bryce_stevens
New member
I'm at my wit's end here and honestly not sure what to do next. My orthopedic surgeon has been saying for months that I need surgery on my rotator cuff, and my physical therapist agrees that conservative treatment just isn't cutting it anymore. But every time the insurance company sends me to one of their doctors for an evaluation, they come back saying surgery isn't medically necessary and that I should just continue with PT. I've had three different IME exams now and each time they contradict my own doctor, and it feels like I'm just going in circles while my shoulder keeps getting worse. The insurance adjuster keeps telling me they're just following the medical evidence, but how is it that every one of their doctors says the exact same thing while my surgeon who's been treating me for over a year says something totally different? I know I need to get some kind of legal perspective on this because I'm clearly not getting anywhere on my own. I've been looking for workers comp claim help New Paltz area since that's where my employer is based, but I guess I'm also wondering if anyone else has dealt with this situation where the insurance doctors keep blocking the treatment your regular doctor recommends. How do you actually get them to take your own doctor seriously when they clearly just trust their own people more? This whole thing is making me feel like I'm going crazy.
