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Cry, 'Uncle'!
by Leah Sellers
2008-11-24 09:09:32
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A Bully in a schoolyard pins a Child half his size down to the ground, pushing the breath out of the Child with his sweaty, leaden Bully's weight. With flailing arms and legs, the Child begs, "Get off of me! You're hurting me! Let me go! You're crushing me!" "Cry, 'Uncle'," the Bully sneers. "Cry, 'Uncle'! Say You Give up, and I'll get off of You! Come on, You yella' bellied Chicken! Cry, 'Uncle'!"

The American Worker's Compensation's brutally dysfunctional and adversarial system has been the Bully squeezing the Life's Breath out of my ‘Being' for the past 19 months. For 19 months the WC's litigious, paper-generating, paper-pushing bureaucracy (created by, for and because of the Insurance Companies, Their lobbyists and Their lawyers) has struggled to thwart almost every treatment and procedure my medical doctors have sought for my return to Health and the quality of Life I knew before being injured (on the job) by one of my students.

The Texas/American Worker's Compensation's Bureaucratically Crazed system has kept me Suffering in Pain, Uncertainty and Loss while forcing me to play the Nonsensical Game of ritualistic denials and litigious hearings They have created to keep me (and all other Patients/Injured Workers) from receiving Proper Care and Treatment. What is Their inhumane Goal? To keep from Paying anything. To get you off of Their books as quickly as possible.

After my last Denial (at one of the many legal hearings I have had to attend in order to move forward with my necessary medical care) for a procedure crucial to my getting to the final phases of treatment critical to the constructive progress of my health, I Cried, 'Uncle'.

Following the advice of family, friends and my doctors, I wrote my assigned State Ombudsman and told them that "I want out of the vicious Jaws of the Worker's Compensation system." I told them that I had been given a special lawyer's name who could help me get on to 'early Medicaid Services and Temporary Benefits' so that I could get the healing treatments and procedures I needed in order for me to be able to return to Life as I once knew it (walking five miles daily, bike riding, kayaking, hiking, working in equine therapy programs with troubled and handicapped youth, singing and dancing in public venues, teaching in public schools).

My Goal? I just want to be Fixed!

As I have told family and friends, "If I had been permanently left a paraplegic my attitude toward things would be very different. I would work to accept my being crippled and get on with my life to the best of my ability. But that's not the case. I am Willfully being refused the Proper Medical Care I need to be made Whole once again by an Insurance Company that sees me as a bothersome cipher on some page. A cipher They want to erase. My Injury is "Fixable". I can be Healed from this Crippling Affliction. I can get back to the Life I had before my Student injured me. I am a member of a supposedly Enlightened Society. I deserve better than what I am getting. I want to be Humanely Treated and Fixed - no more, no less."

So, with that Goal in mind, I contacted my assigned Ombudsman, and They proceeded to get me scheduled me for a Standard Evaluation for another ridiculous hurdle called a Disability Rating (as though anyone can actually effectively evaluate and quantify how ‘crippled' another human being is). During this MMI evaluation, a Patient/Injured Worker is put through a series of tests to ascertain the extent of Their injury. The examination lasts approximately one hour.

At the end of the MMI, the State Designated Doctor uses a pre-designed Rubric to determine what percentage score to ‘give' their assigned Patient/Injured Worker. Without this Disability Rating no one can receive early Medicaid Services or Temporary Benefits.

At the end of our evaluation session, the State Designated Doctor surprised me - surprised Us All. I'm certain that the Insurance Company, blocking my return to health (because the surgery and treatments I am needing are expensive), was anxious to be relieved of my company. Remember, hurriedly getting Injured Workers off of Their books with the least amount of expenditure (despite the cost to the Patient's overall quality of Life) is their Game Plan for All Patients/Injured Workers. Their sole Intent is to discourage the Patient/Injured Worker to the point of 'Crying, 'Uncle'!'

They are trained to bog Patients/Injured Workers down in legal paper work, technicalities and hearings - wear Them down by keeping Them Broken and in debilitating Pain - demoralize Them by systematically diminishing Their Finances and Resources. The Insurance Companies pay 'Their People' to push and shove Patients/Injured Workers out of the System. Move 'em out! Push 'em out! That's the Goal Team! Succeed, and it's Bonuses for everyone (in the Insurance Companies)! If We have to Walk all over the Corpse of Someone else's Life, so Be it!

However, as I said before, the State Designated Doctor surprised Us All. After all the testing was completed, she turned to me and said, "I cannot give you an MMI rating today. Everything that needs to be done for you has not been done. I am recommending that you have the procedure denied to you, as well as a few others."

I was stupefied - gratified! Yes, it means that I must remain captive a few months more within the merciless Jaws of the Dysfunctional Worker's Compensation system, but perhaps there is a Light (and not a chuffing, huffing Train) at the end of this long, dark Tunnel. Only Time will Tell.

In the meantime my Cry for 'Uncle' has become a guarded Sigh of Relief and (dare I say it?) Hope!

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