My first advice would be to talk to a work comp attorney. If your going on ssdi, your injury probably had a pretty high ppd, if not ptd rating. I'm assuming you exhausted ppd or ttd benefits? Have you been declared P&S? If you want Medicare to take over, youd have to do a "compromise and release" with your WC insurance company, and do a "MSA" or Medical set asside for Medicare, Medicare has to be involved in that process or they wont pay for any medical for that injury, or anything that they believe is associated with it.
Most work comp insurance companies will not tell you about
these options, since its cheaper for them to let people unknowingly let the five year cap for medical care end, and yes, even if you needed future medical, there is a time cap, where if the status of your claim doesnt change, the case get discarded in a sense, and requires a petition for re
opening and new utilization reviews to see if THEY feel that medical care at that point is warranted, or necessary because of the original claimed injury.
All work comp medical care is subject to utilization reviews, and they're very crafty in the manners in which they can and do deny future medical care. If your permanently disabled from your work injury, I'd talk to a work comp attorney about
getting medical transferred over to Medicare, you may have a very hard time getting medical insurance otherwise, if you're original employer cut yours like mine was cut. The transfer process is very lengthy and takes the backing of a good attorney, otherwise you could be out alot of money for the MSA exams.
In my state, work comp attorneys get paid from a portion of the work comp settlement, max is 15% allowed by law, the injured worker pays nothing out of pocket. I would strongly suggest you talk to one, as you should be receiving either PPD (permanent partial disability) benefits, or PTD (permanent total disability) benefits. And if your condition is worse than it was when you were given your impairment rating, you can go through the process of getting a new rating, possibly extending your PPD benefits.
Sorry, i know thats not what you wanted to hear, but from your post, I see too many loose ends in your work comp case, and too many opportunities for you to be denied the medical care that you need. Please note, and this is just one example of what they CAN do to you, it is very common for future medical requests to be denied when arthritis sets into an injury, especially if the injured worker is over the age of 18 lol, for a utilization review panel to say that the person was predisposed to arthritis because of their age, and that it was not caused by the injury.
I hope that I wasn't too abrupt with these suggestions, and these may ne things you're already taking care of, I just wanted to make sure that you are aware of the very unconciounable hardships that you could be facing if you do not get your future medical addressed by a professional.
It sounds to me like you have plenty of options, since you're only three years from your date of injury. I hope everything works out for you, and good luck.
Post Edited (2y4t) : 8/1/2012 4:22:27 PM (GMT-6)