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post #1 of 4 (permalink) Old 06-05-2005, 12:11 PM Thread Starter
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Disability, unions, time out of work, etc.

Hey, I know I haven't been around in a while. Click here to enlarge

Anyway, here's the story:

I hurt my back almost 4 weeks ago. I was going to work in the beginning, because it wasn't that bad, but on 5/20 I didn't go in, I was hurting THAT much, and I haven't been back to work since.

On my job, the first 5 days are regular 'sickness', and anything after that is considered disability.
This is where it gets a little complicated.

I've been seeing a chiro for my back pain since then.
Met Life called for some info, including my doc's info, because they would need to speak to him about my claim.

So I get a call on Thursday saying that I was denied, according to the following:
'You were denied, because when we spoke with Dr. ___, he said he didn't take you out of work, nor did he advise you not to go to work, he only told you to 'take it easy' '.

I had therapy on Thursday, and he didn't say a thing to me. (then again I didn't ask, but meh...)
I got this info after I came back from his office.

The problem is, I'm worried that I'll HAVE to go back to work now, but I am still in A LOT of pain. Perhaps I didn't convey my level of pain and discomfort to my chiro, so that's why he said this?

OTOH, I've heard that disability claims are hard to approve.

And what's a little weirder, I got some forms from MetLife on Saturday, but they mentioned nothing about my being denied, or even that they had spoken with the chiro.
It's almost as if they are 'new' forms.
My questions are:

I don't know if I'm 'protected' by my union where this is concerned, or what.

Do I try to resubmit the claim, ie, talk to my chiro again, and explain that functioning under this pain is really not going to work?

I went to my regular PCP this morning, but she can't fill out the forms that I received, since she wasnt the one treating me when the injury began.

I ahve to go for MRIs and such, and I wonder if I can resubmit the claim once that's finished?

I truly apologize that this is so long, but I'm really unsure and confused as to how to go about things from here...I didn't have this problem when I was out for Pregnancy, that was a million times easier!

Thanks for reading and for any answers.
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post #2 of 4 (permalink) Old 06-05-2005, 01:25 PM
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I'd start with calling the chiro tomorrow and discussing the situation, and then see about appealing the denial. Until you talk with him, you don't really know what support you have for your case.

--Nancy L.
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post #3 of 4 (permalink) Old 06-06-2005, 04:05 AM
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What gives you the impression that your injury can be effectively treated by a chiropractor? I am wondering if you have any neurological damage.

I'm surprised that a chiro is considered a primary physician by any insurance company. A regular chiro doesn't necessarily have the same education and knowledge as a medical doctor unless he/she is an osteopath.

You need a referral to a neuro just to rule that out. If your chiro doesn't listen to you, then he needs to go. I would ask Met about the appeal process. I'm sure they have one. At the appeal you should be able to present new information. Again, ask them in advance.
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post #4 of 4 (permalink) Old 06-06-2005, 07:06 AM Thread Starter
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Thanks GS.
I saw my primary doc yesterday, and she referred me to an orthopedic doctor...she doesn't like the idea of me seeing a chiro either.

I spoke to my boss this morning, and he said I can appeal the decision. I'll talk to my chiro today, and I'm going to call MetLife and find out what I need to do appeal.
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