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PA lied about qualifications and caused Workers Comp to be Denied

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Popter

New member
I suffered a herniated disc injury in Nov 2016 while on the job. I sought treatment at a local sports injury chiropractor clinic where another coworker goes for his back injury treatment. I talked to the front desk and they assured me that they had a certified doctor on staff who could treat my injuries and they could help my rehabilitation, I told them that I had a credit limit of 1500 linked to my work's injury outline that they agreed to. I came to find out, from official documentation (A DENIAL LETTER) from the Department of Labor, that the treating physician was only a Physician Assistant and that there wasn't a qualified MD or DO on staff which means I was lied to about the care the establishment could offer. I had to transfer doctors and completely start over at another institution where I met with a new doctor who looked over the medical records I brought from the 1st location and she told me that they were a joke, citing that my medical diagnosis from the 1st doctor was 'pain' . She ordered x-rays, MRI and blood work be redone by trained professionals. When the reports came back, I was given diagnosis stating I had a protruding disc, herniated disc and bio-mechanical lesions in the lumbar region of my spine which is a little better classification then 'pain' I was told this in May 2017 almost 6 months after the injury. I submitted my appeal with the info from the 2nd doctor and after a long waiting period, my Workers Comp case was approved.

I received 2 bills on Saturday from the 1st doctor for $2037 & $1298.02 (total 3335.08) even though we had established a $1500 limit on my account; after each appointment I would check what my balance was and when I got close to the 1500 limit I stopped going to them because I wasn't going to exceed my limit. I was taken off of work by the 1st doctor for 2 months while we were waiting for approval to get an MRI, Feb-April '17 that approval was DECLINED by the DOL because there was no MD signature on the request. I made $52,000 the year prior and last year through injury-work restrictions I made about $8k, I recently received the back pay for last year which was about $17k take home but I am missing around $20,000 in lost wages non-salary position total from last year. I was taken off the schedule completely 6 months after the injury happened and I should've been back to work within first 3-4 months had the medical treatment been qualified/proper. I ended up getting a minor surgery (Lumbar Microdiscectomy) to correct this issue. Needless to say I stopped working missing out on over 7 months of full time work, was lied to about qualifications and services provided including pricing, and am now getting billed over 2x as much as my established limit was. I have contacted the Colorado Attorney Generals office about Consumer Fraud as well as the Colorado Medical Board about the situation, both of these organizations have sent me emails saying they have launched an investigation and I have case numbers for both not sure if that information means anything for you. This seems like a pretty open-shut case to me when you consider that I have lots of documentation to back up my claims, have another coworker who went to the 1st doctor for her treatment and has her own horror story about the mishandling of her finances with their front desk and incompetence of their staff, unfortunately she and I started going there around the same time so I couldn't warn her. Do I have a case? If so, what would the case be labeled under? I was told that this isn't a Medical Malpractice claim so what is it exactly? I want to sue the "doctor" for all the damages done, I spend an entire year injured and am still dealing with the after effects from the injury. How do I proceed?
 
Last edited:


Zigner

Senior Member, Non-Attorney
I don't know CO WC law, but the WC law I am familiar with requires you to go to specific doctors...at least at first, and so long as you haven't previously picked a doctor.
 

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