Friday, February 8, 2008
Looking over your benefits from work while disabled
What does work benefits have to do with being disabled? Isn't that what Workers' Compensation Insurance is for??
Turns out, if you have enrolled in your employer's benefit package prior to your injury, the ins and outs of your work benefits can provide some interesting plot twists in your WC saga. I recommend going through your entire benefit brochure. Don't have one? Request one or go online (- it would be online if you have the option of managing your benefits online). The things that affected me in my time out of work due to injury in terms of my benefits I paid for are:
1. Losing Medical, Prescription Plan, Dental, Vision benefits due to reduction in PAID HOURS.
2. Short term disability and 3. Long term disability which are benefits that most often is paid for through some benefit plan at work.. Part of that automatic deduction from your check every week if you are enrolled in these particular benefits. It helps you out if you become disabled either randomly or from a work related injury.They provide income that you are not receiving normally- however they have limits, and in some cases, won't provide the same dollar amount income as one had before the disability. *IMPORTANT* To receive STD benefits, you — or someone acting on your behalf — must file a claim.
*other points of interest are enrollment, average weekly earnings, paying for these benefits out of pocket while on disability (aka missed payroll deductions) , pre-existing and recurrent disabilities
1. yikes! I didn't know that
2. Short term disability (STD) covered me for the first 26 weeks of my injury. And at which time I had no idea it existed. I am just now understanding that STD and LTD are thing that I have already paid for and I'm figuring out now how they have or have not helped me. With STD, I'm still like HUH?. I'm not sure if I was supposed to receive $ from this plan. I didn't get any... thinking it was because I earned "too much" from WC. There are several sources of potential income while you are out, but they seems to cancel each other out, and the lowest amount is the winner as your main source of income :D
3. Long Term Disability (LTD) has just kicked in although my STD period ended 7 months ago... I guess this normal?? I will admit I was slow to provide them info they needed. My doctors and WC adjustor were slow too. Also. Now that I am PS and WC has ended LTD seems to be my only income now. There are steps I am taking to increase my benefit $ amount right now. It involves lots of forms and reading both fine print AND in between the lines Whereas Another service mine provides is Vocational Retraining $... This week I have a Functional Capacity Evaluation (FCE)- this is the LTD's in house doctor review- to see if I can work at for the same company in any position. I think. HUH? I want to stop here though, because I am still learning about this system.
I will fill in the holes on the questions I have as I get them answered
Turns out, if you have enrolled in your employer's benefit package prior to your injury, the ins and outs of your work benefits can provide some interesting plot twists in your WC saga. I recommend going through your entire benefit brochure. Don't have one? Request one or go online (- it would be online if you have the option of managing your benefits online). The things that affected me in my time out of work due to injury in terms of my benefits I paid for are:
1. Losing Medical, Prescription Plan, Dental, Vision benefits due to reduction in PAID HOURS.
2. Short term disability and 3. Long term disability which are benefits that most often is paid for through some benefit plan at work.. Part of that automatic deduction from your check every week if you are enrolled in these particular benefits. It helps you out if you become disabled either randomly or from a work related injury.They provide income that you are not receiving normally- however they have limits, and in some cases, won't provide the same dollar amount income as one had before the disability. *IMPORTANT* To receive STD benefits, you — or someone acting on your behalf — must file a claim.
*other points of interest are enrollment, average weekly earnings, paying for these benefits out of pocket while on disability (aka missed payroll deductions) , pre-existing and recurrent disabilities
1. yikes! I didn't know that
2. Short term disability (STD) covered me for the first 26 weeks of my injury. And at which time I had no idea it existed. I am just now understanding that STD and LTD are thing that I have already paid for and I'm figuring out now how they have or have not helped me. With STD, I'm still like HUH?. I'm not sure if I was supposed to receive $ from this plan. I didn't get any... thinking it was because I earned "too much" from WC. There are several sources of potential income while you are out, but they seems to cancel each other out, and the lowest amount is the winner as your main source of income :D
3. Long Term Disability (LTD) has just kicked in although my STD period ended 7 months ago... I guess this normal?? I will admit I was slow to provide them info they needed. My doctors and WC adjustor were slow too. Also. Now that I am PS and WC has ended LTD seems to be my only income now. There are steps I am taking to increase my benefit $ amount right now. It involves lots of forms and reading both fine print AND in between the lines Whereas Another service mine provides is Vocational Retraining $... This week I have a Functional Capacity Evaluation (FCE)- this is the LTD's in house doctor review- to see if I can work at for the same company in any position. I think. HUH? I want to stop here though, because I am still learning about this system.
I will fill in the holes on the questions I have as I get them answered
Labels:
$,
benefits,
FCE,
Functional Capacity Evaluation,
HINTS,
HUH?,
income,
Long Term Disability,
LTD,
Mistake,
PS,
WC,
Workers' Compensation
I have a bandaid on my neck
.... this is not a metaphor. This is actually supposed to help.
Ridiculous? Yes.
I decided to watch Eraserhead after my PT visit in which I got the bandaid put on just to surround myself with something more surreal than this fix. Now I am in in the mindset that ridiculous things are only a big a deal as we make them.
Actual solution? Could be.
The bandaid is there as a booby trap, if you will, for when I am studying or on the computer to NOT strain my neck. When I feel the tension on my skin from the bandaid, I know that I am not using my eyes to look down. ¡With symptoms of TOS, using your neck to do look down a lot agitates the ulnar nerve!
I will give it a try for a few days.
Ridiculous? Yes.
I decided to watch Eraserhead after my PT visit in which I got the bandaid put on just to surround myself with something more surreal than this fix. Now I am in in the mindset that ridiculous things are only a big a deal as we make them.
Actual solution? Could be.
The bandaid is there as a booby trap, if you will, for when I am studying or on the computer to NOT strain my neck. When I feel the tension on my skin from the bandaid, I know that I am not using my eyes to look down. ¡With symptoms of TOS, using your neck to do look down a lot agitates the ulnar nerve!
I will give it a try for a few days.
Labels:
bandaid,
HINTS,
PT,
Repetitive Strain Injuries,
RSI,
TOS,
ulnar nerve
Friday, February 1, 2008
new challenge: Getting PT equipment approved
Getting PT equipment approved is difficult. When your doctor or physical therapist recommends it to you, the prescription also has to go to your WC claims adjustor, he (or she, mine's he, so I'm gonna go with that) has to send it to Utilization Review (UR) to be determined necessary or unnecessary. UR goes by the Occupational Medicine Practice Guidelines as set by the ACOEM (sorry- no website for the guidelines, but the library should have it as a book at the reference desk). The good news is, your WC adjustor isn't telling you what treatment and equipment you can or can't receive. Bad news is, the UR is still working for your employer.
My current status is that I am receiving PT right now that treats Thoracic Outlet Syndrome (TOS) by way of something called the Peter Edgelow Protocol. Sounds funny don't it?? :P I promise to share all of my exercises that comprise the "protocol" later. All it means is a particular way of treating pain due to TOS... The equipment that is needed costs about $300 and the claims adjustor has been avoiding all requests to get it approved, combine that with the need for UR and I could be waiting about another 3 weeks before its ok-ed OR denied.
The problem is there are a chain of events pending>> I need to have this equipment in order for me to get the most out of the PT, otherwise, its just neat knowledge and arms the same as they ever was. I have only 2 visits left of PT for this injury. period. And the biggie= once I am done with this PT then my doctor is closing the case and I will become Permanent & Stationary (PS)/ Maximum Medical Improvement (MMI) [both mean the injured has plateaued and not expected to get any worse or better in the next year]. So you see, I need the PT equipment in order to close the case.
What I can do and what I probably will end up doing is paying for this stuff myself (with all my loads and loads of extra money I'm raking in from WC. HA!!....I can forgo food again this month it looks like). If UR deems this equipment necessary for my recovery they will reimburse me. That is the law- its not like, if they find out you are willing to pay for it, they deny the request and you have to foot the bill... although I don't think I am going to call up my adjustor and ask him if its ok for me to pay now & he can get me back later. I am going to stay mum about it and just cross my fingers that it gets approved and I get $300 back!! Also, it turns out I don't have to buy the whole thing and that might shave off some of the cost.
If you get a chance, go check out the link to Egdelow's site and look at the equipment... I challenge you to define thumbometer.
UPDATE:: I got a call ON the very day that I was going to plunk down my own money for the equipment... It was approved!! That was 4 days ago and now I have the kit! Yay!!
My current status is that I am receiving PT right now that treats Thoracic Outlet Syndrome (TOS) by way of something called the Peter Edgelow Protocol. Sounds funny don't it?? :P I promise to share all of my exercises that comprise the "protocol" later. All it means is a particular way of treating pain due to TOS... The equipment that is needed costs about $300 and the claims adjustor has been avoiding all requests to get it approved, combine that with the need for UR and I could be waiting about another 3 weeks before its ok-ed OR denied.
The problem is there are a chain of events pending>> I need to have this equipment in order for me to get the most out of the PT, otherwise, its just neat knowledge and arms the same as they ever was. I have only 2 visits left of PT for this injury. period. And the biggie= once I am done with this PT then my doctor is closing the case and I will become Permanent & Stationary (PS)/ Maximum Medical Improvement (MMI) [both mean the injured has plateaued and not expected to get any worse or better in the next year]. So you see, I need the PT equipment in order to close the case.
What I can do and what I probably will end up doing is paying for this stuff myself (with all my loads and loads of extra money I'm raking in from WC. HA!!....I can forgo food again this month it looks like). If UR deems this equipment necessary for my recovery they will reimburse me. That is the law- its not like, if they find out you are willing to pay for it, they deny the request and you have to foot the bill... although I don't think I am going to call up my adjustor and ask him if its ok for me to pay now & he can get me back later. I am going to stay mum about it and just cross my fingers that it gets approved and I get $300 back!! Also, it turns out I don't have to buy the whole thing and that might shave off some of the cost.
If you get a chance, go check out the link to Egdelow's site and look at the equipment... I challenge you to define thumbometer.
UPDATE:: I got a call ON the very day that I was going to plunk down my own money for the equipment... It was approved!! That was 4 days ago and now I have the kit! Yay!!
Labels:
ACOEM,
claims adjustor,
equipment,
HINTS,
HUH?,
MMI,
Peter Edgelow Protocol,
PS,
PT,
Repetitive Strain Injuries,
RSI,
thumbometer,
TOS,
treating doctor,
UR,
WC,
Workers' Compensation
My story- abridged
Back story in a nut shell: Worked at a cafe for 3 years, started to feel acute pain in both arms around xmas 2006, worked despite the pain for about 20 days before going to a doctor, got modified duty & worked one more week, pain was too intense to function in any of the duties at work, was diagnosed with Repetitive Strain Injuries: tendonitis of bilateral upper extremities, have been off-duty/ unable to return to work as per my treating physician ever since. Currently, I am finishing up my last bit of WC-approved PT, following that my case is going to close, I'll be Permanent and Stationary, my temporary disability status will end and I am not sure what comes next....
Labels:
modified duty,
pain,
PS,
PT,
Repetitive Strain Injuries,
RSI,
temporary disability,
tendonitis,
WC,
xmas
Day 398
How this is gonna work:
I am not going to backtrack and go chronological with my experience. I would stay injured if I were to type that all out and besides, I am not into reliving all of it and, in turn, wallowing.
Instead I am going to cover things:
I wish I had known ahead of time= Mistakes
I have learned along the way= Hints
I still have questions about= Huh?
(more to come?)
I hope I am writing this blog as a resource. And I wish that people will comment, ask and answer questions here. I will be so happy if this happens. You know, I have a ridiculous amount of experience and knowledge about RSIs and the WC system in California now and it would be silly for me to not share it.
Labels:
California,
Repetitive Strain Injuries,
RSI,
WC,
Workers' Compensation
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