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Reply to my ‘Fair Assessment for Compensation letter’

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Fair Assessment LetterAfter speaking with Kris Vanston I now know that injured workers do have the Victorian Ombudsman to turn too for unfairness issues within the WorkCover system.

I had my doubts about contesting my impairment score of 0% (that was deemed permanent I might add), as I am very well aware and have ranted aplenty about Chronic Pain NOT being acknowledged in the guidelines that are used to assess injured workers. That means there is Australian legislation (I’ll rephrase; it is legal) for WorkSafe practitioners to ignore Chronic pain, thus Pudendal Neuralgia. No where within the system will any WorkCover practitioner be able to assess an injured worker’s Chronic pain. I’m experiencing the result of this, I’ve been living this ignorance since March 2007.

I wrote a letter that was ignored for a few months by our WorkCover Minister, WorkSafe and SafeWork Australia. The Victorian Ombudsman employee informed me not to use the ‘info’ email address but rather the ‘enquiries’ one when I’m writing to WorkSafe. Ridiculous but he was right and I eventually received a response.

(Enter sarcasm) I now feel completely healed and completely relieved with the empty response I received. It managed to ‘acknowledge’, ‘agree’, ‘assure’ and confirm all the points relating to this outdated system that I initially made in my letter. I’m also more at ease knowing everyone who assessed me ignored all my symptoms and inabilities and that was legal. I’m also proud of the staff at WorkSafe who are happy to abide by ignorant and narrow-minded measures that would also apply to them in the event they injured themselves at work. Above all, I’m in awe of the WorkSafe staff and all related employees and practitioners who’s reports are so loyal and discerning of these out-of-date AMA4 guidelines (with pain chapter removed), and The Accident Compensation Act 1987.

This template response clearly indicated to me that anyone with chronic pain and with any of the following symptoms/limitations, as a result of a workplace accident will not get compensation: affected toilet function, spasms where you really don’t want them, sensory pain (in my case throughout the pelvis), toothachey nerve pain, weakening legs, burning, zinging, if you have limited sitting ability, if you are limited in walking, standing, working, lifting, bending, exercising, if you have an implant as a result of pain (or even if you need one for that matter), if you rely on daily help, if you can’t drive, shop, sit and type this damn email in one hit etc etc…! Continue Reading

John Quintner’s point of view

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I’m forever searching for a decent explanation as to why the AMA Guidelines used to assess injured workers in the WorkCover system are so poor and out of date, especially when it comes to assessing chronic pain (and in my case of pudendal neuralgia measures a total score of 0!!).

Along my social media travels, searching for answers and researching for treatment or updated information regarding my condition, I have met John and had the pleasure of some great discussions. Dr John Quintner is a consultant physician in rheumatology and pain medicine and has kindly offered to share his published opinion on the matter. Thanks John!

Here’s an excerpt, or download the full pdf document. Continue Reading

‘Chronic Pain Disorder’ medical panel opinion?

Author:

(For a further update on this issue please read Expired and fallen through the cracks)

What does it mean? Well, I’m struggling to get a clear understanding to be honest, even after being stamped with the ‘condition’ and living with it (apparently) for almost 5 years. To date, it seems to have panned out as psychological condition, gynecological condition, we don’t have to pay anymore medical expenses, blank stares, you can refer the matter to court, (and on and on it pathetically goes).

Let me explain myself further (and hopefully I might inspire some wonderful WorkCover specialist to shed some light), here I go:

From what I’ve gathered Chronic Pain Disorder basically means big general pain bucket and, its time to update the Wrongs Act 1958. And I’m stating very obvious information here because our Government has missed a very small detail… its 2012!!! So let me clear my throat… I’m going to have to make it loud… uuuuhuuuum:

Hello, anyone out there? If you are, it’s time to update the Wrongs Act of 1958 and the AMA Guidelines (1990s). Injured workers have injuries that can be addressed more appropriately, giving them a greater chance of getting back to work and lessening instances of permanent damage if the practitioners in the system can identify and use current information.

So what am I saying (and I speak from my own experience obviously)?

After my 130 week payment termination (how convenient for an injured worker to have no income during this time!!! Oh whoops, sorry, I should mention I did have the option to go to Centrelink), I attended Conciliation to dispute this termination of payments and from there was forwarded on for assessment to the Medical Panels (Medical Panels are constituted pursuant to the Accident Compensation Act 1985 and the Wrongs Act 1958 as stated on the website). I was assessed as having a Chronic Pain Disorder, basically, there is no specification for Neuropathic/Peripheral pain, or Neuralgia let alone any specific Pudendal Nerve issues or associated medical term so I was dumped in the big general pain bucket.

(At this point I’d like to break down the chronic pain disorder meaning even further. From my injured-worker-who-is-requiring-support-and-proper-treatment perspective this ‘opinion’ also means: we don’t know anything about back pain, we are not up to date, we don’t care about being up to date, too hard basket, vague, we can see you’re in pain – this’ll do)

So after gaining this vague label (and this is the second one because your WorkCover case number provides the first!), every decision the WorkSafe Agent and associated bodies, made since (or didn’t) stemmed from this opinion. So my follow up Independent* Medical Assessments (IMEs) were with Orthopedic Surgeons and Psychiatrists and yes, you guessed it if you’ve read through quite a bit of this site, they found no injury. Did anyone refer me on to a Neurologist? No. (Did I ask, yes, was I ignored, obviously or perhaps I was caught up in another case manager change over). Did any practitioner really look into my issue? No. They followed the big general pain bucket style, I was thrown in again and again.

However, some medical expenses support continued and also my weekly entitlements. Until last year that is. Firstly, the request for my wonderful, reviving peripheral stimulation device was ignored so I had to seek an answer through the Conciliation process (and yes of course my surgeon and I requested permission but as if I was going to wait 1 year for the faffing around, so I would like to take this opportunity and thank my private health insurer for paying 90% of the costs and continues to be my main medical support through my biggest progress period), and also, some massage reimbursements that suddenly died off too. Shortly after this, all remaining medical expenses were terminated leaving me with $zilch therapy support! In my letter I was told the decision was based on my ‘last’ Independent Medical Examinations (IME’s). What’s strange about that is the referred reports were exactly like all previous IME’s and I had been receiving medical expenses after those reports. This termination letter was quite sudden… out of the blue. It even ignored the most recent report that was due to come from an IME, a Psychiatrist** but had not yet been sent to the WorkSafe Agent or myself, not that it would have made a difference as the psych reports all say I’m fit for duty but it adds to the my point of poor support from this system, and makes me question the far from WorkSafe protocol of asking for a report and not using it. The decision to terminate medical expenses had obviously been made and I have no idea why and never will.

But. I have a hunch why this may have happened suddenly, and here my big general pain bucket opinion reappears. During Conciliation for the above mentioned two disputes (unpaid reimbursements, and seeking a response for the request of my stimulation device), the definition of my ‘Chronic Pain Disorder’ suddenly transformed and became a ‘Psychological Condition’. Apparently, this particular Conciliator thought that for some time, my WorkSafe Agent had it wrong and I was not meant to be having massage treatments or physiotherapy for a ‘Chronic Pain Disorder’ because it was a ‘Psychological condition’ (yes I know I’m repeating myself but that’s the way it was told, and actually repeated again, and again…).

My stomach turned when my Conciliator looked at my WorkSafe Agent representative and in a curious, happy manner said, that’s a fight for another day and continued on to resolve the mistaken unpaid reimbursements and to seek an answer in relation to my request for the stimulation device. At the time I didn’t understand it (and couldn’t for the life of me think of what might be funny either) and nor did I understand later when I spoke to this Conciliator on the phone and he repeated yet again, that I had a ‘Psychological condition’ and even added his confusion as to how a stimulation device can treat a… yes, he said it again, a ‘Psychological condition’. No where did my WorkSafe Agent or the Conciliator, dispute having paid my Neurosurgeon’s appointments???? I won the dispute for my massage reimbursements on account my Insurer was ‘honouring’ their having paid them previously but I was firmly told there would be no more massage treatments or therapy support and certainly no stimulation reimbursement. They were however continuing my General Practitioner and Neurologist’s appointments (but not treatment, get it? Neither do I!)

And the fight for another day? It came. I disputed the final decision made by the WorkSafe Agent to refuse reimbursement for my stimulation device and also tried to dispute the medical expenses termination. I didn’t get very far. Even though I had a professional Conciliator this time, my only choices were to go back to the Medical Panel for reassessment (yes, head back to 1958 and the 90’s!) or I was offered the choice of taking my WorkSafe Agent to Federal court.

My point.

Accurate diagnosis is critical to an injured worker’s support and chances of recovery. That’s impossible if our System uses the Wrongs Act 1958, the 20 year expired AMA Guidelines and unprofessional and uneducated employees.

Conclusion.

So, now I have a brilliant stimulation device implanted, it revived me and gave me the ability to research my issue and that led me to a Chronic Pelvic Pain Physiotherapist, in the General Public system (that’s right, so she’s free), who finally diagnosed me correctly (and you may have guessed I don’t have a psych condition, pain disorder, or Gyneocological condition!). I’m currently having treatment and begun to make some progress, which is giving me hope that soon I might be able to work part time again. My WorkSafe Agent has not contributed to any of the effective treatment and worse still, doesn’t even want to know about it. Of course I tried, the first thing I did when I was diagnosed was call my (passing through at the time) Case Manager to tell him my exciting news and provide the WorkSafe Agent with my Physiotherapist’s details in order to help other injured workers. In one phone call I got the following details:

  • My Neurosurgeon didn’t know how to write reports in order to get me reimbursement for my implant,
  • WorkSafe don’t want to be seen paying for implants,
  • Why would they call the Physiotherapist when she was not treating me for my work injury (back to ‘Psychological Condition’),
  • You have a ‘Gynecological Condition’ (!!!!).

I wrote to our WorkCover Minister.

And please, once again, anyone from anywhere in the system, if I have any of this information wrong or misunderstood, please make a comment. Clarify some detail, answer my queries, give injured workers some hope.

* Read my definition of independent
** I have learnt not to read the reports from ‘IME’s’ especially Psychiatrists as the awful assumptions, judgements and pathetic template style assessment really bothers me, but my husband read this particular report (when it finally arrived months after my termination decision was made) and had to share one bit of information. I was described as tall! I’m 157cm!!!!????… no, not so tall no matter how much I stretch!!

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Definitions of pain

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 aggravated 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.

What is Neuropathic pain?
Neuropathic pain is the result of an injury or malfunction in the peripheral or central nervous system. The pain is often triggered by an injury, but this injury may or may not involve actual damage to the nervous system. More…

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