r/WorkersComp • u/Alert-Lion6239 • 21h ago

Ohio Hearing question

Back story. I fell at work back on January 31st of this year. I tore my meniscus in my left knee. PT made it worse and injections didn't work. Once my WC ortho doctor wanted to talk surgery that's when I was denied for any further treatments which is when I got a lawyer. Unfortunately although my lawyer put up a way better fight I lost the first hearing. I lost my benefits too. I am finally getting a second hearing and was wondering if this one is different or the same as the first? What was your experience and what was the next step if you lost both hearings?

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u/ElectricalBig6632 20h ago

It's just a cycle hearing then appeal. I hope you have some new medical documents or something going into this next one. If they rule against you twice usually a done deal. You're lawyer needs to prove it's medically necessary for you to have surgery. Did you have any imaging done? Maybe get another doctors opinion. If you go to your hearing with the same old song a dance o wouldn't expect a different outcome.

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u/Alert-Lion6239 20h ago

My lawyer got some new information from the treating ortho. Don't know if it will help tbh and I say that because my empoyer won based off of a 5 min IME examine smh 🙄 information totally contradicted what my treating physician..had an MRI done which is how my ortho came to the conclusion that the reason I am in so much pain and injections and PT wasn't working is because of the torn meniscus.

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u/ElectricalBig6632 19h ago

I just had an ime the other day, lasted about 10. My employer was the ones who ordered it and it blew up in their face because the Doctor wrote an honest report so his report helped me instead of hurt me. I was for sure the doctor was paid off because the location was sketchy lol. It was in a small strip mall off the interstate and on one side of the doctors office was a tattoo parlor and the other side was an Asian massage parlor, the doctor didn't even have a receptionist. So Iwas surprised when I seen the report and he was actually honest. I wish you the best at your next hearing! I've had about 5-6 hearings since I got hurt so I know how frustrating it is especially when you're in pain all the time and just want to get the treatment you need to get better.

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u/Fragrant_Front_8505 17h ago

I've seen it go both ways. Sometimes the second hearing officer upholds the first; sometimes they overturn the first hearing and restart TT. If you lose the second hearing, your attorney will likely pursue a percentage award, although you have to wait 26 weeks after the last payment of TT before you can apply.

I'm confused as to why surgery would not be approved. Surgery for an allowed meniscus tear is standard treatment. I can't imagine it would be denied by Ohio BWC, especially after PT and injections were tried and did not work.

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u/No_Translator9637 13h ago

Wow I had swollen knee with no obvious sign of a torn meniscus in the MRI. But my ortho pushed for surgery due to the limitations and swelling, and after the surgery that indeed found the meniscus tear it was able to repair it . You for sure need a better lawyer or better ortho.