Saturday, May 17, 2008

An Open Letter To Work Comp

This is a personal rant and if one of the Barbarians could bring a printed copy to our next outing, I would greatly appreciate it. I don't have a printer and need a copy for my records. Plus, I need to vent.

My worker's comp representative never returns my phone calls and after leaving her a message last week about the latest refusal to hire me for a job that I really wanted, and which could have substantially improved the quality of my life, I finally received the doctor's determination yesterday and I have to say that I disagree. Not only did it not address my issues, but after two years and a private investigator, More... they are still trying to blame it on a previous injury. One I have never had. And just for the record, I have never complained about my ankle. It has never been twisted or strained, was never mentioned as part of the work comp injury and I really don't understand why it was included in the QME report. I read for a hobby, I don't ski, play tennis or basketball, jog or do any type of high impact sports. I have never had a broken bone.

Work comp believes that my toe (the one that's fused with two screws in it) is only 5% disabled. The toe itself may be only 5%, but it affects the quality of my life every day, both waking and sleeping. The weight of the covers on the toe wakes me up at least five times a night. And heaven forbid that I get twisted under the covers. That pain is a real eye opener, complete with stars.

Previous to the injury I walked my dog daily, could move quickly through Costco at least 25 times a shift and had successfully taken off 50 pounds. Just by walking daily. Since the accident I have been unable to walk my dog around the park without my knee swelling and my toe becoming numb, red and I am unable to stand in an anatomically correct manner. I have always had good posture (courtesy of the Army) until recently but now I find that I balance most of the weight on my left leg and hip which is causing its own little problems with my back. I am constantly shifting my weight from side to side and if forced to stand more than a few minutes (like in a grocery line) I look for ways to prop my right foot higher than the left.

I have also regained 45 of the 50 pounds (and my dog has gained five), can no longer walk more than a mile without pain and have to use a step stool to get things off the back of my kitchen shelves since I can't stand on my toes. It's a good think I'm not a ballerina. It's a bad thing that I am 5'1".

My work and everything that I have been trained to do requires that I stand for 8 to 9 hours with constant walking in between, so saying that I am fully able to return to work is a crock and is a decision made by someone who thinks that walking to their car constitutes getting around. Who cares if I can't and could never do squats? As I told Dr. B, this was first noticed at fourteen (not 17) when my dad came back from Korea and was showing us how the natives sat. I now walk on the outside of my foot because my big toe only contacts the ground if I deliberately force it by rolling my foot to the inside with every step and then my knee has sharp lances of pain horizontally across the kneecap. In what way am I capable of working a 10 hour shift on my feet, carrying an average of 40 pounds at the same time and then do it all over again the next day? And the day after that.

Previous to the injury I wore a size 6 shoe, a 6 1/2 if they were of the skinny variety. Now I require a 7 to 7 1/2. They must be completely flat with a hard sole, a rounded toe and a large toe box to accommodate the angle the toe is fused at. For some reason, the scar from the fusion is exactly where the edge of the top flap of the shoe presses on the foot and the pain located on the ball of the foot, where most people put pressure while walking or running. Any type of heel is totally out of the question. I have taken witnesses (you should try shopping for these requirements if you don't believe me) to show the difficulty of buying shoes. I usually spend about three hours, seven or eight stores and end up with a pair of sneakers or sandals with an adjustable strap across the top of the foot. The sneakers have soft tops and don't put pressure on the fusion. Sandals are for casual summer wear.

The shoes the doctors recommend start at $250 a pair and are not covered by work comp, (but work comp is willing to pay me $230 a week, which I use for rent, food and gas. All my other bills obviously fell by the wayside and I'm still trying to get the money together to declare bankruptcy), they still look like sneakers and none of them are appropriate for dress wear. You know, the stuff you are supposed to wear when you go to an important function or, in my case, job interviews. I have been told to my face that my footwear is not appropriate for work. Or interviews. Isn't that special, to say nothing of embarrassing. When I was in the Army, my platoon sergeant used to try and match the shine on his jump boots with mine. Now I wish long dresses were in again so I can hide my shoes.

Previous to this injury I had my own personal chef business. I was only doing the weekend work for Aidell's to try and get my foot in the door (Rachael Ray and Martha Stewart started somewhere) and to earn a little extra money for my 50th birthday. Well, my personal chef business is history, all the money I spent training, buying extra equipment, designing and running my own web page has been wasted. For my birthday I was poor and in pain and the birthday this coming Monday doesn't look much better and in many ways worse because now I have no savings at all. Cooking holiday dinners (something I've done for most of my life) for family and friends practically destroys me. I have to take way too many breaks which makes dinner later than usual and the next two days I lay around taking aspirin, icing the knee and toe and moaning in pain.

Speaking of pain, let me reiterate this one more time since the doctors seem to have a hard time reading a chart or listening when they ask you what your allergies are. I am ALLERGIC to NSAIDS (they affect my breathing adversely), I am also ALLERGIC to morphine codeine, tylenol, hydrocodone, oxycodone, fentanyl, tramadol (Ultram), talwin, and amesec, to name a few. I don't make a big fuss about my pain because there isn't anything other than demerol that works on me and I would prefer to save that for something like a car accident or other major trauma. So no, low dose NSAIDs and opioids aren't an option.

After the tsunami in the Indian Ocean I wondered if I would be able to run fast in an emergency. Due to the size of my breasts, this was impossible so I opted to have them reduced. While now it doesn't hurt my chest to run, I still can't move in a hurry because I can no longer push off with the injured foot. As a matter of fact, anything that requires stretching the leg and pointing the toe causes painful cramps and spasms in the calf and directly behind the knee. None of this was an issue before my accident. By the way, have you spoken with my former supervisor who saw me within 30 minutes of the accident and can testify that the knee was swollen, purple and immobile? Or that I used to move quite quickly while at work?

When work comp decided not to approve acupuncture as a modality, it put me out of business. Yes, I am an Acupuncturist and used to be licensed by the State of California. At one time it was determined that acupuncturists weren't capable of running a case appropriately. Well, I was the primary care on a few cases and believe me, I ran a much tighter ship than the one I've been sinking on for the last two years. Pain was assessed every time, you guys didn't do that for me for six months and then again briefly during the QME. My "treatment" consisted of being told to go home and stay off it to see if it would get better. Period. Well, it didn't and it got progressively worse. If proper procedures had been followed there would have been a record of my pain, what made it worse, what made it better. But none of those questions were asked of me. Six months after the accident the foot was authorized for surgery and Dr. N and I discussed that wearing the walking boot while healing from the foot surgery would aggravate my knee but it had to be done. From that point on, the knee became worse and nothing was done until the following May, nine months later. When I asked for physical therapy to help rebuild the calf muscle after being in a cast for several months, Dr. J wasn't that helpful, didn't think I needed it even though the right calf was just a stick and the left calf was muscular. I finally got physical therapy which consisted of telling me to ride a bike, spread my toes and lift my heel off the floor ten times a day. Whoop de doo.

I finally saved up enough money to buy a bike and rode it faithfully because Dr. P said it would help build up my quads and that would take pressure off my knee. The knee felt pretty good (I was up to almost 20 miles a day), but I started to develop problems with the foot. I told Dr. P in August that I was having trouble and he told me to continue riding and to come back in a month. By the end of September the toe was constantly swollen. The beginning of October he expressed surprise that I had a fusion and told me to quit riding the bike because how one puts pressure on the pedal was exactly where the fusion was and that I should take up the elliptical machine instead. I joined the YMCA at the cost of $52 per month, had a personal trainer work out a program to strengthen my legs as Dr. P suggested and I still have pain. But now I can no longer afford to attend the gym and buying a home system is completely out of the question.

I quit riding the bike but the toe was still swollen and numb. On October 10, 2007 my foot slipped off the brake and back onto the accelerator while I was parking and the police determined the swelling in my right foot to be the cause of the car accident. This accident totaled my car and caused me to jump through several hoops for the Department of Motor Vehicles in order to get my license back. It took almost three weeks to get an appointment with my work comp doctor and by then I had been taking aspirin four times a day and icing the foot to get the swelling down. It looked pretty normal by then, but the damage to my life and my car was done. Now instead of driving the just paid off car that got 35mpg, I drive an eight year older car that gets 18 mpg and my car insurance has doubled.

I used to make several thousand dollars a month, now I make less than one. Instead of giving me a lump sum, you want to stretch it out so that it is basically useless to me, other than to keep my head barely above water, until I have used up the $3K that you think destroying my life was worth. Then I am on my own, for the rest of my life. In pain and with difficulty walking. Problems I did not have before the accident. I can't go back to being a massage therapist because I can't push off with my right foot, it's painful and then my knee buckles. I can't go back to practicing acupuncture because I don't have the money for the license fees (now that acupuncture is accepted by work comp again) or the continuing education credits that are required.

This small, part-time job and the ensuing accident have had seriously negative consequences for my life. Everything that I have been trained to do ($100K for the AP degree), my hobby of cooking that I was turning into a profession and now the ability to find a job that will allow me to survive in today's economy, are further out of reach than they were when I was twelve. I'd like to say thank you, but I usually require a kiss when I'm being... shafted.

Oh, and by the way, Dr. B spent 19 minutes with me as actual face time, not the hour that he says. It took me longer to get back and forth to the X-Ray place than he spent talking, or more importantly, listening to me. If I could afford a lawyer, they would be the one writing this letter and handling this case from this point on.

Debsweb and Big Brass Blog