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Pete's Story:

My work place injury has caused me to have permanent restrictions if I were to return to some employment different to what I've been doing my whole life. These restrictions include, no static sitting or standing, be allowed to change positions from stand to sit when required, no walking for greater than 5 minutes, no bending, no twisting or stooping, no ladder climbing, stair climbing as tolerated, no lifting more than 10lbs once every 15 minutes and to be allowed stay within pain parameters at all times. These restrictions have been accepted by the WSIB as permanent.

Last March I borrowed a 4 wheel walker and found that by using the devise I was able to extend the time I was able to walk before I had to sit down. This was great for me and allowed me to go such places as the grocery store, Walmart and Canadian Tire and remain relatively pain free. I mentioned this to my Dr. and he recommended that I get a walker of my own because of the increase in mobility I found the device to give me at the same time being allowed to sit and stand as needed. My Dr contacted WSIB as, and WSIB said that the reasons provided that I use a walker were only subjective and that my Dr had not provided enough objective medical or rational for me to be approved for the use of a walker.

I sent my Dr the information I'd been provided by the WSIB denying my use of the walker and my Dr was completely perplexed by my adjudicator's decision. I wrote my adjudicator and he responded with another letter to my Dr explaining he required medical objective and rational, not subjective opinion based on what I told my Dr. The WSIB adjudicator called me by phone and told me that he was planning an LMR for me and that since the WSIB had not approved my condition as one that would require a walker therefore if I was to show up for an LMR assessment with a walker, I would be placing a further restriction on my self and could quite possibly be deemed as being non-cooperative.

This argument between the adjudicator, my self and my Dr has gone on since May and finally around the end of June my Dr wrote the adjudicator and told him he felt the adjudicator had all the necessary information needed to show that I benefited from the use of a walker. My Dr. also explained to the adjudicator that he's not in the habit of giving his patients frivolous advice or recommendations concerning their health care. In late July I received a correspondence from my adjudicator stating that he had consulted with a WSIB medical consultant and it was deemed the restriction for me to use a walker would NOT be allowed on my claim and if I go to an LMR assessment (this is important) and EVEN MENTION TO THE LMR ASSESSOR, ANYTHING AT ALL ABOUT MY Dr RECOMMENDING I USE A WALKER, I WOULD BE DEEMED AS BEING NON-COOPERATIVE AND I WOULD IMMEDIATELY HAVE MY LOE CUT OFF. I said I would appeal his decision and for him to send me my complete WSIB file.

The adjudicator was busy telling me how thoroughly he had gone over my file, being he was #5 on my case in 17 months, and he had found nothing that would prevent me from attending an LMR. I said for someone who has carefully examined my case file, would not being able to drive be considered a restriction? "What do you mean" he questioned at which time I pointed out, on my last progress report my medication was increased do to an increase in my pain and a deterioration in my condition and because of the way my meds effect my cognitive senses, my Dr feels it would be wise for me not to drive. I went on to explain I had been having trouble with my short term memory and my ability to concentrate for quite some time now. He replied that he had missed that on my progress report and now this new information would be cause for him to once again take this all back to the WSIB medical advisors and put the LMR on hold.

Last week I got a call from my NCM (WSIB nurse case manager) and she began with I just want to have a talk. We spoke of my injury and so on and so forth, my treatment, my meds, my life style (6 beers a week but not while taking my meds) and what activities I engage in. I was honest and told her if it had not been for my wife, absolutely nothing would be done as far as the household chores go. She spoke of perhaps my Dr should have me go to a pain clinic and she also mentioned she would check with the WSIB Dr's with reference to my meds and my problems. The NCM also stated during her conversation, that she thought me being such a young man of 48 years, I should have no problem with an LMR and finding an SEB. I told her I was 56 years old and because of my meds didn't feel I would be able to be retrained. Would that also make me non-cooperative? Hell even with out the meds I didn't figure I could be retrained. Sheeeesh. She's been quite thorough as well

As I said, I had already formally asked for the appeal package for the walker decision and when it arrived I couldn't believe the contents that was and wasn't included. The appeal pkg was all pretty much accurate until adjudicator #5 took over my claim in May. There was numerous omissions from the conversations I had had with him and most of those omissions were to his benefit or the WSIB's benefit and to hide his threats. It would also seem my NCM had done a complete psych exam of me by phone, and stated that I was consuming alcohol while taking my meds. As for the amount and type of medication I was taking the WSIB Dr stated that it was normal and I could quite possibly having cognitive problems, but since I consume alcohol those problems would most likely be more intense. My NCM is now recommending a complete psych exam of me by WSIB in order to determine the TRUE me as she feels I was exaggerating my condition. Also she has inquired why my Dr has not pulled my drivers license as yet and why my condition has not been reported to the provincial agency in charge of Driver's Licensing.

I have hired a lawyer.


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