a little over 2 months ago i slipped and fell at work, busting my knee. i filed an incident report and gave it a few days to see how i felt before seeing the doctor.  a few days later i went, they took an x-ray (negative), so he ordered physical therapy.  3 weeks later its approved and i end up doing 8 or 9 sessions with the pain increasing.  

the doctor says enough, mri time.  another 3 weeks go by and its approved so i get it done.  today we went over the report, pretty much negative (no torn meniscus or ligaments, chondromalacia patella [runner's knee], some shit about a cyst and ganglion degeneration).  the doctor referred me to a specialist.  i'm sure it'll be another 3 weeks before its approved.

what's it take to get a second opinion?  i have all of the doctor's reports, a copy of the mri report, and the mri images on dvd.

why does it still hurt?

Chondromalacia will continue to be sensitive, especially if you put stress on it.  You know like walking, or standing, or breathing!  My doc actually gave me a profile that said "no stairs" for mine.   PT helps some, and the injections are an option.  Go to the specialist, but if he doesn't tell you, just remember that the syn-visc type injections don't make it better, they just make it feel better. So once the shot wears off, your knee is worse and you need a refill!

yeah, i tend to walk a lot for work.  like sometimes over 30,000 steps per day.  and there are times when i have to stand in one spot for a while.  not being able to squat without swearing is shit too.

Go see an orthopedic surgeon.  Without a good history and physical exam, everything is guesswork.

This is part of the problem of gatekeeper medicine, where a primary care doctor rides herd on the wild specialists.  The problem is that many times PCPs don't know jack, and cause wasted dollars and time off work.

Quick example from real life.  Mechanic develops wrist pain at work, bad enough that he can't do his job.  Goes to the PCP and gets diagnosed with a sprain, placed in a brace, prescribed an NSAID and told to follow up in a week.  One week later, no better, so order an x-ray (most PCP can't name all the carpal bones in my experience).  Wait a couple of days for another follow up appointment, and the x-ray is read as normal.  Now off to physical therapy, which doesn't help.  Another F/U appointment, still no better, let's get an MRI.  F/U in a few days to go over the MRI results...and it is normal.  So now the patient goes to see an orthopedic surgeon (my partner).

At this point the patient has been out of work for close to a month and has had x-rays, MRI, and PT.

My partner asks the patient where it hurts, patient points to the first extensor compartment.  Patient has a positive Finkelstein's test.  Patient has DeQuervain's, is given a steroid shot and has complete pain relief upon leaving the office (due to the local) and returns to work with no further complaints.

Go get checked out.

i will see whoever they send me to.  i'm just getting tired of waiting 3 weeks between something being ordered and it being approved, with the adjuster not responding to any inquiries.  

i shit you not, the doctor today pulled up google on his phone and started searching for the items on the radiologist's report.  i really miss my orthopedic surgeon at the mcbride clinic in oklahoma.

care to look at an mri?  jk...kinda.

So I went to the specialist that the worker's comp insurance company referred me to. Those idiots sent me to a cardiologist. But, hey, at least I know know that I have hypertension.

WC sucks.

I'm a Florida Work Comp case manager.  There are no second opinions.  You can put in a request for a new Ortho physician under the "One Time Change" clause if you haven't used it yet, but if you don't like that physician, you're stuck.

So I see.  I'm sure it'll be another 3 weeks before another appointment is made.

Have you communicated with your adjuster?  They should have sent you some paperwork, along with their info. If you don't have that, talk to your HR department, and request that information.  If you pester your adjuster, you will see things happen faster.

Well they have yet to get me into see an ortho yet so I guess I still have the option.

So you're seeing an occupational specialist.  You can request a new occupational specialist, but I'd wait.  You don't want to waste your one time change until you really need it.  3 weeks really isn't that bad considering most people have to wait longer than a month.

I was involved in a 3rd party WC case.  It took 6 months to get the surgery, to fix a split labrum and torn off (at the shoulder) biceps tendon.

To top it off, since it was a 3rd party case you are FORCED to litigate for damages and recovery of medical payments.  I was happy just to be put back together.  I didn't want to sue anyone, but that wasn't one of the options.

The attorneys made the money.

1/3 of the settlement goes to your attorney. 2/3 of the remaining 2/3 goes to the insurance company.  You get what ever is left minus all the expenses.

The adjuster has never once answered or returned a phone call and to my knowledge has never responded to an email.

No.  Their primary doctor requested that I see an ortho specialist.  The insurance company sent me to a cardiologist. When she asked why I was there and I told her it was an OJI knee injury she looked at me like I was retarded.

Sounds typical.  

At this stage it sounds like your case is heading in the right direction, but at a snails pace.  You have two options.  You can do a refusal of work comp, and go on your own using your own insurance, or wait until they assign you a knee guy to continue with work comp.

I would wait, and take the assigned ortho and continue under work comp.  There isn't as much of this crap once you're under their care unless they order surgery.

Their primary is the occupational specialist.  It's usually a walk in clinic, but some companies use regular doctors.  They don't usually send you to your PMD unless they need a medical clearance.  I'm not sure why you would need one at this juncture unless you have preexisting heart problems or hypertension that may interfere with treatment plans.

I wouldn't be surprised if something was "missed" considering I have no say in who looks at the pictures. The first doctor I was seeing said somewhat jokingly that worker's comp takes so long to go through because they're hoping you die before approving anything.

I'll wait. I'm already 2 months in and I knew it wasn't going to be a fast process.  Sending me to the wrong type of doctor pissed me off though.

The insurance company is your issue.  They are no better than your personal health insurer.  They have to protect their bottom line, and will drag their feet the entire case.  I've seen some insurers take as long as three months to approve little things.  What city are you in?

Being a worker comp case manager would you recommend him getting an attorney if he does not get better and the medical care he receives is not on par with what s prudent person would consider adequate. I've seen some worker comp cases where the case workers were absolute dicks and once an attorney got involved treatment got a lot better.

I went on workers comp under the heart and lung act and the case worker tried to treat it like a regular workers comp case. Big no no. I am a retired firefighter. Hell the county even tried to get me to take another job within the county. I just looked st them and said hell no. I'm not leaving fire rescue. I was protected by the heart and lung act.

The county and case worker tried to screw me at every turn until I said enough an got an attorney. Now I'm not saying your like that. But the case workers report to the employer and their primary goal is to save the employer money.

This was not with just me but with every firefighter that got hurt.  You need to be very careful on worker comp. Do not sign anything that would give your rights away. Where they try to get you is to put you back to work before your healed because you need the money.

They'll want you to sign a release to come back to work. If your not better get an attorney. Now lets be clear. If you can not do the job they hired you to do. They can fire you. They do not have to put you into another position.  The main thing you want to to get proper medical treatment and go back to work.  But depending on what you do. You can hurt yourself more or hurt others.

But from what you just described you treatment is way off from being adequate care.  You need to sit down with your case worker and talk with them. Explain to them your concerns. I fired one and got another because I complained that he was not doing his job and was to aggressive. All he wanted me to do was sign releases and I said no.
I keep getting sent to wrong doctors also. I am a paramedic also and they weren't jacking me around. I told them I was going to use my private health insurance to get treatment at one point.

Case worker said I could not do that. I said watch me. I can go to any specialist I want with my private insurance without a referral.  We have great insurance with fire rescue. I keep it when I retired screw Obama care.  But if you have to there are tons of attorneys that will do workers comp out there if you need one.

My personel insurance is alot better and faster than workers comp. I do not need referrals to see specialist all I have to do is call make appointment and pay. It took me over a month to see a worker comp doctor. I can see a doctor on my insurance in a week or less. The employer and insurance had to approve treatment and cost.

I have no idea. I am curious if I have to pay for the lab work and future visits to the cardiologist or if the WC insurance is picking it up since they're the ones who sent me.

Hollywood.

Your situation is much different than his, and is not even comparable.

I wouldn't lawyer up unless they start denying services.  Once you lawyer up, you're going to start getting fucked by a lawyer also.  

OP, I would keep calling the adjuster and leaving messages, daily if you have to.  Keep track of every call and time of call in case you end up lawyering up.  If you have a phone recording app, use it.  Be sure you let them know your are recording if you get a live person.  Also make sure your keeping track of your mileage to and from the clinic.  Mileage is compensable in the state of Florida, but your time is not.

I haven't missed any work and I'm not hobbling around crippled, but I could do without the pain, especially when I wakes me up at night.  I haven't slept through the night in 2 months and my focus and attention to detail is starting to suffer. Plus being tired all the time.

I've scheduled all of my appointments on days I'm off.  I've never signed anything other than new patient info for the doctors.

Dealing with Worker's Comp is hell. Period. I have been dealing with those assholes for just over a year now due to a knee injury. Two surgeries later and my knee still isn't right and a lot of it has to do with their bullshit/denials/etc.

I could go on for days with horror stories but don't really want to do so on a public forum.

i've already submitted 2 mileage sheets, one 6 weeks ago and still no check.  it was resubmitted when the hr lady sent the second sheet.  i'm not at the lawyer stage yet, but i have a folder with all of the paperwork i've received.  

so who is on the hook for the cardiologist and blood work that she ordered?

I have no idea.  I'd have to see your chart, your physicians dictation, the DWC25, and your treatment plan.  Your adjuster will need to discuss that with you.  In most cases, you'd be responsible for that, unless you didn't have any preexisting reason to justify such a request, than its on them.  Submit the bill, and see what they say.  If you already paid it, submit the receipt for reimbursement.

Call a reputable workers compensation attorney.

they didn't charge me for the office visit today and the doctor had no idea who would end up paying for anything in the future.  i have no reason to believe that i have a preexisting condition to warrant a trip to the cardiologist and the doctor didn't say anything about any notes in my file that she had faxed over from the first doctor.  after going through the file she still had no idea why i was referred to her.  i'll try to get the necessary info you talked about.  what's a dwc25?

The DWC25 is a form your occupational physician fills in after each one of your visits that breaks down your treatment plan.  It will list stuff like ordered tests, PT, work restrictions, etc.  Some physicians will give a copy to the employee.  Your adjuster and possibly your employer are getting them.  

i have copies of all of those.

The DWC25 is only a partial glimpse.  Those dictation notes your adjuster gets will say why you were sent to your PMD, or you can call and ask the clinic.

i'll call their office and ask for a copy of my file.