I wasn't taking a personal stab at everyone in the insurance industry...just at the fact that even when someone in said industry actually comes across a honest to goodness case of why [we] pay insurance in the first place and still denies the case...well...this world sure done gone crazy! I know insurance is a necessary evil...but I don't think everyone in the industry is evil. They are just doing their jobs as ordered...with a jaded outlook for every case!

I don't see the irony that you speak of Maddy. All I took away from this situation is that this particular insurance claims workers had no instinct of right and wrong, fair and unfair, good and bad. And for what reason? It was instilled in him to find a way to deny this claim, as he probably did with every other claim he had before him at the time, and make it hard for us to ever get an approval. We weren't going for the mother load here. We only wanted a percentage of his lost wages and the medical bills taken care of. We could have gotten by without the lost wages if the doctors hadn't made it a worker's comp case and our health insurance could have paid the med bills. After it was deemed a worker's comp case, hubby no choice but to let them take the ball and roll with it. I never mentioned a law suit. We never intended to sue for anything. We couldn't even afford to sue even if we wanted to...but we never wanted to. If the people who run the insurance industry have lost all instinct of good and bad intentions, there is no hope for a honest person to make a claim and we should leave the insurance dealings up to the crooks and the claims adjusters. Least this way they'd know who they were dealing with instead of just stamping "denied" on every case...including the honest ones! I don't find that ironic...I find that sad!

BTW...we are fine now and have recovered financially because we DIDN'T persue a lawsuit. Had we tried to sue for approval...we'd have owed more than what we were seeking.

In all the years that my husband's company has paid into worker's comp...they have NEVER paid a single penny to an approved claim, nor have they ever approved a claim. As stated earlier...his company had only 3 claims in all it's years in business. The insurance rate is sky high because of the type of business it is...yet the accident rate was nil till the first "false" claim (which wasn't the company's fault...they had no idea this kid they hired was sue happy), the machinery accident and then my husband's claim. Nothing is justifiable to me as to how this situation was handled.

Don't pity us Maddy (we are fine...and would have been better if the insurance company hadn't gotten involved)...but please don't laugh at the situation either. I can't find a thing to giggle about in any of the dealings! There is good and bad in every situation in life...and the trick is to be able to differentiate! When you've lost that ability...you've lost a big part of your humanity! That's nothing to laugh about!!!!!!

__________________
Minds are like parachutes. They only work when they are open.

~Thomas Dewar~

Sorry, I didn't mean to offend. I was less than clear in my original post.

Maddy no need to apologize...everyone posts from their particular viewpoint and one is not more correct or appropriate than another.

__________________

The practice of putting women on pedestals began to die out when it was discovered that they could give orders better from there.~ Betty Grable

If I wanted your opinion, I'd remove the duct tape and ask you for it.~ Me
<~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~>
One man's dream is another man's nightmare~~~~> §¤ Lilith ¤§
~>My Scribbles<~
==>Gone Shopping<== ~Just a Quickie~ *~A Celebration Vacation~* ~Surprises~ Sleeping With the Window Open
What Did You Do Today? Self Defense Class ~Short Sweet Snippets~ § Summer Spin § Story Challenge Submission Pajamas

Lixychick: first of all..((((hugs)))). I have never in my life heard such a story. I am glad that you guys have recovered finacially, but, like you say the system has failed and badly. I am expereincing some unbelievable treatment at work, Its like i went from being a good employee to a piece of shit in a day. I truly do not know what originally caused this condition, i just know that the job as further damaged my tennis elbow and now the nerve damage. I seeked treatment on my own, which now seems to be a "problem". I told my employer what was causing the pain, and they just more or less so, oh well, you are just getting older. I filed the report after doing work that caused me not to be able to move my arm and kept from being to sleep, or do anything without severe pain. The morning that i told them at work that i couldn't do what i had done on the previous day i was cussed at, had stuff thrown around in the office i was in, and belittled. I was pissed so much that if i could have i probably would have decked the supervisor. I had filed a report earlier in the month, and he never filed it. I filed the second report and he didnt turn that one either until i questioned his boss. There has been so many things that seems so wrong in this case, it is unbelievable. I really do not wish to sue, i have never been the type that thought that was the way to go. But, it makes me wonder as if in your husband's case if legal representation is a necessity. I talked to the case manager and he says he was never notified that i was seen by a workmen's comp surgeon or scheduled for surgery. Now i wonder how this is possible when the whole thing had to be approved by workmen's comp? All I know is, i am tired of all of this and want to be able to move my arm/hand with out pain. Thank you so much for your input, it really has me wondering what the heck i should do.


(((HUGS)))

Please excuse my spelling

You want to hear about workmans comp, well I am going to tell you of two cases.

First, My SO was a nurse in an hospital and was working on her floor when one of her patients after having a major operation on his own makes up his mind to get out of bed because he refuses to use a bed pan. My SO notices that the readings on his monitor are very screwy and goes to his room to check on him.

She catches him coming out of the restroom and goes to help him. He tells her that "he doesn't need any damn help and to get out of his way." She backs off but stays in case he has any problems, and of course he does. He manages to trip over his own feet and in the process grabs the front of her uniform pushing her over backwards. As she hits the floor he lands on top of her and in the process of all this she recieves a back injury.

It takes four other nurses to get thi guy off of her, he is not a small man, and she ends going to the emergency room on a gurney. They X-ray her back and say they can't see anything and then release her to go home. Even though she can't walk she goes back up to her floor and files an accident report and documents everything in her nurses notes.

The next day she is off and very sore and tender as you would expect. She sits down on our couch to relax but can't get comfortable. She goes to get up and she can't, the pain is so bad she has tears in her eyes. She has me take her to the Doctor and he refers her to the Hospitals Nuro Surgen.

After doing a MRI he tells her that she has a back injury and she needs surgery to relive the pressure on her spinal cord. When she reports all this to her supervisor she is prompt told that they don't know what she is talking about.
This is where I get our lawyer involved.

Lucky for us she made copies of the accident report and her nurses notes, but even so we need the originals and guess what they say they couldn't find them. This drags on for months. After consulting with us our lawyer suponeas all the Hospitals Records for the month that it happened. When I say all records I mean "all" of the Hospitals records for that month. We then go to pick up the records with a sheriff's deputy and the hospital tells us we can't have the records. But with assistance from 5 more sherriff's deputies they suddenly find her records and turn them over.

Well now they have been stalling it in court after denying her workmens comp claim for 8 years now and who knows how long that will continue. Oh and by the way the night they carried her down to the ER they had the gall to send us the bill for her treatment.

The Hospital Adminstrator has had the gall to ask us to drop the the case three or for times and I always give him the same answer, "When Hell Freezes Over."

The Other case involes me, I stepped in a hole at work and tore up my knee. The company I work for sent me to thee company doctor and then sent me to one of the best knee doctors in the country. They paid me workmens comp while I was off, paid all medical and rehab cost, and checked on us constantly to see if we needed anything until I got back to work. I have nothing but praise for them and they way they handled the whole thing. I signed a release a year and a half after I returned to work on the provision that if I ever had any further problems I could get Medical treatment.

Workmens Comp can be a Blessing or pure Hell depending on who you are dealing with! Good Luck !

__________________
The Mind Is Your Limit. As Long As Your Mind Can
Envision It, You Can Do It!

I admire your moxy Sad sam! Stick to your guns buddy.

__________________
I am here for only a short time on this earth. My goal is to make everyone I see smile if only for a moment.

Maddy? It wasn't necessary for Lilith to speak on my behalf at your response...but since I have been here so sporadically lately, I am grateful that she spoke up to hopefully put you at ease!

I am a hothead when it comes to someone wronging my husband...and I'll not let anyone off the hook without my letting them know they've wronged a truely wonderful man! When I read that it tickled you a bit to read of our circumstance...I just went into overdrive...bringing up all the old feelings that had encircled his case. I didn't mean to lash out at you...and for that, I am sorry (it had to be said Lil...and I knew it already!)!!!!

I was just trying to make a point that the human factor has changed so much that right and wrong are no longer a consideration...but the almighty dollar has a seat at the head of all things anymore!

I understand your reply hun...I was just taken aback at the "laughing" part! I can't make excuses for all the sue happy people of this world. I just know we aren't contributing to it and never intended to!

I hope you understand!

(((((((Maddy)))))))

__________________
Minds are like parachutes. They only work when they are open.

~Thomas Dewar~

I fully understand your point, and I can fully see where I set off a fire in your heart. I have a very jaded and cynical view of the world, & all I can do sometimes is laugh at the irony that a person just trying to do the right thing by being honest, gets the proverbial slap in the face and boot in the ass for not abusing the system like the majority & I agree fully with you, it's WRONG! I only have minimal experience with work comp, but the little I do know is very close to what you have said, where the system seems to have far more denials than approvals (of course I've worked for Gracious & Generous Insurance... we sometimes paid too easily IMHO) ... I'm of the view that this is the response of insurance industry due to being abused & not the intention from the onset. All things come with a price tag in our society, & the unfortunate price in this situation is the hardship placed on those that were doing the right thing.

Slightly off the point, work comp lights a fire in my heart at times too. I know a state trooper that was shot this year, due to the injury being on the job, he was considered a work comp case. I saw through the eyes of his wife the poor treatment he received at the hospital, dr visits, home nursing care, etc. To think his job is to protect and serve all of us, & that's the treatment he receives after taking a bullet? Not to mention that his pay on work comp was only 60% - I found it to be outrageous that this is what my state provides. In order to continue to maintain the family's lifestyle he was forced to use all his earned vacation & sick time so that he'd stay at 100% pay for as long as possible.

It is looking more and more like that workmen's comp is not going to cover the surgery. I guess i was to honest in seeking some treatment on my own. Like i have said all along i am not sure what intially caused the whole problem I just know what has made it worse. Not really sure what i will do, but workmens' comp is supposed to let me know in tuesday what there decision is, surgery is scheduled for thursday. :bang:

good luck with the surgery and i hope that workmans comp helps you out

__________________
Trees give peace to the souls of men * Nora Waln

The forest would be very quiet if no other birds sang than those who sing the best * Henry van Dyke

some fairly sordid tales, rambles, and anecdotes
Hypothetically Speaking * Something More * Cammy Interrupted * An Experimental Vacation * Masked * so..damn..hot * Thank You * My toy, his idea * no.19 Maple Lane * I Have A Surprise For You * Yesterday * In a Quiet Kitchen * help me decide * untitled prose * more untitled prose

I'll be sending warm thoughts of comfort and healing your way

__________________

The practice of putting women on pedestals began to die out when it was discovered that they could give orders better from there.~ Betty Grable

If I wanted your opinion, I'd remove the duct tape and ask you for it.~ Me
<~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~>
One man's dream is another man's nightmare~~~~> §¤ Lilith ¤§
~>My Scribbles<~
==>Gone Shopping<== ~Just a Quickie~ *~A Celebration Vacation~* ~Surprises~ Sleeping With the Window Open
What Did You Do Today? Self Defense Class ~Short Sweet Snippets~ § Summer Spin § Story Challenge Submission Pajamas

wyndhy, and Lilith; Thank you for you kind and warm thoughts, i hope that i can still come here to the boards. Gonna be kinda hard,with one hand but i am sure gonna try!

Good luck darlin and DON'T try to overdue it after the surgery OK? ((((((((hugs))))))))

__________________
I am here for only a short time on this earth. My goal is to make everyone I see smile if only for a moment.

aww...c'mon...you've done it before, haven't ya
at least let us know that you're ok after thursday

__________________
Trees give peace to the souls of men * Nora Waln

The forest would be very quiet if no other birds sang than those who sing the best * Henry van Dyke

some fairly sordid tales, rambles, and anecdotes
Hypothetically Speaking * Something More * Cammy Interrupted * An Experimental Vacation * Masked * so..damn..hot * Thank You * My toy, his idea * no.19 Maple Lane * I Have A Surprise For You * Yesterday * In a Quiet Kitchen * help me decide * untitled prose * more untitled prose

Thanks..you are a dear..dont worry, i wont do anything that i dont think i shouldnt do...((((hugs))))