Senator Edith Prague

Legislative Office Building

Room 3800

Hartford, CT  06106-3800

 

May 31, 2006

 

Dear Senator Prague,

 

This letter is to provide additional information regarding my surgical need in 2005 and to inform you of omitted information provided to you in Chairman Mastropietro’s September 8, 2005 letter.

 

I initially contacted you on July 27, 2004 and informed I was subject of a binding order from a December 17, 1993 informal hearing.  At that time, the commissioner issued a Form 36 unilaterally, without the request of the Nationwide Insurance attorney or agreement among the parties present. And it became binding.

 

Chairman Mastropietro wrote in his letter “As you are aware, a commissioner does not have the power at an informal hearing to issue binding orders.”

 

The Chairman’s’ statement appears to support my claim that I have been denied due process in my proceedings with Workers Compensation from the beginning.

 

Again I would ask of you to inquire why I was denied medical treatment at the 1993 Informal Hearing through Commissioner Spains Form 36 issuance. 

 

The following information I will provide to expand information you received from Chairman Mastropietro.

 

Attorney Andrew Morrissey was representing me in this matter and he had a dozen informal hearings prior to my meeting in December 20, 2004 with Commissioner Salerno where we discussed my diagnosis and treatment options I had received from Dr. Bitan of Beth Israel Hospital, New York City.  Commissioner Salerno stated that Workers Compensation would not pay for an out of state procedure but cited no reference.  Everyone at the meeting was in agreement that Dr. Yue of New Haven, CT was the expert in the field and Attorney Monahan for Nationwide, Attorney Morrissey and Commissioner Salerno had recently attended a workshop sponsored by Dr. Yue.  Additionally, Dr. Yue had performed the same procedure I required, under Workers Compensation.  I kept my appointment with Dr. Yue in January 2005 and his diagnosis was identical to Dr. Bitans’.

 

The surgical procedure Dr. Yue recommended was that of Disc Replacement with the chance of Vertebrae Fusion, which would be determined at the time of the operation . The program Dr. Yue offered had a cost saving of 50% . These were the facts I discussed at the May 20, 2005 Informal Hearing with Commissioner Frankl.   Commissioner Frankl was aware that surgery had been scheduled for over three months with Dr. Yue prior to our May 20, 2005 informal hearing.  My scheduled surgery date was on June 14, 2005.  I also went to extra time and expense to obtain a CD version of my most recent MRI.  I was prepared to show the exact sequences of MRI film on notebook computer I brought to the hearing.  Commissioner Frankl not only would not look at the film, he ordered the notebook computer unplugged. 

 

 The mis-information relayed to you by Chairman Mastropietro is that I stymied something by obtaining “my own surgery”.    Workers Compensation has itself stymied everything.  I never cancelled any Commissioners Exam..  It was in fact Commissioner Frankl that cancelled the exam.  When I informed Amy at the Hartford Workers Compensation Office that I had undergone a surgical procedure and requested WC  input on how we would handle the third party evaluation, I was put on hold while she conferred with Commissioner Frankl.  She relayed to me the exam is cancelled, and further that Commissioner Frankl has terminated my benefits.  Of course this information was of concern, that he is again acting without due process and I am not represented by attorney.  Were these the same benefits being cancelled that I never received in fourteen years which were cancelled in 1993?  I would expect the Commissioners’ exam is more than a look-see, involving a medical review and films which wouldn’t have changed.  In fact the new films taken during the surgery and nerve damage evidence would have provided much more valuable information and saved everyone time and aggravation. 

 

The last thing Commissioner Frankl did to place an obstacle into the process (stymie) was to excuse himself from my case and order transferred my docket to Middletown CT District 8 Workers Compensation office because I had previously contacted you regarding my abuse as a Workers Compensation Defendant.

 

Dr. Yue said that the procedure took an extra 2 hours due to the diseased nerve growth within the disc space.  This nerve damage is clearly evident on the CT scan provided to Dr. Yannopolus who performed the Independent Medical Exam for Nationwide Insurance shortly before my surgery.  I believe Dr. Yue was surprised I did not experience permanent nerve damage. He knew that I could not wait any longer, that the risks were increasing.  He said if he had known the nerves had grown into the discs so prevalently, he would have likely passed on helping me.  That’s how bad it was.  And that was the source of the chronic pain I had experience for 14 years.

 

Yet Commissioner Frankl was presented with this information and his solution was to order me to postpone surgery.  What was it that Chairman Mastropietro said about not issuing binding orders at an informal hearing?  I informed of the chronic nature of my condition and immediate needs and again tried to present the MRI evidence.  Everyone is agreed that if I had not surgery on June 14, 2005, I would not have had it by today, one year later.  I would like to relate my disease to that of Governor Rell.  Both uncontrollable and both likely to kill.  I would like you to call her and ask her if she could have waited a year for her surgery?  And how she would liked to have paid for it?  I would ask you to call the Governor and have her refer to my November 30, 2004 letter asking for her help that I might be pain free by Christmas and ask her how she would feel if some man “ordered” her to postpone her surgery? 

 

After the May 2005 Informal hearing, Nationwide Insurance stooped to a new low in their abuse.  They called Dr. Yue daily and attempted to persuade him not to operate.  Was it because they know they are liable for my medical bill or what?  Can you imagine anyone calling your doctor attempting to prevent you from receiving treatment?  Let me re-phrase that.  How would you feel if I called your cancer doctor and told him that the pain was all in your head and not to give you life saving treatment?  The effect they had was to create serious doubt in the thinking of my doctor.  So much that he contacted another patient and informed her to come in for pre-surgery evaluation because there might be a cancellation and she might get my operating room and special offer.  I spent days in serious worry over this and I had to convince Dr. Yue to be again considered as a surgical patient.  As it turned out, I was the last person to receive the special surgical offer in Connecticut and practically the country. 

 

What does is say about a system to help injured workers if such a serious abuse will obviously and knowingly go without retributions or sanctions?  In short, these actions are approved by Connecticut Workers Compensation.

 

I spent every dime I had and more for this surgery.  I did not have money to fill a prescription for anti-biotics for a possible post surgery infection.  I am paying monthly for the money I had to borrow. 

 

Does this sound to you the way Workers Compensation is suppose to work?

 

In 1993, my treating physician recommended Pain Management.  It was in 2003 that I paid for Pain Management myself and began to receive significant pain relief.  If I had this treatment in 1993, it is likely I would have been diagnosed properly at that time.  This was the abuse I went through for ten years. And this was the medical treatment I was denied at the 1993 informal hearing that I again ask you to investigate.

 

The doctor I saw for Nationwide Insurance and the practice of three doctors in the Orthopedic Center of Connecticut perform hundreds of Independent Medical Exams (IME) for Nationwide Insurance and receives an average of $ 1,100 each.  Nationwide is in continual contact with them.  Their claim representative Jane Perry discusses each and every case.  Imagine the medical reporting out come of doctors that profit substantially from Nationwide Insurance and the potential of report corruption adversely affecting the injured worker, their family and the whole process.  Now that is stymied. The commissioner was even disgusted with this doctor.  Commissioner Frankly threw the report at the Nationwide Attorney.  He apparently knew what kind of a crooked report Nationwide was trying to pass off.

 

We assume minimally that we will receive medical treatment if we are hurt on the job.  And that the people in charge are the experts.  Neither is apparently true.  The shame is on them that their expertise is so lacking that they cannot identify an injured worker when they meet one.

 

As you can see from this additional information all I have done is be injured, complied with every request within the system and not stymied anything.

 

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