How do I get an orthopedic referral?

If you are an employee who has been subject to a injury workplace involving strenuous physical activity, you are likely presenting symptoms of an orthopedic injury.  Your C-42 panel very likely limited your choice of three physicians to urgent care facilities or a primary care physician and one chiropractor.  Upon presenting to your primary care physician, you are likely further subjected to conservative treatment of physical therapy and steroid injections.  That MRI you may or may not know about is not being recommended or its not being certified as medically necessary by the insurance carrier.  If this scenario applies to you then you should be very assertive with your physician in asking for that MRI or being referred to an orthopedic specialist.  If you have a spine injury where there is a nerve impingement affecting motor skills or causing numbness or radiculopathy, then demand a neurosurgeon referral.  Be professional and courteous so you avoid the physician referring to your demands as “symptom magnification.”  This is a buzz word placed by physicians to cryptically telegraph the insurance carrier you are exaggerating your symptoms.  Be consistent if demonstrating your symptoms and communicate a proper and sincere level of pain when inquired.  If you communicate a 10 level of pain to every inquiry by the doctor during the examination, you are likely to be scrutinized.  The physician can actually ask you to perform certain physical maneuvers to isolate the source of the pain such as asking “does it hurt here” or asking “where does it hurt.”  If you  falsely communicate the anatomical area as the location of pain, the physician can determine you are not telling the truth knowing there is no possibility physiologically that the area referenced can be the source.  If your physician inquires as to how you are feeling that day, make sure you communicate how you feel for that day only.  However, you should also respond as to how you are doing in general as well.  The physicians often dictate their reports as you no longer having any pain in general when your particular reference was only to that day.  The insurance carriers will scrutinize such responses in their attempt to minimize the impairment ratings.  Continue to communicate the symptoms with specific references as to certain activities that generate the pain.  Refer to tasks such as lifting items of certain weight, standing or sitting for a long period of time, and such other daily tasks.  The more specific you are, the more credibility you will have with your physician. It is important to generate a record for yourself for future reference in particular issues that may arise with department of labor or the Court.   Following these recommendation will increase your chances of acquiring an orthopedic referral and not reaching “maximum medical improvement” with your primary care physician.