The LA County Observer

Observations of a LA County Resident

How did I get here? And why I got an attorney?

Written By: raconte - Jan• 05•17
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When I suffered my work-related injury being represented by an attorney was the furthest thing from my mind that is until I felt that Adventist Health (that religious hospital/healthcare corporation) was “messing” with my care.

After my fall on the wet floor of the restroom at the hospital I was sent to our employer’s workers’ compensation clinic/physician for care. While I was somewhat underwhelmed by the physician’s level of knowledge he seemed attentive and taking the appropriate steps to evaluate and treat my numerous injuries. The problem arose several weeks later when I found myself unable to place any weight on my right leg. While I had injured this leg in my fall the physician found primarily soft tissue/strain-like injuries, so I couldn’t understand why I couldn’t bear weight on my right leg. Stumped, I returned to the clinic for re-evaluation and surprise, surprise, I had a fracture that the physician had overlooked.

The physician ordered a cast walker, better known as a moonboot. Unfortunately, he didn’t have one he could fit me with so it was up to me to call around and find a store where I could purchase one. I was expected to pay for it out-of-pocket for which Adventist Health (that religious hospital/healthcare corporation) would reimburse me, which they eventually did thanks to a very professional and compassionate employee in Human Resources at Glendale Adventist Medical Center (GAMC). However, you’d think that a health organization would have such materials on hand or have a relationship with vendors/suppliers that could get them what they needed them stat – but I guess not.

So with the moonboot found and fitted I prepared myself to “wait-out” the almost six weeks that the physician estimated it would take to ensure full healing. In the meantime I began a series of physician visits to treat my other assorted injuries, including consulting with an orthopedic surgeon to fix the torn meniscus in my left knee, another injury that was the result of the same workplace accident. During one of my orthopedic appointments the surgeon agreed that I was a good candidate for surgery and we discussed the surgical plans. It was at this point that I asked him that if I had surgery immediately and considering that my right leg was currently in a moonboot this would leave me confined to my bed if I had surgery before my moonboot was removed. The orthopedic surgeon thought about this for about a minute and asked when the moonboot was to be removed and I replied in two more weeks. After some additional discussion he decided that since I was a diabetic we should wait until my moonboot was removed so I’d have at least “one good” leg to get around on while recuperating from left knee surgery. Since being confined to a bed for two or more weeks was not sound medicine for a diabetic such as myself and could lead to more dire consequences. I left his office that day not only with a treatment plan, but an appointment two weeks out for surgery. Everything was set, or so I thought.

Shortly before my surgery date I received a letter from the Adventist Health (that religious hospital/healthcare corporation) claims adjuster, Mr. CA, informing me that since I had refused surgery I had been deem “permanent and stable”. This designation would also affect my workers’ compensation payments and I would now be receiving permanent disability (PD) since I was no longer eligible for total temporary disability (TTD). Shocked by this change I contacted Mr. CA (I could do this since I had no attorney at that time) and asked him about the status change, since when I left the surgeon’s office two weeks earlier I was deemed TTD. Mr. CA went on to explained that he had contacted the surgeon and asked him to review his opinion, which the surgeon did and it was decided that I was now PD. I explained to Mr. CA that, at least in California, a physician cannot change a medical diagnosis of a patient without reexamining that patient which, hadn’t occurred in my case and any way I had a surgery date set and would be having surgery shortly, so how could I have refused surgery?

It was at that time the Mr. CA would utter those fatal words “we do it all the time”. I asked him to hold on for a moment so I could get my daughter in the room to listen to our conversation on the speakerphone. Once there I asked him to repeat his response to my question of the legality of having a physician changing a medical diagnosis without reexamining the patient, and Mr. CA repeated once again “we do it all the time”.

It was at that time that I knew I would need an attorney to sort this situation all out, and the search for a shark began.

More to follow. . .

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