Sciatica problem

[tomandjerry]

What is the name of your state (only U.S. law)? Michigan.

Hi all,

Here is the situation. A family member of mine used to work at 7/11 for few years. He got a back problem as a result of some heavy lifting. He's in his fifties. He was on disability and then settled in court for some amount of money. His specific problem was the L2 and L3 displacement I believe. As of today, its been about few years since the settlement. He hasn't been able to work because of the back problem and now he has Sciatica. For those of you who doesn't know what it is, its a pinch in nerve causing SEVERE pain that makes even a healthy person disabled. Now my main question, What should we do? We can't afford health insurance and won't get medicaid either. Can we do anything against the 7/11? If anybody reading this is in insurance business, please let me know what kind of insurance would cover this and how much would it cost. Please reply ASAP as this is very important.

 

[Ladyback1]

What is the name of your state (only U.S. law)? Michigan.

Hi all,

Here is the situation. A family member of mine used to work at 7/11 for few years. He got a back problem as a result of some heavy lifting. He's in his fifties. He was on disability and then settled in court for some amount of money. His specific problem was the L2 and L3 displacement I believe. As of today, its been about few years since the settlement. He hasn't been able to work because of the back problem and now he has Sciatica. For those of you who doesn't know what it is, its a pinch in nerve causing SEVERE pain that makes even a healthy person disabled. Now my main question, What should we do? We can't afford health insurance and won't get medicaid either. Can we do anything against the 7/11? If anybody reading this is in insurance business, please let me know what kind of insurance would cover this and how much would it cost. Please reply ASAP as this is very important.

What was the wording of his settlement? Some settlements are "full and final"--which means that is the end of the WC claim. Other settlements can leave the medical portion open.
Has he continued to treat for his back problems since the settlement? If so, who paid for it? Sciatica *usually* resolves it's self w/ conservative treatment (anti-inflammatories, gentle stretching/range of motion exercises, muscle relaxants, whirlpool/hot tub, chiropractic treatment.) A LOT of people suffer from sciatica and are NOT disabled.

If he hasn't been able to work, and feels he is disabled why has he not pursued applying for SSDI?

 

[tranquility]

Was the settlement in worker's compensation? What did the settlement say?

All future rights to further compensation may have been given up for the settlement money.

 

[OHRoadwarrior]

The best treatment for sciatica is through a pain management clinic doing nerve blocks. Without insurance it could run about $4k initially. With insurance about $400 initially, through the first injection. MRI's and EMG would be more.

 

[Ladyback1]

The best treatment for sciatica is through a pain management clinic doing nerve blocks. Without insurance it could run about $4k initially. With insurance about $400 initially, through the first injection. MRI's and EMG would be more.

I would have to respectfully disagree. The standard and "best" treatment for sciatica is non-invasive. NSAIDs, prescription Rx like Neurontin or Cymbalta or even Prednisone dose pak, Physical Therapy, Chiropractic. Nerve blocks would be the treatment of last resort prior to surgical intervention.

 

[OHRoadwarrior]

I would have to respectfully disagree. The standard and "best" treatment for sciatica is non-invasive. NSAIDs, prescription Rx like Neurontin or Cymbalta or even Prednisone dose pak, Physical Therapy, Chiropractic. Nerve blocks would be the treatment of last resort prior to surgical intervention.

You also suggested he apply for SSDI, for which he would be rejected, having failed to explore current more effective medical solutions.

 

[Proserpina]

Both of you please - stop it.

SOME pain clinics will go straight to a nerve block due to the patient's history and/or the nature of the condition - they recognize that going through the ABCs just to have documentation just isn't going to be good for the actual patient.

Some will absolutely do the ABCs before the nerve block. It really just depends.

So on that bit? You're BOTH right.

Whoda thunk it?

 

[ecmst12]

Um...you don't know what he has or hasn't explored, nor can you POSSIBLY know whether he would be approved for SSDI/SSI.

 

[Ladyback1]

You also suggested he apply for SSDI, for which he would be rejected, having failed to explore current more effective medical solutions.

No, I inquired if the gentleman had not been able to work and felt he was disabled, why he had not pursued SSDI. Completely different from suggesting he apply. I don't think he's eligible, I suspect there may be some malingering (cynical and jaded after too many years as a claims examiner)

Personally, I would guess that the gentleman "took the money and ran" so to speak in regards to the settlement, and did not realize the far reaching implications of said settlement. There are a few work related injuries that actually qualify as permanently and totally disabling. Sciatica is typically not one of those injuries/occ. diseases (neither is carpal tunnel, much to the chagrin of many claimants and attorneys ) I also suspect that there's more to the story than we got. Hence why I asked if the man has been continuing to treat and who's been paying if he has.

 

[OHRoadwarrior]

Advising him to apply for something he is going to be denied for, does not assist him.

 

[Ladyback1]

Advising him to apply for something he is going to be denied for, does not assist him.

I did not advise him to seek SSDI. I asked why he had not pursued it. I'm curious as to why the OP thinks that "severe" pain is disabling.
And, none of us know who will qualify for SSDI.

FYI...from www.ssa.gov/disability:
The following can result in favorable disability determination.

1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:

A. Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine);

OR

B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;

or

C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b

 

[Proserpina]

Y'know, when y'all have obtained your medical degrees and have actually examined the OP then - and ONLY then - should you be piping up about a possible diagnosis.

 

[Proserpina]

Um...you don't know what he has or hasn't explored, nor can you POSSIBLY know whether he would be approved for SSDI/SSI.

I'm about to break out the Virgin Funsuckers

 

[OHRoadwarrior]

Y'know, when y'all have obtained your medical degrees and have actually examined the OP then - and ONLY then - should you be piping up about a possible diagnosis.

How about firsthand experience for 500 Alex. I not only have that one, I have several other pinched nerves.

 

[ecmst12]

Perhaps you do, but your experience is still not the same as anyone else's.