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Back and Neck Injury: First 60 Days Vital

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Stanwood, WAWhen Tim suffered a back and neck injury in 2009, his family doctor told him to take two aspirin and take it easy for a few days. Since that time his life has been a hellish roller coaster ride of pain meds and surgeries, and near financial ruin. Tim believes if he received proper treatment soon after the accident he would likely be back at work today. Instead, he is disabled and unemployable.

Tim was a mechanic for Boeing when he “exploded” the disc between L4 and L5 just before Labor Day Weekend. On doctor’s orders he had physical therapy, but that aggravated his back. He continued to work for about a month until the pain became unbearable.

“I went back to my doctor and he just prescribed muscle relaxants,” says Tim. “By the end of November I saw a neurosurgeon who gave me steroid injections in my spine but that didn’t help. I had an MRI that determined I needed surgery to remove the damage - the disc material - because it was blocking the nerve going down my left leg, which was numb clear down to my toes. I also had tingling and burning sensations in my back.”

Tim’s neurosurgeon prescribed Tylenol and codeine, to no avail. He then had to wait until the second week of January to get the surgery authorized by Boeing’s insurer - it took that long for their claims manager to approve the surgery. Tim’s condition went from bad to worse: the surgery increased the pain and numbness. Next up he saw a pain specialist in nearby Everett, who put him on morphine, and a slew of other meds, including a drug to stop muscle spasms. After a few months he saw yet another pain specialist who substituted morphine for fentanyl patches.

“One year later I had another surgery, which resulted in moving pain to a different location in my leg, but the original back injury site was my main concern,” Tim explains. “Meanwhile, I was getting long-term disability benefits from Sedgwick, my health insurer through Boeing. I moved to the Philippines in March 2011 because I couldn’t afford to live on 60 percent of my income. I had a friend who offered to take care of me - I couldn’t even dress myself at that point and I could barely walk.

“Five months later I flew back to the US for a follow-up appointment. In their reports, two doctors said that, because I was in such extreme pain, I would have to stay on these pain meds the rest of my life because there is no cure for nerve damage. I found out later that if these issues aren’t addressed in the first 60 days, the nerve damage becomes permanent. Boeing made me wait six months before my first surgery - they created this monster.”

Tim returned to the Philippines. In November he received a notice from Boeing: his primary doctor said he could return to work! Interestingly, his claims representative, who had been helpful since his injury, now gave him the cold shoulder.

To make matters worse, the pain meds had taken their toll. Tim had such bad constipation that his legs were swollen to the point that he had to be hospitalized. Around this time he saw another neurosurgeon, had another MRI and another surgery scheduled.

Back Injury Compensation Claim

And he had another issue to contend with - Sedgwick was determined to cut off Tim’s disability benefits. He soon found out that insurers have an “unspoken set of rules” when you hit the two-year disability mark.

“They got nasty after they didn’t get the right answers from my surgeon,” says Tim. “Even though I saw their independent medical examiner (IME) before I moved to the Philippines, they insisted I see another one. My neurologist disagreed with their IME and said that my only hope to get off all the narcotics was to get a spinal stimulator. And here is the kicker: Boeing refuses to pay for it. The state of Washington considers it experimental. Just about every other state in the US, including Medicare, pays for this device...”

Tim says that Sedgwick then went shopping for a medical opinion in their favor. They went back to his primary doctor who wrote that Tim could return to work, even though Tim hadn’t seen him for more than a year.

“I then got a letter that said I had to return to work in seven days or I would be terminated, and no more benefits,” Tim says. “I appealed and the state of Washington overturned Boeing in December and reinstated my benefits, and ordered Boeing to change my primary care doctor to my doctor here in the Philippines.

“Fast forward to April 2012. Sedgwick had scheduled another IME exam and they flew me back to Seattle. This time, they chose an orthopedic surgeon from Texas to be the IME. So what does he know about neurological damage? He said I could go back to work full time.

“And here is another issue: Dr. Rivera, my neurologist in the Philippines, has never been paid by Sedgwick, even though the state ordered Sedgwick to pay him. He has requested additional MRIs but Sedgwick ignores all requests. Instead, in November 2012, they cut me off again.

“I didn’t return to work, so that ended my insurance and any pension. It was perfectly timed by Boeing: I was terminated with less than 30 days to go until I would have been vested in the company. It was all planned. This time I hired an attorney and he appealed Sedgwick’s decision. It was overturned again and I was finally reinstated just a few weeks ago with back pay to November 14, 2012.

“Here is the kicker: the major side effect of these drugs is constipation. Sometimes I can’t go to the bathroom for a few weeks. The first week of December I got a stomach ache, in my appendix area. I was in terrible pain and went back to the hospital. My gallbladder was ten times its normal size and full of gallstones.

“I couldn’t afford surgery. I sent a letter to the state of Washington but no response. My 80-year-old mother tried to come up with money and finally the Mormon Church stepped in and paid for the surgery here in the Philippines. It cost $6,500. It would have been $65,000 in the US. I sent the bill to Boeing but they are refusing to pay and I am still fighting that.

“One week ago I got a letter from my attorney. Boeing is flying me back to the US in a few weeks and sending me to several of their IME’s, so I have to go through this whole nonsense again: They will cut me off again and I will go without any money again during the appeals process. This is their unwritten rule: they mess with you big time to beat you down.

“Meanwhile I am still seeing a pain specialist and pay out of pocket for meds. My left leg is completely numb and my right leg is getting the same way. The last MRI report says “major narrowing in disc space between L4 and L5” and the vertebrae are almost touching now because there is no disc left. So I have another surgery to look forward to.

“My doctor suggested a TENS machine, but Boeing refuses to pay. Physical therapy just aggravates the condition so basically I am screwed. My choice is to stay on the pain meds, which are slowly killing me, and fight Boeing. Or try the stimulator - but they refuse to pay for it. They won’t even try the trial for the stimulator before it is permanently implanted to see if it will work, which costs about $6,000. I wish I could afford to pay for it.

“This is my situation: Boeing is trying to prove I have no physical defect to keep me from work. But the side effects of these drugs, especially the Fentanyl patches, have kept me from work. My attorney will argue the point that it is too dangerous for me to work, and for others to work around me. I make stupid mistakes. Last week I plugged in the vacuum cleaner to 220v instead of 110v and fried it. No company will hire me after taking a drug test. The drugs have made me unemployable.

“And if Boeing is doing this to me, how many others are they doing it to? It is ludicrous that I have suffered so much because of (what once was) a minor back injury.”

LawyersandSettlements contacted Boeing: Their spokesperson advised that we contact Sedgwick. Stay tuned.

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