Worried about upcoming NS visit

[onedaysoon2010]

I know I haven't been on in awhile ... I've been dealing with life and have had to put Chiari on the back burner for awhile now with work and the death of 2 of my grandparents, plus the kids and and searching for a new PCP ...
However, I received a letter in the mail stating that worker's comp had set up an appt with a neurosurgeon for an Independent Medical Evaluation. The NS is Dr. William T. Monacci who, from everything that I can gather on the Internet, is one of the NS on the list of Chiari Specialists (for the US Military) but seems to be based in PA although he does have a license to practice in WI.

While half of me is excited with this information, the other half of me is totally nervous as in my opinion, all these IMEs really want to do is discredit you so that WC doesn't have to pay anything. I haven't used WC for anything except my initial urgent care visit. All of my follow-up care regarding the Chiari and concussion have been taken care of by my insurance.

My question (after this long back story) is how can I get this NS to look at the overall picture instead of just trying to figure out if my claim (which work made me do in the first place) is faulty? I'm pretty sure that he will be looking for all sorts of dumb stuff and this will just be a waste of my time and his.

I have had noticeable symptoms of Chiari since 2003 which coincided with my 3rd pregnancy. Ever since I gave birth to her, my overall quality of life has been on a gradual decline without me really paying attention because I could usually just toss it off on something else. Now, because of the concussion, I am aware of the reasons for the gradual decline and after the concussion came an onset of a number of new symptoms as well as some of the old ones getting worse. I don't blame work for this as it was something I was born with. Just the extra symptoms are starting to get to me.

How do I talk with this NS without feeling like an idiot and without him treating me like there is nothing wrong with me just to appease the WC people?

[selmaS]

  Well it could be he is who they use to sit on the WC board or what ever they call it....so, u may be right.

So, if u have congenital Chiari then WC will reimburse u for costs due to the concussion  only.....as it was pre existing.

  All u can do is b up front and honest with them like u have been and continue to say what u have, u know u had these issues b4, but the accident made it worse.

  Good luck

[onedaysoon2010]

Hi....as u mentioned u do have to go to this and it will be determined if ur chiari is congenital or acquired....if congenital, WC will not cover it as a hard sneeze or cough would have triggered it, they will only cover the emergency visit for the injuries incurred.

Hi Selma,

I am pretty sure that it is congenital as I've been having problems before the concussion. I haven't really been having WC cover anything (meds, follow-up visits, etc) as I have been using my own insurance for all of that. And the CT scan showed the malformation but it was nowhere near where I had hit my head. I do know that there are a number of things that have come on since the concussion that I didn't have previously.

I explained all of this to the WC lady, stating that while the concussion may have exacerbated my condition, it was already there before the concussion.

I truly think that all this would have happened eventually had I not hit my head, I just probably wouldn't know about the Chiari yet as all my drs seem lame and dorky. And I probably wouldn't have been so vigilant about trying to research all of my issues together as I had never connected the dots before.

I am in Wisconsin and don't have a military background whatsoever but all I can find on the internet about any William T Monacci is this one who is a military NS who practiced out of PA but has a license for WI as well. So I am less than sure of what to think about all of this because according to the good old internet, William Monacci practices in PA and there really isn't any record of one here in WI.

[selmaS]

  Hi....as u mentioned u do have to go to this and it will be determined if ur chiari is congenital or acquired....if congenital, WC will not cover it as a hard sneeze or cough would have triggered it, they will only cover the emergency visit for the injuries incurred.

If found to be acquired, that is a different story....and that is what will make WC cover u or not.

If u r past ur states required time frame for being treated by their Drs, u can usually go to a Dr of ur own choice, but since u said Military, I am not sure how that works.

I know in PA for WC u must see their Drs the first 90 days after that u can see ur own....

[onedaysoon2010]

I don't really have a choice except to go to the appointment as it was ordered by WC. The papers said that I needed to bring all previous CT Scans and MRIs to the visit. At least I know that he will look at them himself instead of just relying on the radiologists interpretation ... And they have given me one phone number, and that's for directions only. So it seems that I'm not allowed to ask questions before hand.

And thanks irislita. Everything just seems to be too much to handle at the moment

[irislita]

I understand ur fear and frustration!!! As most of us are sent to an unpleasant runaround...and as far as i remember u already had these types of visits. The only thing u can trust in if he is a real specialist and understands this disease he will not brush u off.talk to his secretary or department.i found out talking in person is the most important.ask them if u should send ur results before so they can evaluate the case and tell u if they see a matter for the visit...if they tell u beforehands they dont think ur chiari is not ur problem,dont waste ur time and try to get another specialist.i dont know if i could help u...p.s.so sorry of what u r going thru!!!