Wednesday, November 26, 2008

Our WCB Nightmare

I haven't posted about this yet but I guess I better. Back on July 29 Colin injured his shoulder at work. Our dr. couldn't see him right away so he went to the walk-in clinic and was prescribed painkillers. A week later he went to our family dr. and has been seeing him regularly ever since. At first the dr. thought it was a temporary injury but it turned out that it's much much worse. And through it all the only constant has been a nightmare of a battle with WCB that has ended badly much to our disappointment. Because honest people get covered, right? It's only those who are lying about an injury that don't get covered, right? We blindly pay WCB thinking that when we are injured at work that they will step up to the plate and take care of us.

Two days ago we were so hopeful. They had the results from the MRI and our doctor's report that shows that Colin has tears in the tendons of his shoulder including in his rotator cuff "consistent with the motion of the action Colin was doing at the time of the injury". The MRI also states that another MRI will have to be performed with dye which has a 6-7 month wait list but the WCB adjustor said they could expedite that. He said he would call back yesterday after talking to the medical adviser at WCB.

Well yesterday Colin talked to his case manager again at WCB and he says that they've officially denied his claim based on the fact that the first dr. Colin saw wrote on his report that the injury was the result of a car accident. Colin specifically told the dr. (at the walk in clinic) that he was injured at work but the dr. also asked Colin if he had ever been in a car accident and Colin said that yes he had - in 1998!!!!!! That's OVER TEN YEARS AGO!!!!!!! So the Dr. must have forgotten the work part when he was asked for a report and wrote that he was in a car accident and that is the basis of WCB denying the claim!

And of course the walk in clinic doesn't even take phone calls. I told Colin he needs to go back to the clinic, find out when that dr. is working and get him to send in a revised report but it might be too late.

I seriously cannot believe they have denied a legitimate claim. I PRAYED and PRAYED and PRAYED and I just feel so defeated right now. Colin has called the adjuster's supervisor but he's out of the office until Friday. And apparently it's near impossible to "un-deny" a claim without going through the whole appeals process (we have 90 days to appeal and have already started the process and they have up to 5 MONTHS to respond to our appeal).

Colin is in SO MUCH PAIN. He is unable to work. He can't drive a vehicle for any length of time because the seat belt hurts his shoulder. He can't sleep at night. He can't pick up his boys. He can't even open a new jar of Cheez Whiz. He's been told that he is at extremely high risk to rip the tendons and rotator cuff permanently if he is not careful which could cause irreparable damage. I don't know how he is to be expected to provide income for us until he can finally have his MRI and surgery in 6-8 months!!!!

I just don't know what to do. I am praying for a miracle - that this supervisor has a way to approve the claim.

3 comments:

Rosalyn said...

Hi Katrina,

Just read your last post ( a fellow flybaby) and I can certainly empathize with your predicament. We have gone through something similar too. Might I suggest calling someone in the legal field to see what they might be able to suggest. I will keep your family in my prayers.

Rosalyn

Dyan said...

We will be praying for you. God is bigger than WCB!

Anonymous said...

How are you planning to get by in the meantime - is Colin looking for work? Is he doing physio for his shoulder to help it get better?