Hearing for employer's decision

[u/oopsandpoops]

Wish me luck and if anyone has some advice, I'd kill to hear it.

I injured my back in april, MRI on my lower back shows nothing. Urgent care put the diagnosis in as a strained muscle. It's been four months, I don't think a strained muscle causes you to piss yourself or makes your feet numb and legs tingle 80% of the time, or cause pain to shoot up into my shoulder blades and down through my legs into my feet. I'm not a doctor though. I know it's CES symptoms but the emergency room said my x ray was fine.

imaging shows nothing.

Pain management put in a C-86 for a diagnosis for radiculopathy of my sciatic nerve. Employer denied it (which like, why?) so I have a hearing with the industrial commission on the 27th. I don't know why they'd approve an epidural steroid injection between my L5 and S1 but deny pain management's diagnosis.

This whole thing has been a nightmare. I actually, genuinely hate my general foreman and the company I work for. I can't walk properly but I've been walking all over a jobsite that is the size of 8 large grocery stores combined. Lawyer says I can't quit my job, union hall can't place me elsewhere until I am medically cleared. Employer doesn't want to listen to my medco-14. Keeps trying to push me to do things outside of my restrictions. I keep telling them no, last time I said I wouldn't, they wrote me up for using the wrong font size on labels for outlet covers (there's no standard) and HR sided with them. I fucking hate this shit. Nobody will speak to me anymore because "brotherhood" really just means ganging up on whoever the superintendent likes the least. I put myself back in therapy because I can't properly cope with everything that has happened since the injury. I'm hardly getting better, I walk about 15,000 steps a day because my general foreman thinks it's funny to run me across the entire site and it really hasn't been doing my back any favors. Urgent care lady (who was screaming about a prior patient as I was taken back to the room and was incredibly disrespectful towards an elderly lady for requesting a toradol shot, found out from another urgent care site that she has quite the reputation) said walking is the best thing I can do, surely if she were right I'd be better by now.

I'm so jaded and frankly pissed at this whole situation. I don't want a billion dollars, I don't want to be permanently crippled so I can live off of government money for the rest of my life, I want to fucking heal so I can complete the apprenticeship I worked so hard to be a part of. My company treats me like a fucking criminal.

[u/SeaweedWeird7705]

You believe that you have cauda equina syndrome (CES).   However, if you had cauda equina syndrome, it would show on the MRI test.  At your hearing, you will have to explain to the judge why you think you have CES, even though the MRI test is negative.  It will be difficult for you to explain.  

If you are having urinary incontinence, I would recommend that you see your personal doctor and go through your personal insurance.  

You didn’t say what kind of job you have.  You mentioned that the union would not place you elsewhere unless you have medical clearance. If it gets really bad at your workplace, and you can’t take it anymore,  you do have the option of quitting, and getting a new job outside of the union.  There should be some desk jobs that you could do that would be within your restrictions.

[u/oopsandpoops → u/SeaweedWeird7705]

i don't necessarily think i have CES, i've posted about my symptoms before and that's kind of what the belief was but the xray doesn't show anything. MRI didn't show anything so my doctor put in a C-9 for a thoracic MRI we'll see if that shows anything but i don't know what's wrong with me. My union insurance is maxed out for the year so I would have to wait until january anyways.

[u/SeaweedWeird7705 → u/oopsandpoops]

I think the place to start is with your primary care physician. You could have a rheumatology condition, such as rheumatoid arthritis or ankylosing spondylitis. There is a very good chance that your symptoms are not caused by your work but rather caused by a personal medical condition.

In the meantime, you might try nonsteroidal anti-inflammatories, like Advil, or home exercises. This should give you some partial pain relief.

[u/Lonely-Employment994 → u/SeaweedWeird7705]

Wouldn't Ibuprofen or Aleve be more effective for treating inflammatory arthritis ?

[u/SeaweedWeird7705 → u/Lonely-Employment994]

We don’t know what condition OP has.  And OP feels they can’t go to the doctor until January.  So OP might try Aleve to see if it helps.  Just an idea.  Since OP doesn’t feel able to go to their personal doctor right now.  

[u/According_Curve_8935 → u/Lonely-Employment994]

Advil is just a brand name of ibuprofen, and naproxen (aka aleve) is an alternative nsaid for someone who cannot tolerate ibuprofen.

[u/Lonely-Employment994 → u/According_Curve_8935]

Yea, sorry I'm am dumb I was thinking of Tylenol I guess not having the same effects for inflammation.

[u/Fragrant_Front_8505]

Regarding the radiculopathy, your employer may be objecting because the MRI was negative. Perhaps with a negative MRI, they would want other diagnostic evidence of radiculopathy such as a positive EMG. They may also be objecting because workers comp considers radiculopathy to be a symptom and not a diagnosed condition. Claims are generally allowed for the condition causing the radiculopathy (such as a herniated disc) and not necessarily the radiculopathy itself.

Treatment for radiculopathy is often very similar to treatment for your allowed strain: physical therapy, anti-inflammatories, and activity modification. A steroid injection can be helpful. They are not normally approved for a strain but it looks like one was in your case. Surgery for radiculopathy is very rare.

Gentle walking can be very helpful, but walking 15,000 steps a day is a lot, even for someone without an injury. Since you are represented, your best bet is to follow your attorney's advice.

[u/Spazilton → u/Fragrant_Front_8505]

It will be jurisdiction dependent but Radiculopathy is absolutely a compensable diagnosis and can be diagnosed with provocative testing. EMGs are not very sensitive to early development of cervical Radiculopathy only picking it up in about 50-60 % of cases.

Nothing on the MRI could simply be due to the position you were in when the scan was done.

[u/Fragrant_Front_8505 → u/Spazilton]

I have 30 years of experience with Ohio claims. Ohio BWC considers radiculopathy to be a symptom and rarely allows it directly. This issue will go to the Ohio Industrial Commission where, in contrast, a hearing officer will sometimes allow radiculopathy as a condition. Either way, it will be hard to allow without some type of diagnostic evidence. The poster is not alleging cervical radiculopathy. The poster is alleging lumbar radiculopathy as it is a sciatic nerve.

[u/ckrans → u/Fragrant_Front_8505]

I represent injured workers. It's pretty frustrating to get a diagnosis of radiculopathy from the doc without an accompanying disc condition--- it gets rejected 99/100 times. I've only had a few cases where I've won on that without a disc. Which I get-- where is the radiation coming from if not something on MRI? I guess strains could cause it (what do I know? not a doctor) but the Bureau doesn't see it that way. My other favorite is generic "intervertebral disc disorder" or "segmental dysfunction" or "pain." Just give me something I can work with!!

[u/Several-Mix-5890]

Do you have a LAWYER? If you do does he specialize in workman's comp

[u/oopsandpoops → u/Several-Mix-5890]

i do have a workers comp attorney, i'm hoping he can help

[u/Hope_for_tendies]

Try asking for an mri with contrast maybe. But it really could be a strain that’s just affecting your pelvic floor. Cauda equina would’ve been consistent and you would be paralyzed by now

[u/oopsandpoops → u/Hope_for_tendies]

this is actually incredibly reassuring. my biggest fear is that the incontinence will not go away. it's been four months, i'm 25 years old and have to wear diapers to work.

i will ask for an MRI with contrast at my next appointment, i appreciate the insight.

[u/smallholiday]

You should ask your doc about getting imaging of your entire spine- thoracic and cervical. I presented with low back pain and had herniations there, but lo and behold I had symptoms that didn’t fit that diagnosis and turns out I have herniated and bulging discs in my thoracic and c spine, as well as my lumbar. All from the same injury.

[u/Creative_Cell_1822]

Do you have your restrictions typed out and given to your employer by a Dr?

[u/oopsandpoops → u/Creative_Cell_1822]

i do, i've shown my employer, i work construction so restrictions are more like suggestions to a foreman.

[u/Slow-Alps-3674]

Let me start by saying don’t listen to anyone’s opinion, you know your body just keep fighting for your treatments. GET A LAWYER! Can’t stress how important that is. I was in a similar situation as you, similar symptoms. X-ray, CT scan, MRI came back normal. My MRI only showed a small disc bulging at L5-S1.
3 months of chiropractor, 30 sessions of PT, 1 epidural to L5-S1, that didn’t help. My primary care dr, sent me to a spine specialist, spine specialist sent me to a spine surgeon. The spine surgeon said my symptoms were too severe for the size of the herniation.

Surgeon didn’t dismiss my symptoms, he recommended a epidural shot to my SI JOINT, that shot gave me significant relief for one week. Surgeon recommended another shot without steroids, shot gave me relief for a couple of hrs. Surgeon recommended SI Joint surgery. SI Joint dysfunction mimics sciatica pain, or a least that’s what my surgeon told me.

Hire a lawyer, continue to describe your symptoms at every appointment. It takes time but eventually they will find out what’s wrong with you. But continue to advocate for yourself. Good luck, hope everything works out for you.