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anyone gotten UR reversals or won IMR Ca Workers Comp: for chronic pain treated with opioid therapy

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Chronic Pain
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Posted 11/22/2014 8:33 AM (GMT 0)
Hi everyone totally new...so be kind blush

I'm looking for advice or experience info from anyone who is taking opioids and are CA IW. Specifically oxycontin (slow release) and actiq (breakthrough) have taken these meds successfully for 10+years no issues except WC changes (same doc, one pharmacy, blah blah).

If you have a similar situation and have some positive advice, I'd really appreciate it...looking for:

evidence-based articles for opioids (esp. fenyanyl)

BULLET-PROOF REPORT to help stop the madness...exactly what daily activities your doc tracks, what tests you fill out at appointments, how often do you see doctor? what your report looks like so UR doesn't get triggered.

UR Denial/modification ..Reversals: and info as to how your doc or attorney or you went about getting the reversal.

Winning IMR cases envolving opioids (esp oxycontin and fentanyl) and info as to what documents were reviewed by the IMR (what you, attorney or doc made sure IMR guy looked at to help you win). What documentation I should make sure is provided to IMR doc. I was injured in 1984 and my Agreed Medical report supported the same opioids I am on right now...so there is no way that a UR eval can be done by using my past 4 doctors notes.

Lastly, For those that have been treating with opioids for a long time, is there something your doctor, attorney or u have done to make WC understand the your in the elite group of people that opioids works for? Thus avoiding the monthly UR Denials, IMR, Harrassment?

Thanks looking forward to some good advice eieio
Posted 11/22/2014 5:25 PM (GMT 0)
Hello & welcome to the forum. Sorry to read the problems you are having concerning medication. To my knowledge we do not have any members here at the forum that have had a worker's comp claim in Ca & were on the medications you have listed. With the new rules & guidelines in place & the DEA being involved, Actiq is pretty much reserved for folks with a terminal illness. We see people from time to time that come through the forum that are unable to get it even with private insurance.

Good luck.
Posted 11/22/2014 7:06 PM (GMT 0)
Dear MOderator, Thanks for your input...the reason I tried asking is that i found several people on this site using actiq for chronic pain and also having issues...getting approved etc. so I thought I would take a chance. Maybe someone out there knows someone.

One way or another I think this will be a good place for me as you have many resources and knowledgeable people from what I have read.

Thanks for your time
Posted 11/22/2014 7:53 PM (GMT 0)
I imagine you were reading through some of the old threads. Before pain mgt became so restrictive we did have a few members that were able to get Actiq but of course all of that has changed now. If you go back to any of those old threads, if you click on the persons name it will show you the last time they posted here at Healing Well. Some of those people may not be active any longer at the forum. What I have noticed with Oxycontin is depending on the area depends on whether its available or not. The way things are now for so many CP patients, I think its going to get a whole lot worse before it gets any better.

When you have the time you may want to share a little more about yourself with us, such as the type of injury you are being treated for & that sort of thing. Weekends tend to be slow but keep checking back.

Take care.
Posted 11/24/2014 4:25 AM (GMT 0)
Welcome to the group.

While your specific questions may not be answered, you will find many supportive people.

I hate that you need to join our club, but glad you found us.
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