I had carpal tunnel surgery. The insurance company’s UR denied post-surgical hot/cold therapy. IMR said the therapy was appropriate, but denied it as no longer useful since IMR took 3 months to rule and the time when the therapy would be effective had run out.
About Me: My name is Katrina Quach. I’m 52 and I live in Garden Grove. I am married and my husband Don and I have a 16 year old daughter.
My Job and What Happened: I worked as an Accounts Payable clerk for Aurora Corp. of America. I spent 9 years typing, doing computer work, accounting and data entry. I loved my job. After about 7 years, I developed numbness in both hands and my wrists. My fingers started to ache, and I felt pain and soreness in my hands, wrists and arms up to my elbows. I had trouble sleeping due to the pain. My hands got weak.
What this has meant to my life: I couldn’t cook for my family, even the chopping was painful. I used to love to exercise and play badminton, but I can’t any longer. I’ve lost weight from the lack of sleep and stress. I couldn’t even wash dishes or carry groceries. I had to have carpal tunnel release surgery. I don’t know if I’ll ever be able to return to my job as I still have tightness, soreness and pain.
How Utilization Review (UR) Delays and Denials Affect Me: My recovery from surgery was very painful. The doctor prescribed hot/cold therapy, which would have been very helpful and I would have recovered faster, with less pain and more completely. Without the therapy, I had to rely on painkilling drugs, which caused their own problems and didn’t relieve the pain.
How Workers’ Comp was supposed to help me: Workers’ Compensation was supposed to provide appropriate and timely medical treatment to help me heal and return to work as quickly as possible. I had surgery, but the workers’ compensation insurance company denied post-surgical therapy. When I appealed to IMR, they agreed the treatment was needed, but ruled that the months’ delay going through UR and IMR had rendered it ineffective any longer. The insurer delayed and denied the treatment until it was no longer helpful. They didn’t have to pay, but I paid a high price.
For more information, contact Steve Hopcraft, 916/457-5546; email@example.com; www.caaa.org