Subject:      Some General WC info for newcomers
To: SOREHAND@ITSSRV1.UCSF.EDU

I have seen several newcomers on the list, lurking or otherwise, so I thought
I'd put together a little checklist with regard to Work Comp and RSI. Keep in
mind that I am not a doctor, lawyer or otherwise and these are only my
opinions. I know when I first entered the world of RSI and WC everything was
new and overwhelming. Sometimes it helps to have a place to start. Also, keep
in mind laws and rules vary from state to state and province to province. Be
sure to check your local laws.

First and foremost: (WC)

-Make sure your employer has filed a First Report of Injury. This is a form
one usually assists your supervisor in filling out. In most states, there is
a strict time frame for the form to be filed. First it usually goes to the
insurer for the company. Next it must go to the equivalent of your area's
Department of Labor. You can check that the form was filed on time by calling
your local D.O.L and speaking with an ombudsman or advisor. In most cases,
you simply have to give them your SSN and they can tell you the status.
Furthermore, this is an absolutely excellent resource for WC information. The
advisors are there to answer the most basic of questions on up to the most
complex. This is a free resource you should use whenever you can. I have
found that doing an internet search using the terms "(your state) worker's
compensation" yields the local webpage.

 One of the first things to ask them is whether or not you have the right to
choose your own treating physician. If not, get a list, if you haven't
already, of the acceptable physicians. If you can choose, personally, I feel
you should. (In My Opinion.)

 Try keeping a pain diary. This is helpful to you and your Dr. I try to write
(or dictate into a microcassette recorder if I cannot write) down the
activities I did each day, what caused pain, what did not and why I feel the
pain happened. You'd be surprised to discover that taking out that garbage
each morning can set off a whole day's worth of flare ups! This diary will
give you a good idea of your limitations, too.

 Also, documentation is the key to Work Comp, in my opinion. I have several
3-ring binders that I keep. One for my employer's correspondence, one for
correspondence with the insurer and yet another for Dr documentation. I save
everything and never give out the originals to anyone. I also compiled a list
of all important phone numbers so I don't have to go flipping through
everything (ouch) each time I need info. I also keep files from Sorehand
posts I find important and a general RSI file from the internet. Sometimes I
bring these into my Dr appts and discuss the articles with my Dr.

 I also keep a small notepad in my car. Another question to ask the WC
advisors is whether or not the mileage you drive to and from your medical
appts (dr and PT) is reimbursable by the Insurer. Monthly I send in a letter
to the Insurer with the mileage and the request for reimbursement. The more
on top of it you are, the better. Some states allow a 30-day grace period
before any requests have to be paid. The miles add up. I recently received a
check for over $150. That's a utility bill paid!

 I log each and every phone call to and from my employer, or anyone else
(other than my Drs.) that is involved in my claim. I summarize the
conversation, times, dates and the name(s) of everyone I talked to. This may
seem trivial, but it is amazing how stories and information can change over
the passage of time. I recently saved myself over $1040 in back Cobra health
insurance premium payments because I was able to tell my employer the time,
date and name of the person that gave me the erroneous information. I also
save all voicemail's, too.

 There is usually a "waiting period" before one can receive the WC benefits.
In my state it is 3 days, but in states like Florida there is a 7 day waiting
period. It does not matter if you are off work, in most cases, and still
getting paid by sick time, or vacation, you are still entitled to the checks.
You may have to sign them over to your employer until you are off payroll,
like I did, but make sure you are getting the checks. Keep in mind, too, that
in some states you ARE NOT REQUIRED to use up your sick time or vacation time
in order to be eligible for WC benefits. The full rate of pay is nice to
have, but keep in mind that you may need some of that sick time when you
return to work, too. Usually one is paid WC benefits at a rate of anywhere
between 60 and 66 & 2/3% of your  AVERAGE weekly wage. WC benefits are
nontaxable, too. The rate of the WC benefits is dependent on your taxable
income prior to leaving payroll and the laws in your state/province.

 Sometimes a "nurse" from the Insurer will call you and request information.
Don't be shocked by the calls. You may want to check with the WC advisors as
to whether or not you MUST give him or her any information. In my state, I am
*not* required to tell a nurse anything. I, personally, chose NOT to. Again,
my strong opinion, but sometimes this can really become a game of
"telephone." I feel the fewer people involved the better. That leads to fewer
misinterpretations and misunderstandings. BUT, it is up to you to speak with
them or not. Just be aware that it is common to receive calls from a WC
nurse. I was recently told by another Sorehander that sometimes a WC nurse
will accompany the client to the dr appt and SIT IN on the session. It's up
to you to decide if that is positive or negative, but again, it is wise to
know your rights BEFORE you get the call, or the unexpected guest.

 In general this should be a guide to get you through the first 90 days of WC
hell. <wink> After 90 days there may be new issues like Vocational
Rehabilitation and Independent Medical Exams. (IME's and Voc Rehab for short)
If anyone wants any info on that I can certainly post what I know.

 I am no expert by any means. Some of this may be new to you, some old hat.
All I can say is that when this first started with me I felt overwhelmed by
the system and I felt like NOTHING was in my control, let alone my own body.
I am sure other Sorehanders will have something to add, or to disagree with
and I welcome that. This is meant to be simply one person's starting point
that can hopefully help others.

 In my world I have two sayings: S/He who has the most documentation WINS and
Knowledge is Power. If this helps one person, then I am thrilled!

 Good luck and hang in there. Everything happens for a reason, it's just up
to us to figure out what that reason is.


Subject:      Some General Dr information for newcomers?
To: SOREHAND@ITSSRV1.UCSF.EDU

This is the second in my little installment. (LOL) As I was thinking about
WC, I also thought about what a huge issue going to and getting a good Dr can
be. Here are some very general things to keep in mind. Again, this is only
Anne's opinion and situations can vary from locality to locality and person
to person. I am NOT a doctor or lawyer. Simply an RSI sufferer. This may
again be remedial, or new. You decide, but remember, this is one gal's
opinion and story. : )

 Going to the Doctor:

I like to make a list of questions to bring along. It can be so easy to
forget to ask some very important questions. I keep a post-it handy in my
house and jot down things between appts I feel should be addressed. My dr
always says at each appt, "<fake sigh> What's on the list this time, Anne?" :
)  Others on this list bring a microcassette recorder into the session (with
prior permission, of course).

If you are working and have work restrictions, make sure your doc is as
specific as possible. For example, I was put on "light duty" and was forced
to file in tall filing cabinets for 8 straight hours. This made things much
worse for me. After calling my dr, I was given restrictions that said
something like, "Anne can only file for a maximum of one hour per day. She
can write no longer than 5 minutes without a 10 minute break. Anne cannot
lift more than 10 lbs with her right arm (injured arm) and no more than 25lbs
with her left (non-injured) arm. She can stand for up to 5 hours and sit for
no longer than 3 hours." Etc, you get the point. These specific restrictions
really helped me use the light duty time to heal.

After the passage of time with no real marked improvements, I was sent to an
orthopaedic surgeon for an evaluation. Surgery was recommended. Subsequently,
I saw my treating Doc and I brought up alternatives to surgery. Most of which
I heard from Sorehanders. I was sent to Physical Therapy. I have a home
exercise program and I also looked into things like meditation, yoga,
Feldenkrais (sp?), Alexander Technique, homeopathic remedies, support groups
and other long term solutions. For me, surgery was not the best option. I was
able to get better faster without surgery than in the time it would have
taken to heal completely from the offered surgery. Just because a doc may
recommend surgery does not mean that is the only answer. For some, surgery
works and is the best avenue. For others, it can backfire and create more
problems than you had pre-op. Just something to keep in mind.

 I know several Sorehanders have not received any Physical Therapy (PT) yet.
Personally, I feel this is a necessary step to recovery. Again, people have
mixed results. I was able to take what worked in therapy and use it to heal.
Not all suggestions helped. I feel PT is a great avenue because most PT's
deal with RSI sufferers every day, all day, versus your Dr which may have 3-4
clients with RSI that s/he sees twice a month. In PT we came up with some
very creative solutions to my limitations. It is definately worth a shot. If
you aren't in PT yet, please talk to your Dr to see of this would be a
positive step.

 I see a Sports Medicine doctor. He is in a regular General Practice clinic.
I needed no referral to see him. My WC insurer loved this because he is more
specialized and frankly, costs them less than, say, an Orthopaedic
Specialist, each visit. I have found he knows more specifics about muscles
and movement than my first GP doc. By the way, I saw my first doc (in the
same clinic) for 4 months. He never recommended PT! He was sick one day and I
saw my current dr. Immediately he gave me the referral for PT. This goes to
show that even docs in the same clinic see RSI differently. I often wonder if
I would have improved more quickly had I been in PT sooner. Ah well.... live
and learn, right?

Another thing I'd like to mention is the fact that in most states, you are
entitled to a copy of your personal medical file. I have been going to my
clinic since I was 11 years old. Looking back, I should have asked my dr to
create a seperate file for my WC claim visits. The Insurer was able to get my
medical history from the ages of 11 to 28. How they loved to blame the
softball mishap I had in 11th grade and the broken toe when I was 21! If
possible, ask your clinic if it is at all possible to create a seperate file.
I wish I had. I never signed a release form for the insurer and that has been
a bone of contention throughout the whole process. I am a private person and
I loathe the fact that they have all that medical history on me that is, in
my case, completely irrelevant to my current injuries. As the WC process goes
on, it may be wise to request a copy of the file. This way you can see
exactly what is being sent to the insurer by your Doctor and this gives one
an opportunity to clear up any misunderstandings. I casually mentioned that I
returned from a trip to Jamaica to my Dr and he put that in my report! The
insurer had a field day with that one. My dr was just being himself and meant
no harm, but in the end, it could have hurt me dearly. I also never mention
personal problems to my Dr at those visits. They can end up in the file. I do
address the depression the injuries can create, however. It's a fine line and
certainly up to each and every individual. : )