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Reflex Sympathetic Dystrophy (RSD) (CRPS) Message Board


Reflex Sympathetic Dystrophy (RSD) (CRPS) Board Index


What about infusion therapy? Michelle (who used to post on this board often) reported that she achieved complete pain relief from Lidocaine infusions. She went to Schwartman at Drexel. I am almost certain she said she went for 3 separate treatments, others on this board might remember more details. Ketamine low dose infusions are also available but are supposedly more controversial. I was under the impression that they were only available at Drexel and South Florida Univ, but today I found out that some other medical centers offer them, too.

What do you mean when you say that the RSD is an "allowed condition" under your WC claim? I'm also under WC but haven't heard that term used.

A Dr. I saw in Boston yesterday wants me to get a SGB within a week. Don't see how that will happen...I'm also SOOOO tired of fighting the system. He also mentioned putting a catheter in my neck to deliver drugs right where they are needed, and then his 3rd suggestion was the SCS. But my lawyer hasn't contacted me and the Hartford already refused to pay for my consult let alone future treatments. And it's Friday so guess what??? Nothing's happening between now and Monday....

What do you think the chances are that the WC companies catch the Christmas spirit and take a break from busting our chops? Wouldn't that be sweet?

Sandy
Hi Sandy-
For worker's comp., when you are initially injured on the job they give you diagnosis code/codes for allowed conditions for doctors to treat you for. For example, for me, I had an anterior calcaneal, 2 navicular, and cuboid fractures of my left ankle/foot. The occ. med doc. gave me the initial diagnosis of left foot fx, left ankle fx, left foot sprain, left ankle sprain. These were the only conditions that were allowed to be treated under my worker's comp. claim. However, when I saw the ortho guy, he submitted a C-9 form and requested the additional allowances of the fractures; I had to file a motion with BWC in order for my work to either accept or deny these additional allowances/conditions for treatment, which they accepted because of the supporting doc. from my CT Scan. Then, came the Lisfranc injury. They added that on without any trouble because of supporting doc. from my ortho doctor. Then came the RSD over the past couple months. Initially, my ortho guy submitted it on a C-9 form for the additional diagnosis; I had to file a motion(agreeing to the diagnosis) to get it added on. However, when it went to BWC, RSD automatically goes to a physician review. A BWC doc reviewed my chart, or let's say really didn't review it,...and totally botched the review and denied the additional allowance of RSD. I appealed his decision and then BWC sent it to an industrial commission to be decided. It was at that hearing that the IC hearing officer, my attorney, and the risk management group with my work had to all present the information for a decision to be made as far as getting RSD added to my claim as an "allowed condition" for treatment. WC WILL NOT treat/allow anything that is not an allowed condition, especially RSD. They denied PT, the blocks, everything since October. I was forced to go through my private insurance because the RSD started to progress and I had to get a block for confirming diagnosis/therapeutic treatment. Luckily, my pain management doc accepts BWC and also my insurance. So, we proceeded with the block the week before my hearing. It only completely confirmed the RSD. There was no question at the hearing...the information was so overwhelmingly in my favor, the other side had absolutely no case. The hearing officer added RSD on as an allowed condition on the spot(which usu. never happens), and my employer waived the 14 day appeal period so that I could get treated. But, now I am still running into trouble with a CRR RN at Careworks reviewing the C-9 request for add'l blocks...they take as long as possible and then decide that it has to be sent to a MD for review, and that MD is out until Tuesday...how convienent? My block is scheduled for Monday, and I'll have to proceed with the block....the bills will get straightened out later. The whole thing is that RSD is now an allowed condition to my claim...there should be no reason why they are even questioning the blocks...it should be allowed as stated as standard treatment for RSD patients. That is what I don't get, and that is what my occ. med doc doesn't get. Careworks(MCO for my employer) has made this so difficult. I doubt you will hear anything by Monday---things take at least 1-2 weeks to get approved, and if yours has been denied up to this point, something isn't right. Is RSD an allowed condition? RSD is a very hard condition for WC to accept and add on. Mine actually was added on pretty easily because there was no question that the fractures/trauma resulted in the RSD. There was so much supporting documentation from all of the treating physicians, it was pretty hard for them to have a case against it. But, you have to fight for it. They put me through the ringer, and I think they thought that I would give up once the BWC doc denied it initially. But, that just gave me more ammo and I got an attorney who was very well known for BWC and RSD cases in Columbus. Usually, he told me it takes 3-6 months to get RSD added on to a claim, because you go to hearing, appeal, hearing, appeal, hearing, appeal forever because most employers don't want to have to pay for an employee that has RSD. It is a huge expense that they incur. But, it isn't fair to make patients wait as long as they do, and end up with progression just because they don't want to pay for it. We didn't ask for this at all! WC is the most frustrating healthcare system I have encountered!
As far as the infusion therapy, I was reading about that this evening. I don't know if anyone in Ohio does that. A Lidocaine infusion seems pretty simple, and so less invasive. I'm a nurse, so I have a lot of medical knowledge....probably more than I really wish that I had at this point. I'll have to talk with my PM doc on Monday and see if he does that, or knows of anyone that does. Maybe the Cleveland clinic, but I can see that being a nightmare with WC. I hope you get your situation straightened out soon. Try to hang in there, and don't give up fighting. That is what they want you to do...don't give in. If there is any way you can get the block, go ahead with it. Like my attorney said, get the treatment now, and worry about the bills later. You need to get treated before it gets out of control. Take care. Katie





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