently applying for disability due to Lyme and Babesia that was dx in 3/04......This year was horrendous and I can no longer work. I worked in human resources, but unfortunately don't know enough about WC regs, BUT I have friends who work in that area!!
I think it's strange that you did get approved 3 months ago, and are getting workman's comp, and now they want a 2nd opinion. I'm very surpised they didn't ask for a 2nd opinion in the first place.
I think you are right in saying that you can not turn down going down the appt. to the bariatric specialist in San Antonio. And also yes, I believe it is correct that the 2nd doc will have to confer with your LLMD.
Do you have anyone you can talk with in your human resources office? That would help tremendously to get ahold of the regs and find out your rights and what the procedures are........
My concern is what happens when 2nd doc possibly does not agree w/ first diagnosis? Then where do you go from there? Is there an appeal process, or do you go for a 3rd opinion??
You may email me and if I can help I will certainly try from my end to pull together some info.
Hang in there!!!
Gail
Posts: 562 | From Wellsville, PA, USA | Registered: Jan 2004
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kam
Honored Contributor (10K+ posts)
Member # 3410
posted
We had several people at work come down sick around the same time with the same symptoms.
One received workmen's comp with a valley fever/CFS/fibromalgia dx. (She is refusing to see a lyme specialist although she has many of the symptoms)
Another was approved with fibromalgia brought on by stress at work.
I went for answers and for treatment. I too was given the dx of fibromalgia/CFS/stress but that didn't make sense to me.
I have my final workmen's comp hearing the first week of March.
I am considering other labels if it helps get the workmens' comp through.
Like one of the other workers said, she needs the income in order to help her recover. It doesn't matter what they label it.
The only problem I see with this is that the other two are not getting treatment and seem to be leary about seeing a lyme specialist because they may loose their workmen's comp and then medical retirement.
I continue to hope that they will see a lyme specialist.
I am hoping that it will be determined that there is too big of a coincidence that we all came down sick around the same time with the same symptoms and were given the same labels along the way and I will be approved also.
But, I think I need more doctor's backing me up. I am not sure how all of this works.
I do have a workmen's comp attorney. He receives a percentage if it is approved so I am not paying out of pocket.
The one supervisor who was approved has the same attorney. I gave her his name.
The other worker has another attorney out of the area although the attorney who was recommended to me is closer to her??
I think it would have helped if we all had gone with the same attorney.
I am not sure how this helps you.
I do know that the other teacher asked me for a recommendation for a doctor but then went with the one the attorney suggested and that workmen's comp suggested.
She recently talked to an attorney with the CFS organization that said we are supposed to be able to choose which doc we see.
But, it doesn't seem to work like this and I am not sure how to make it work.
Posts: 15927 | From Became too sick to work or do household chores in 2001. | Registered: Dec 2002
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posted
PinchotGail, check this site out. FEDERAL EMPLOYEES' COMPENSATION ACT SUBCHAPTER I - GENERALLY �8103 Medical services and initial medical and other benefits and the web address below. I know it is long but these are some of the regs. on FECA. You will see at the below site that it says the worker "The United States shall furnish to an employee who is injured while in the performance of duty, the services, appliances, and supplies prescribed or recommended by a qualified physician,.... " http://nt5.scbbs.com/cgi-bin/om_isapi.dll?clientID=325975&infobase=feca-act.nfo&jump=8103&softpage=PL_frame#JUMPDEST_8103.
Now of course it goes on to say,.."The employee MAY initially select a physician to provide medical services, appliances, and supplies, in accordance with such regulations and instructions as the Secretary considers necessary, and MAY be furnished necessary and reasonable transportation and expenses incident to the securing of such services, appliances, and supplies..."
Take note of the MAYS in the sentences.
I was told by my claims examiner that I needed to read the regulations, and I am doing so now, but this one popped up.
Pinchotgail, am looking foryour email or i forgot how to find it. Yep, let's work together if we can on this.
Yes, let's stay in touch, and KAM, what is your business, are you a teacher of biology, environmental, etc. I am going to look up Valley fever, or is that a name of a condition for folks who are in a sick building?
Loretta
Posts: 156 | From Corpus Christi, Texas USA | Registered: Sep 2004
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posted
Hi lemonhead, Sorry to hear about your troubles with the DOL/OWCP, you`re not alone. I too was infected on my Federal Govt job back in 1992 when they knew there was a risk of tick borne but never bothered to tell anyone about it. Like you, I also have an approved claim for LD and associated infections.
I`m still dealing with the DOL/OWCP and may be able to help you in some ways, I also have the name of a Federal Workmans comp attorney in Georgia who is educated on Lyme Disease and it`s co-infections, he is very good and a very rare find. You have to remember there is a big difference between workers comp and Federal workers comp.
If you`d like, I could contact you on Friday and detail you in on my experiance with the Federal OWPC. Let me know, hang in there. POP
posted
Yes Pop please do so. I best not give you my telephone number so email me. My email is [email protected]. Email back and i wil give you the number as i didnt have your email. Loretta
Posts: 156 | From Corpus Christi, Texas USA | Registered: Sep 2004
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