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denisemariepaulene

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Everything posted by denisemariepaulene

  1. Well, ElleMD, thank you for your condescending reply and as you seem to think you have all the answers in this situation, and they are always the same, please just leave me alone. You apparently have more time on your hands than I do. Supportive comments might show a different side of you. Amazing how one gentleman was able to respond privately to me in 30 minutes with the case law and how to go about this in a productive way. He mentioned how he monitors this forum and several others and remarked upon the egos and disrespect that you and a few others have in this venue and is considering flagging you.
  2. Attorneys are not encouraging me to settle. They just don't want to just handle the service dog issues as not enough money in it for them. If I settled my benefits, there is a significant fee. Thank you for your response. Bottom line is I may need an assisted living arrangement as I age with the injuries. The e/c knows that and it could be financially responsible. Over 10 years ago several financial firms ran the numbers of medical needs, costs, and lifespan; all calculated value over 7 figures and were presented when my attorney had to offer settlement figures. E/C actually took those documents and contacted the firms...only.offered $100,000 which they could not offer any justification to the rather surprised arbitrator. Obviously, there was no settlement, went to court and e/c ordered to continue benefits. SSD determined I was totally disabled without filing a reconsideration when I was 50. My case doesn't fall under any managed care restrictions or process, and the e/c is delaying and/or not authorizing the pain management epidurals, nightmare medication, and other benefits now. etc. I am having to pay over $2000 for the epidurals as self pay, when comp only pays $800-900. The attorney handling this wants to make certain the petition includes every benefit being denied. I'm trying to help him as much as I can when he asks. Am trying not to take advantage of a personal and legal friendship. He is trying to determine who gets to decide all the matters related to the service dog if the e/c is willing to negotiate the entire petition without settling my medical benefits. That is an important matter. Do not want to be matched with a dog that does not bond or not trained with me involved. Wish it to be a local trainer rather than away at a camp and I have only 2-3 weeks at the end of training to stay there to have the dog bond and work with me. Have dealt with my permanent injuries for over 30 years. I simply will not be able to afford the retail self pay cost of my healthcare that is covered by WC.
  3. Does anyone have any information or caselaw regarding WC and e/c responsibility as a medical necessity a service dog if medical benefits have not been settled. Appears may be a case of first impression in Florida. No workers comp attorney will accept the case as not enough "skin" in it for attorney fees.
  4. Had two serious accidents as covered and provided under Fl WC l,aw. Fist was in Oct 1984. Neurosurgery required. Chronic pain continues. Did not settle medical benefits and are open today, per the State Financial Services and the e/c for the employer who is self insured. See Neuropsychiatrist and pain management MD each month and med RX covered. Did not need a service dog. Went back to work for 5 years before attending law school. Attended and graduated cum laude from law school in 1992. 2000 admitted to practice law before Supreme Court of US. Practiced law until March 2000, when large truck hit my car and totaled it and nearly me. My auto and workers compensation covered the medical and other related expenses. Per my neuropsychiatrist RX service dog and one became availkable without need to file claim Workers comp e/c in Florida responsible for medical expenses as I was returning from neurologist for check up of second surgery needed in neck from Oct 1984 wc accjdent and the e/c of 1984 paid medical and continues to pay medical benefits. I am not the oldest medical case in workers comp in Florida. It is now Jan 2018. My service dog died 6y months ago. Seeking replkavement per pain management MD and psychitrist RX and medical necessity RX. Cannot find any FL case law on WC e/c providing service dog; may be case of first impression here. Anyone deal with this issue or aware of any caselaw regarding same? 14
  5. Thank you for your response to my inquiry. I am in the South, and there is a saying that I'd liked to share with you regarding the discussion and personal legal opinions that responded to my inquiry last fall: "THAT DOG WON'T HUNT." The last thing, and least wise thing, in our legal world, would be fo me to ask the carrier for a succession service dog to learn if one would be provided. Then try to find a wc attorney to file a petition for same. 1. No WC attorney will take the case unless I agree to a settlement of my medical benefits. (Not enough $ for the attorney to take the case otherwise.) 2. I have permanent serious injuries and would be an absolute fool to settle my medical benefits for life. You understand also the complications of the Medicare set-asides involved. 3. While an old friend that still practices WC has decided to try to take on the case, it is by sheer friendship and having practiced in the WC trenches years ago with me that he is stoked enough by how a number of my physicians' medical necessity requests for other needed care I have had for years are being denied. He and I understand the game being played; the carrier is trying to wear me down and force me into a corner in order to get me to agree to a settlement of my medical benefits. They tried it with our clients, and we fought hard to prevent it. 4. There is another Southern saying to be shared: "One can ignore the discussion of a long winded man; but when a Southern woman isn't talking, pay attention. She is hiding the shotgun behind her back." The shotgun isn't loaded with all the specific shot needed yet and I am trying to secure that it does. 5. When I can have enough info of the details, and have prepared the three specialists caring for me for the last 30 years on how exactly their Medical Necessity Requests must be written as opposed to the typical medical care Medical Necessity Requests are drafted, and the specifically needed requirements to acquire a proper functioning breed and trained service dog in my geographic location, I will fill that gun with the all the shot my attorney to prepare the petition. He will know when to fire it before the carrier even knows the petition absolutely meets every and all the necessary requirements. That petition for the service dog is much more complicated and detailed than any my friend or I have ever seen, much less drafted. 6. Then I am in the position to hire my attorney and hand him the shotgun and let him do what he knows best to do. Never met a better WC attorney, and he is successful, respectful, thorough, and respected, not hated, by any opposing WC attorney or WC judge in our jurisdiction. I am very glad I let him win a poker most of the time. 7. Cases are beginning to be reported in the positive by some of your more understanding members that meet the criteria of current WC law and service dogs and my appreciation to them is great. THEY GET IT! The response last fall was mostly discussion, and no one felt the care of the service dog would be provided even if the service dog was. I have not just been sitting around. My disabilities eventually cost me my livelihood and much more. From the numerous calls, letters and discussions with doctors and vets, none have ever had a carrier just politely agree to a service dog, and as importantly, critical specifications must be included to acquire the proper dog, training and location of same. The physicians medical necessity documents need to be very specific and documentation of the nexus between the injury and the unavailability of a lesser expensive medical provision There are other issues even if the carrier agrees, which I need to find as many answers as possible, so if a petition is filed, certain very important conditions are also requested such as who has the freedom or the responsibility for locating a proper trainer, the breed of dog, the location of the training, the number of years requested for healthcare of the dog. Appears a private trainer near me needs to be found and requested, why the specific breed, size, pedigree documentation and healthcare of the dog must be requested and agreed to by the carrier. If I ask the carrier for all these stipulations, greatly doubt it will just agree. And as already mentioned NO ATTORNEY would take the case unless I would also settle my medical benefits. Now, if the attorney(s) who sent me this smug message can prove that he/she even knew or could meet the standards and all the details to be explored properly, and would take my case or find a WC attorney to do so and would not again tell me to handle my own case (in spite of injuries (including brain injury), let me know. You would be one hell of an attorney. I rather believe, even if I did not have my challenges, in Lincoln's quote about an attorney who represents himself has a fool for a client. Please be more introspect and kind to anyone seeking advise or caselaw on this forum.
  6. Had two serious accidents as covered and provided under Fl WC l,aw. Fist was in Oct 1984. Neurosurgery required. Chronic pain continues. Did not settle medical benefits and are open today, per the State Financial Services and the e/c for the employer who is self insured. See Neuropsychiatrist and pain management MD each month and med RX covered. Did not need a service dog. Went back to work for 5 years before attending law school. Attended and graduated cum laude from law school in 1992. 2000 admitted to practice law before Supreme Court of US. Practiced law until March 2000, when large truck hit my car and totaled it and nearly me. My auto and workers compensation covered the medical and other related expenses. Per my neuropsychiatrist RX service dog and one became availkable without need to file claim Workers comp e/c in Florida responsible for medical expenses as I was returning from neurologist for check up of second surgery needed in neck from Oct 1984 wc accjdent and the e/c of 1984 paid medical and continues to pay medical benefits. I am not the oldest medical case in workers comp in Florida. It is now Jan 2018. My service dog died 6y months ago. Seeking replkavement per pain management MD and psychitrist RX and medical necessity RX.
  7. Dear ElleMD, Thank you again for your response. I asked about the service dog and Florida Workers Comp and do have an old colleague who periodically handles an issue with my wc medical benefits/ I asked about this issue on this site because the first thing I learned before ever filing a claim is to know the answer before I ask. This issue is one that I cannot find an answer, and I have just reached my colleague regarding the service dog issue. I was reaching out in this site to see if anyone had been involved in a similar matter. I am disabled, and have some significant challenges and cannot practice consistently. Have drilled through Lexis without finding a case on point. It was not my intent to insult or use you, it was a matter hoping someone had encountered a similar situation and if not, know I am going to have my colleague decide if we should proceed knowing it may be case of first impression in Florida. It would not be the first time my workers' comp claim for certain benefits has been a case of first impression and survived the appeal by the e/c. after I located case law in California that was on point.. I have read your letter carefully several times. All I can add is that I have already researched and addressed issues you discussed with the appropriate state agencies and departments. I definitely am not anywhere near the oldest open wc case in Florida by any strength of my imagination; even my own adjuster has cases much older than mine. The states wc ombudsman for wc claimants discussed the matter about the service dog with me at length, I was advised to file the claim as my medical benefits remain open and there statutory law is silent in this matter. Like you, I know Medicare has absolutely nothing to do with this matter, except when SS determined I was totally disabled by the truck accident, that was the benchmark that determined I was also permanently disabled under Florida Workers Compensation law. While organizations and non-profits "provide" service dogs, the waiting list is longer than I can see. And the mandatory "contribution", if I am appropriately partnered with a service dog, is as much as $30,000.after a one or more year wait. I no longer wonder why so many children who need service dogs don't have them. Just take a look at the "Fund me " sites on the internet. As far as my doctors and husband, the question of my need for another service dogs is a closed matter. It's the funding, locating the proper puppy and trainer that needs addressing. If other resources are not available, I will discuss with my colleague to request the court to release funds from a special needs fund to be used. The settlement for future wage loss from the lawsuit involving the trucking company that hit me was mandated by the court to be placed into a special needs fund as it found my injuries to be so serious that I was not compentent to manage the money., It is not to be used for medical care, I have a trustee and the trust was invested by a professional for the purpose of specified needs. The court would have to be persuaded that the service dog is needed and not available to me by other sources in order for the court to order release of funds for that purpose. Until two years ago, my Social Security disability benefits were issued in the name of a payee and directly deposited to a special bank account.as SS determined my injuries were so serious to that I could not manage my social security benefits. Perhaps you will understand now why my dog was so valuable to me and my life and why my wc medical benefits have not been settled. I am not the collateral damage of some minor curable injury. I am the injury and deal with it every day of my life
  8. Dear ElleMD,

     
    Thank you again for your response.  I asked about the service dog and Florida Workers Comp and do have an old colleague who periodically handles an issue with my wc medical benefits/  I asked about this issue on this site because the first thing I learned before ever filing a claim is to know the answer before I ask.  This issue is one that I cannot find an answer, and I have just reached my colleague regarding the service dog issue.  I  was reaching out in this site to see if anyone had been involved in a similar matter.  I am disabled, and have some significant challenges and cannot practice consistently.  Have drilled through Lexis without finding a case on point.   It was not my intent to insult or use you, it was a matter hoping someone had encountered a similar situation and if not, know I am going to have my colleague decide if we should proceed knowing it may be case of first impression in Florida.
     
    It would not be the first time my workers' comp claim for certain benefits has been a case of first impression and survived the appeal by the e/c. after I located case law in California that was on point..
     
    I have read your letter carefully several times.  All I can add is that I have already researched and addressed issues you discussed with the appropriate state agencies and departments.  I definitely am not anywhere near the oldest open wc case in Florida by any strength of my imagination; even my own adjuster has cases much older than mine.  The states wc ombudsman for wc claimants discussed the matter about the service dog with me at length, I was advised to file the claim as  my medical benefits remain open and there statutory law is silent in this matter.
     
    Like you, I know Medicare has absolutely nothing to do with this matter, except when SS determined I was totally disabled by the truck accident, that was the benchmark that determined I was also permanently disabled under Florida Workers  Compensation law.
     
    While organizations and non-profits "provide" service dogs, the waiting list is longer than I can see.  And the  mandatory "contribution",  if I am appropriately partnered with a service dog, is as much as $30,000.after a one or more year wait.
    I no longer wonder why so many children who need service dogs don't have them.  Just take a look at the "Fund me " sites on the internet.
     
    As far as my doctors and husband, the question of my need for another service dogs is a closed matter.  It's the funding, locating the proper puppy and trainer that needs addressing. 
     
     If other resources are not available, I will discuss with my colleague to request the court to release funds from a special needs fund to be used.  The settlement for future wage loss from the lawsuit involving the trucking company that hit me was mandated by the court to be placed into a special needs fund as it found my injuries to be so serious that I was not compentent to manage the money., It is not to be used for medical care,
     
     I have a trustee and the trust was invested by a professional for the purpose of specified needs.  The court would have to be persuaded that the service dog is needed and not available to me by other sources in order for the court to order  release of funds for that purpose. 
     
    Until two years ago,  my Social Security disability benefits were issued in the name of a payee and directly deposited to a special bank account.as SS determined my injuries were so serious to that I could not manage my social security benefits.
     
    Perhaps you will understand now why my dog was so valuable to me and my life and why my wc medical benefits have not been settled. I am not the collateral damage of some minor curable injury.  I am the injury and deal with it every day of my life.
  9. The .service dog was not needed until after the second injury which occurred coming back from the check up by a wc neurologist. A truck struck me and aggravated the current ongoing injuries of 1984 and created serious new ones. I did not have a service dog until after the second wc accident, as injuries occurring going to or from a wc assigned doctor are the wc responsibility.
  10. Hello, not certain if you practiced WC law in Florida, but I still have open medical benefits from the 1984 laminectomy, discectomy, and fusion. Had received medical benefits consistently every month since then by the pain specialist, neurosurgeons, and neurologist, including epidurals about every 6 months apart to control the pain sufficiently for me to practice workers compensation and civil trial law. A second laminectomy, discectomy, and fusion were needed in 1999. When returning from the neurologist for check up after the second laminectomy, discectomy, and fusion, I was struck by large truck, causing additional injuries to my back, head, face etc.. In Florida in 1999, e/c had to cover any injuries aggravating or new ones accruing going to or returning from the physicians assigned by the e/c. The pain management and neuropsychiatrist have seen me on a monthly basis since that time. I see the neurologist at least once and year for check-up, and for treatment in hospital for the related seizures and resulting falls in 2016 and 2012. In the fall from the seizure in 2016, a vertebral fracture was found and vertebroplasty was performed to prevent its collapse. I see a dentist 3 times a year for related issues due to the medication. My service dog was with me until June 2017, when congestive heart failure had me make one of the most difficult decisions of my life. Been difficult living without the help he provided. I know my e/c adjuster and she is available when there is a mixup or error in medications. A workers comp colleague has been responsive when the e/c attorney pushed to make me settle my medical benefits.,I simply refused and the judge agreed. My monthly appointments with my pain management physician and neuropsychiatrist are already scheduled through December. Therefore, the injuries are related and covered under workers compensation per Florida law, and have no problems receiving them. My service dog is the only new issue under medical benefits I years. Any healthcare not related to wc is paid for my Medicare insurance or cash. I assure you the law firm representing the e/c is an aggressive one but follows the w/c law. I have never requested anything my physicians have not ordered. I have their prescriptions now to start the search for the appropriate trainer and puppy to develop another service dog for me.......it has to be done bow even though I am not over the death of Scooter my service dog. Please advise me why you do not believe I still have wc medical coverage, that my injuries are not related and but continue to be treated by the e/c. My attorney and i cannot figure out why they re not related, nor does the e/c attorney as a WC judge has ruled them to be years ago.. The big question is whether the service dog is a medical benefit or other benefit with just a different name. Thanks, and I appreciate your reply. Denisemariepaulene.. My appoints are set with my physicians foreach month hrough thr end of the year,
  11. Why do you state the worker comp claim should already b closed...years by settlement in Florida? Is there something about FL WC claims you know that I don't and I practiced WC in Florida....e/c has tried very hard to back me into a corner to do so by not providing surgery and other care, but at the doors for the WC hearing, they realized I meant no settlement....My injuries are lifetime and continuing to require ongoing care? Please response, as I am not very familiar with this forum and am not certain where to respond to your statement. The year of my initial injury, the substantive law did not permit settling the medical care. My substantial benefit rights are based on the year of injury. The procedural laws can vary from year to year. May thanks.
  12. My accident occurred in 1984 and the second one involved being hit by a truck in2000. Several years after the 2000 accident my doctor recommended a service dog as that injury compounded my former one, and in FL injuries incurrd going to or from the employers approved physician are covered. Have not been able to work since 2000 accident. Was approved for SS and Medicare.
  13. Thank you. The need for the service dog was from my wc condition getting worse. The training of a new service dog is part of the expense involved. Would you please advise me as to what source you used to find the answer to this question? I truly thank you for your reply.
  14. No, the service dog was needed after the WC acciident. The training of the service dog is part of the expense of the new dog. Woud you please advise me as to what source you used to find the answer to this question? I really thank you for your reply.
  15. At what age, if any, does a 1984 workers compensation medical benefits end if former injured employee has received continued and consistent medical care from several employer approved physicians, and care is related to worker compensation injuries?
  16. Issue: Under Florida worker compensation, medical obligation, Is employer responsible for providing a service dog to a former employee whose medical benefits are open if former employee worker compensation physicians prescribe a service dog for former employee after former employee's service dog of 14 years dies due to congestive heart failure.? Need for service dog occurs due to workers compensation injuries, and former employee acquired the first service dog without assistance from or cost to the employer. Properly trained service dog expense is $30,000 plus the life time of medical vet care, food, equipment, etc.
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