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Off to the Convenor of Medical Panels with my invisible pain

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You know that feeling before something great is going to happen, like just arriving at the airport and knowing you’re off on a great holiday? It’s a great feeling isn’t it? Makes your insides really happy, the body and mind get a lift, and troubles seem to slide away, everything feels like it’s going to be alright. Well, I couldn’t feel more the opposite right now. I have an appointment with the Convenor of Medical Panels on Tuesday and I’m feeling more like I’m facing a funeral.

Who are the Convenor of Medical Panels for those lucky enough not to have had any experience with them? I’ll just pop in their website information as they explain it best:

Medical Panels are constituted pursuant to the Accident Compensation Act 1985 and the Wrongs Act 1958.
A Medical Panel may be asked to provide an Opinion where there is disagreement or uncertainty about aspects of a WorkCover related injury or medical condition.
A Medical Panel may be asked to provide a Determination where there is disagreement or uncertainty about the degree of impairment resulting from an alleged Wrongs Act injury.
A Medical Panel Opinion or Determination on a medical question must be accepted as final and conclusive.

If you’re an injured worker, you won’t need to read on as you’ve either experienced the Panels yourself, or after reading the above lines you’ll know exactly what I’m about to say. For those who are not injured workers and want to understand your injured worker friend, read on. And if you are a Panels assessor*, please, consider the following and what injured workers have to endure when they face you.

Following, are my thoughts and the questions that will swivel around my brain, down my spine and burn my pelvis until this appointment is over and the final decision is mailed to me.

I’m fearful:

  • I’ve been inaccurately diagnosed by the Medical Panels before and because of that I had to see endless Independent Medical Practitioners (IME’s) who couldn’t assess or treat me appropriately. This resulted in me losing my entitlements for medical expenses and above all, I was never treated or diagnosed for my work injury properly. What if the Medical Panels get it wrong again? What capacity could I be stuck with for the rest of my life?
  • What if the ‘assessors*‘ ignore the accurate reports that state my true injury which is Pudendal Neuralgia, and instead use the binding decision: ‘a chronic pain disorder associated with a general medical condition and psychological factors, where psychological factors predominate, which has arisen as a consequence of a now resolved soft tissue injury. The Panel concluded that the nature of the worker’s psychiatric condition is such that she is not capable of performing her pre-injury duties as a graphic designer.’ Does this diagnosis explain that sitting is difficult for me (as are most movements and activities)? Will they acknowledge the truth, that I have no ‘psychiatric condition’ or ‘psychological factors’? Will they take into account all the information, will they be bothered reading it?
  • Can they override a previous binding report? Will I get a reference to my correct diagnosis or will I be bound to the above decision?
  • Do these assessors* know the Pudendal Nerve? Have they heard of my condition? No one else seemed to in the WorkCover system and when I asked for a relevant ‘assessor*‘ I had a Rheumatologist assigned. Is that good or bad?

I will be judged:

  • My pain is invisible, not only on the outside but my scans show no evidence of my injured pelvic nerve (or at least it’s not obvious to practitioners I’ve seen with the exception of my TCM who clearly sees evidence of damaged tissue in one of my scans… but who, in the Western World of medicine, is going to believe a TCM) so this clearly won’t help with assessing capacity.
  • I have reports, accurate ones that I believe explain my injury and I also have a capacity report from my lifelong GP that notes my limited capacity for work, the work restrictions (eg, 15mins sitting at a time, no standing still for more than 20 mins, no lifting etc) and thorough information about my treatment (implant, nerve blocks, medication, massage, acupuncture etc). It’s all there but my concern is will these ‘assessors*‘ that have never seen me before and have no idea what my last 6.5 years have been like, agree? And why is my GP being questioned anyway?
  • Who are these ‘panel’ members that in a 1 hour appointment can give a binding report about the amount of work hours I may have for the rest of my life!?
  • And apparently there is an examination. An examination for my condition (those of you who puke easily might want to skip this para) is an internal exam both vaginal and rectal, and also includes a pin prick test along ones finer bits to see where feeling has been lost. That’s not a test I’d prefer to do with ‘assessors*‘ that are not familiar with my condition, nor one that I feel is applicable in assessing working capacity? If that is the case and they feel they can measure capacity that way then they should really come visit me post examination too, as an examination like that would bring on a 48 hour flare at the very least. Not to mention these sorts of assessments are not the sort of ‘activity’ that form my job description… I understand if there were a physical ability assessment (walk quickly, squat, lift, work a problem out etc) which I have previously not been able to complete as it was too difficult. But my point is, if this Panel are going to be searching for pain evidence to match my quoted capacity, I’m a goner.

I’m doubtful:

  • How can I not doubt? My medical CV for the first 4.5 years of this journey is impressive to the highest rank of professionals… if they all missed my diagnosis and no one in the WorkCover system ever even came close to assessing me accurately (in fact they were more a hindrance) then how can I believe that a Rheumatologist, Pain Specialist and two Psychiatrists will assess me accurately?
  • When I look at the receipt of reports that have been handed over to the assessors, both WorkCover conducted investigations have been provided. Why would these putrid and incomplete reports be necessary? Why would these assessors agree to a position that invites them to view those investigations for consideration when making a decision about an injured worker?
  • If I hadn’t provided my accurate and diagnosing reports from the past 2 years, I would not have had any accurate detail presented to the assessors as my WorkSafe Agent has chosen to ignore all those reports.

I’m feeling desperation:

  • I paid for WorkCover and was promised ‘quality insurance’ if I hurt myself at work as all employers and their employees are in Australia. I’m currently receiving no payments, the accuracy of this assessment weighs on part payments for the rest of my possible working life. I could have sat back and stuck with my current binding agreement that states I will never have capacity to work again and my payments would have continued, but Theo and I are making the most of our situation, I am able to contribute to our business with Theo’s hourly help. We’re taking a huge risk as without Theo’s support I cannot work at all, will this be respected? Is this going to be understood or abused?
  • Will the ‘assessors*‘ not understand the injury and my limitations, ignore my GP’s report and state I can work full-time thus ruling out any future payments? I’d have to dispute that in Federal Court (opening bid there is 25K).

Almost defeated:

  • The decision that will arrive in the mail (whenever it does post assessment) is going to be ‘it’, final, binding, a decision that holds up in a Federal Court… a decision made to suit The Act 1985 (there’s that reference to our pre historic legislation again), a decision made to fulfill the AMA Guidelines that can’t understand pain because the definitions have not been updated (or were excluded all together). What if the decision means no more financial support? What if…

I’m going to have to stop there, it’s getting too daunting now – switch to positive Soula mode…

Hopeful:

  • In true form to myself, I’ll choose to end on hope. I’m going to believe that I will be well enough to speak and communicate my issue, regardless of the pain it causes later, and that I will physically cope in my sit/stand/shuffle ability, with the hundreds of questions fired at me and the investigative tone in those questions. I will cope with these five assessors* whose approaches had me checking the thesaurus for applicable words to describe their looks to which I felt all were relevant and will paste here: “distant, remote, reserved, withdrawn, unemotional, unsentimental, dispassionate, cold, cool, indifferent, unconcerned; formal, stiff, businesslike; informal starchy, standoffish, wooden. (yes, I’ll include the antonyms for extra clarity: emotional, warm)”, and I will hold on to my heart’s guiding note, even though it’s been tarnished by the WorkCover system, that I believe in human honesty and kindness and that those assessors* will believe me and do the right thing, believe me and agree with the practitioner who knows my injury and me best, my lifelong GP.
*I use the word Assessor throughout as I feel it’s a more suitable word for the practitioners that choose to participate in the WorkCover system. They assess, they don’t treat and an injured worker is not to ask any questions or expect any advice during these appointments.

Feedback

3
  • Jacinta

    The process sounds truly awful. Sending you lots of positive energy!

    • Soula Mantalvanos

      It’s the only way, sadly Jacinta. I can’t wait for it to be over. The pain levels are rising in true anxiety form, so can’t wait for the other side, a huge rest and another mountain behind me. Hopefully, with a good outcome. Thanks for being here xx

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What is Pudendal Neuralgia (PN)?

Most simply put PN is Carpal Tunnel in the pelvis/buttocks. Compression of the Pudendal Nerve occurs after trauma to the pelvis and is aggrevated with pressure. The pain is often described as a toothache like pain, with spasms, sensations of tingling, numbness, or burning. It can be very debilitating.

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