How are we supposed to survive?

[buttergirl12]

The insurance company/worker's comp is going to cut DH's payments because some stupid doctor said he was slightly disabled. He had back surgery in April and the rest of the disc came out and is on his nerve after that. He can not move without a lot of medication. He can't sleep in bed because both his arms will go completely numb. One of his feet is numb all the time. His back is hurting so bad. Physical therapy for this ruptured his hamstring. He will need another surgery. And this doctor says he his barely disabled and needs to wean of his meds. We can barely pay our bills now. We have no savings because he has not been working since last summer. I work from home full time with 2 kids in the house because we can't afford a babysitter and I will have to get a note from my midwife that I can go back to work before the 6 weeks maternity leave for number 3 (this was not planned and we were not being careless, contraception is not 100%) is over. I can't get a second job because I need to spread out my job over the day to take care of the kids while DH struggles to do chores around the house. We don't spend money on us at all. All we do is pay the bills and there is not much at all we can do about those. We pretty much just have the basics. We can cancel cable but that will only save us $50 a month. We already live in a house that's too small for us (2 bed, 1 bath, no basement). I don't even know if I can fit 3 car seats in the car we have now. DH is crying right now because he knows he will have to work while being in that much pain.
I already feel like my life is all work and no fun, I already worry about paying the bills, I worked so hard to fix our credit and now I have to find another $600+ a month to barely make it.
Just figured out they want to cut $1200 a month....

[wencit]

:hug:

That sounds like an awful situation to be in. Is there any way you can get a second opinion from a different doctor, one who will be sensitive to how much pain your DH is in?

I'm so sorry you're going through this.

[arivecchi]

I'm so sorry you are going through this. Can you appeal the decision somehow?

[buttergirl12]

His own doctor says he is totally disabled. Once in a while the insurance company sends him to one of their docs and he's the one who said DH is mildly disabled after he had to help him on the exam table. From the way this doc talked to DH there was no way he considered him mildly disabled.
We do have a lawyer and we will request a hearing but that will take a long time. If we are lucky we can get a loan and pay it back if we get back payments but who knows.

[bigpassport]

Do you have a workers comp attorney? Can you appeal the wc doc's decision? Was that the permanent partial disability evaluation or an interim evaluation?

[HannaAddict]

You need a really good attorney who specializes in worker's comp. (There are many bad worker's comp attorneys out there, much like family law. It helps to get a good referral from someone who has used them.) The insurance company is in the business of denying benefits and does the so-called "IME's" or "independent medical exams" where they pay doctors whose job is to say the person can work, is malingering, etc. If your attorney is not aggressively pushing back, you need to find a new one. Good luck, that is an awful situation.

[gatorsmom]

Lots and lots of prayers coming your way. I"m so sorry you are going through this. It's so scary to know that anyone of us can suddenly be put at the mercy of those dam* insurance companies at any time.

If there is a special place in hell for anyone it is CERTAINLY for doctors who underdiagnose an ailing patient to save the insurance companies some money.

Please let us know how you are doing. I'll keep praying for something to turn around for you. hugs.

[Fairy]

You need a really good attorney who specializes in worker's comp. (There are many bad worker's comp attorneys out there, much like family law. It helps to get a good referral from someone who has used them.) The insurance company is in the business of denying benefits and does the so-called "IME's" or "independent medical exams" where they pay doctors whose job is to say the person can work, is malingering, etc. If your attorney is not aggressively pushing back, you need to find a new one. Good luck, that is an awful situation.

Exactly this. If your husband was injured at work, then your WC atty takes no fee at all unless you win (20% is standard). You absolutely should not be existing right now without your atty, and a GOOD one. Comp attys get a very bad wrap as the ambulance chasers, but they are, indeed, the unsung heros of people like your husband who are truly injured at work and in desperate situations. Please contact one, and if you need help figuring that out, PM me. I have alot of lifelong knowledge on this subject.

[egoldber]

I agree, you need a WC attorney. My DH (before we married) was injured on the job and it took over a year before they would pay him what was owed. :irked:

Have you considered applying for financial assistance? Food stamps or WIC (usually easier to qualify for) could be a big help to your family right now. :hug:

[kijip]

:hug:

ITA that you need a GOOD lawyer. Many cases like this require an administrative appeal or an outright lawsuit. What the insurance company is doing is wrong.

Also, apply for food stamps and WIC- this is why they exist, to help you in your time of need. Though, depending on how much you make, it is less likely that you would get food stamps (the income limits are very low).

And if it does not look like your husband will be able to return to work soon, you may consider filing for bankruptcy if you have a lot of debt in addition to your regular necessities. When it comes down to it, food and heat are more of a need than credit card payments. If he can go back somewhat soon, it would be great to avoid bankruptcy but if this is a very long term thing or becomes a permanent disability, bankruptcy will make it easier to get by on your income + whatever disability payments he is eligible for.

:hug:

[ha98ed14]

Have you considered applying for financial assistance? Food stamps or WIC (usually easier to qualify for) could be a big help to your family right now. :hug:

Yes, this. WIC. You can get it even if you are employed. Especially because you are pregnant; that makes you very eligible. I am sorry you are going through this. :hug:

[Melanie]

I'm so sorry. Everyone else has had really good advice, I just wanted to say that I would be over the top in tears of frustration and blinded with anger right now. You sound like you are working really hard to hold it together for your family. That must be exhausting.

[buttergirl12]

We do have a workers comp attorney and he is trying to fight for us with the new MRI. We also got notes from both of DH's doctors that he needs the second surgery and they consider him totally disabled. I make too much money to get any assistance. Meanwhile my lazy, crazy in-laws are on social security without a care in the world and think them being bored is a lot worse than our problems. But that's another bitch. No news from the lawyer yet but no official word from the insurance either. We applied for a personal loan from our bank just in case we need the moey to live on for a few month.
Thanks for all the suggestions and kind words.

[Fairy]

We do have a workers comp attorney and he is trying to fight for us with the new MRI. We also got notes from both of DH's doctors that he needs the second surgery and they consider him totally disabled. I make too much money to get any assistance. Meanwhile my lazy, crazy in-laws are on social security without a care in the world and think them being bored is a lot worse than our problems. But that's another bitch. No news from the lawyer yet but no official word from the insurance either. We applied for a personal loan from our bank just in case we need the moey to live on for a few month.
Thanks for all the suggestions and kind words.

I think you need another atty. Both your docs consider him totally disabled (as opposed to having x% loss of the use of an X)? So, you mean PTD? Permanent Total Disability? Cuz if this is the case, then why is the insurance company saying he can go back to work? In this case, you should be heading for trial. And whatever the disposition at the moment, you should not have to be applying for a personal loan, which is just a mess.