Challenge/Encouragement

[RDUczyJr]

I have posted several times and received valuable information. My latest post was regarding insurance company battles and my return to work. I had my TKR on April 29th and I feel I am doing really good...I still have some swelling. I have excellent movement of ther knee. I still get some pain after PT and at night. I have been working very hard to get back to normal and I feel somewhat discouraged as my employer (police dept) seems they would rather have me retire then come back. I feel I can eventually and my surgeon agrees. They are putting me through an IME with the insurance company as I am battling with them regarding my TKR being work related. I had 5 previous arthroscopic surgeries prior to my TKR over a period of 20 years. In addition to that battle my dept wants me to have an IME from a Dr of their choice. So I'm battling with the insurance company to have my medical bills paid and it appears also to keep my job. I spoke with my PT who told me she had a fire fighter return to active duty from having a TKR so I don't think it's impossible. I really don't want to retire but this entire matter makes me rethink it. Sometimes I wish I didn't even get the TKR..of course when I talk like that my wife gets very upset with me. I can see where people throw in the towel....and give in. Any thoughts would be greatly appreciated.
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[Josephine]

You REALLY wish to have all that pain back? I very much doubt it. A period like this can be a dreadful stress and I wish you success with it.

 

[Gretchendz]

These things are very complicated in the U.S.

Is the IME for worker's comp? If it is regular health insurance it would not matter if work-related or not.

There are usually several things involved and people get easily confused:

--Regular Health Insurance
--Workers compensation which pays benefits and health coverage if it is work-related
--Family Medical Leave (FMLA)--provides up to 12 weeks unpaid leave with the employer paying what they usually do for you and guarantees you get your job back if physically able
-short and long term disability insurance (pays part of your salary while you are out)

Then there is the return to work issue. The employer may make you go for an IME if they think you are not physically able to return to work.

If you give some more details, we may be able to help.

Also, many police departments are unionized. If yours is, I'd recommend you contact your union rep immediately. They can/should help with these things.

P.S. Your wife is right!
Good luck.

 

[RDUczyJr]

The first IME is for worker's comp. The second IME is for my employer. I would think they may conflict wioth each other's results. I'm sure worker's comp will conclude that I would be able to return to work. I am employed by a small PD...we do have a bargaining un ti...but we are small. I did get a lawyer to represent me.

 

[Gretchendz]

Glad you got a lawyer. You are right in that they may conflict.

If you have health insurance and either sick pay or LTD anyway, I wouldn't worry about the WC IME. It's only important if you need the pay or medical coverage. Of course, usually the health insurance company wants to prove it's work-related to move the expense from them to WC. If so, you should comply with the paperwork and all--but in the end, it is the insurance company's problem--not yours

Obviously, if you want to return to work, the employer's IME is important!

As you can probably tell, I do this stuff for a living, so I'll be happy to help with specific questions if I can.

Another option to consider--if you qualify for a decent pension, think about taking the retirement and getting another job. If you have a pension as a base, it's amazing that you can take a lower paying (maybe less stressful) job elsewhere and actually improve your income ...Just a thought.

 

[Rowdy66]

Hey, I would consider retiring if you get a decent retirement wage and then you could get another job. My thoughts though are that the PD will come back with a referral for your retirement and Workers Comp will come back with you can go back to work and you are going to end up in court. I know you want to keep your job but if they don't want you they will find a way to get rid of you, or that is how I have always seen it work. I would rather take what is offered and get out with my dignity, so to speak. I worked for the State and went out on short term disability and it turned into long tern mainly due to my employer deciding they would be better off. Most people give up, I didn't. I got and still receive full benefits for life just like I had continued working right up until I was 65. I do know you are in for a fight but sometimes you just have to stand your ground. Of course it is everyone's individual decision as to what they do and how they handle it. I wish you luck and stamina. You may need both. Rowdy