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Should i do the surgery for tts?

Posted by William Wilt on 3/28/04 at 11:37 (148002)

My ortho said he wants to go in and free up the nerve and clean my tendonitis up in the tarsal tunnel area. My only symptom is pain as i have NO BURNING, NUMBNESS, TINGLING, just pain in the inner ankle in the tarsal tunnel area. He said success rate is 50%. I can walk noramlly without a limp i just feel the pain upon weightbearing and evn at rest. I think this might be risky as my symptom is only pain, any thoughts on peoples experiences would be appreciated.

Re: Should i do the surgery for tts?

Elaine T on 3/28/04 at 12:17 (148004)

William, the only thing I can offer is what my surgeon told me; that this decision has to be totally mine. You have to decide how debilitating your pain is, how much, if any, of your life revolves around your TTS, etc. I waited a long time, and if I had it to do over again, I wouldn't have waited so long. But in my case, the TTS dictated what kind of shoes I could wear, what activities I could do. You might take a piece of paper and put down 'pros' and 'cons' but make sure any decision you make is your own.

Re: Should i do the surgery for tts?

Mailman on 3/30/04 at 22:44 (148165)

William, I have read several of your posts saying that you believe it is work related. If you work as a letter carrier, you need to go tell your supv. that you need a CA-2. Get letter from the doc stating your symptoms and treatment and that he/she believes it to be work-related. You will also need to write a statement as well. You need to do this before you have any surgery. Using your own sick leave is not that great. You will have to buy back your leave which is a pain. Also if your claim gets approved, they will let you buy back your leave. You will owe some money though. Since you are a letter carrier, unless you have spent most of your career on a mounted route, your claim should be approved. At that time, you can request a CA-7 to get paid every two weeks TAX-free. It will pay 66.6% if you have no dependents and 75% if you do. I didn't see that you have had an NCV/EMG. I would highly suggest that before I had surgery. Most likely your supervisor has no idea how the OWCP system works. None of my supervisors have a clue. As I had to learn by doing, I pretty much know how it works. Like others have said, don't take surgery too lightly.

Re: Should i do the surgery for tts?

William on 3/31/04 at 06:37 (148169)

Mailman,

Your post is greatly appreciated as I see your knowledge of USPS dealings. Have you had TTS surgery? I personally have been a mail carrier for 10 years and have walked all my career, except maybe as a PTF where I would get a mounted route maybe 1 month out of the year if lucky. I am scheduled for an NCV/EMG next week as I am still using my sick leave and my Foot and ankle orthopedic doctor will support me as it being a overuse injury.

A few questions I hope you can answer regarding CA2.

1) I have seen 2 podiatrists previously who would not support me as it being work related, yet now I swithced to a Foot & Ankle Orthopedic Surgeon, which has more schooling, so my question is will this be a problem if it says on page 2 of the CA2 of the first treating physician was the poditrsit who did not want to help me? Should i still put his name down, actaully the supv has to fill this out but i do not want to conceal any info.

2) I have already prepared my EMPLOYEE STATEMENT regarding job conditions such as waklking 6 miles a day 5.5 hours on uneven ground, porches steps, through snow as i used these factors for my argument. The CA2 staes that i must provide a detailed history in my narrative, i included the names of the 2 poditrsts i have previously seen even thoiugh they wanted nothing to do with OWCP or the USPS. My narrartive reads ' On 7/15/03 i developed inner ankle pain as it came on as i was walking my mail route. I did not think much of it but it progessivly got worse as i repotred to work daily. I made an appointment with dr evans, then later dr smith because i was not getting better i decided to see dr willie wonka a foot and ankle ortho.' is this okay to include the 2 other monkeys as i included them in the detailed history because they did in fact treat me.

3) Finally, Should i give my CA2, employee narrative, and medical narrative to my supervisor or send them to injury comp of the USPS myself? I don't know if i really trust my supervisor to not read my information and submit it in a timely fashion.

4) 1 more question,sorry but i'm new at his and the union has not been much help. If my CA2 is approved will i be notified by mail of this and how soon does the post office have to offer me a job on limited duty? Will they drag there feet? After it is approved do i give my doctor a CA17 duty status report and does he have to send this to owcp? I am ondering on this because i do not have much sick leave and cant afford to waste time. Currently i been ouot of work for 4 months on s/l and finally ffound a doctor that wants to support me. He wanted me to go on light duty for basically sitting, but USPS denied me this as i requested it to postmaster. Now 4 weeks later my doc says attempt to try mountwed delivery only, but i'm not sure this will be that easy. Will it look bad if i'm able to do mounted and I'm filing a CA2? I need money, i eeven had to tap my TSP as a medical hardship. Thnkas for your advice.

Re: Mailman post is for you thanks

William on 3/31/04 at 06:38 (148170)

thanks read the next post by me

Re: Should i do the surgery for tts?

Mailman on 4/01/04 at 01:45 (148243)

William, it would be easier to respond if I knew what area. If you are in the Eastern area, I can be really specific on what you need to do. You will need to file a CA-2. It is best that you have the CA-2, your narrative, and doctor's note of work related diagnosis, conservative treatment taken, and further findings. OWCP truly frowns upon the use of a podiatrist. Make sure to have all your ducks in a row. When you have all the paperwork requested together, make sure you make a copy of everything. It is your supv. responsibility to report this to Shared Services, but if I were you, I would send them and DOL a copy of the CA-2 and other info. Like I said, the system is not known by many (with the exception of those who are lazy and dont' want to work) It takes a long time for legitimate claims due to this. As you have a walking job on concrete and uneven surfaces, there should be no reason for denial unless you are an avid runner or mountain climber or jump out of airplanes. In your narrative you need to address any injury you have ever had in your entire life and tell them about the extra curriculars you have been involved in. Technically you have 30 days from the date at which you found out this was work related. I can give you even more specific info if you are from the 'Eastern Area' I am in Cincinnati District and have had PF surgery and TTS surgery. I really caution you to try every conservative treatment available before having surgery. If your claim is approved, you need to put in LBB paperwork right away. Mine took almost 8 months to get it back and don't forget that you will owe money back. Start saving NOW Let me know if you have any more specific questions

Re: WEstern ny district

William Wilt on 4/01/04 at 08:41 (148253)

mailman,

i from the western ny district and what if i cannot get the CA2 submiiteed beffore the 30m day time period? Will my claim not be accepted?

Re: WEstern ny district

Mailman on 4/02/04 at 13:28 (148307)

In block 11 on the CA-2, it asks for the date you first became aware of disease or illness. You said that you had not been diagnosed with TTS yetIf you are filing based on another ailmentyou need to mark that date in #11. In block 12 it asks for the date you first realized the disease or illness was caused or aggravated by your employment. In #15 it asks 'If this notice and clim was not filed with the employing agency within 30 days after date shown in #12, provide reason. Make sure your reason is a good reason. You may want to wait to have all documentation in hand. I would as the DOL is notorious for losing things.
Make sure that your supervisor gives you the receipt of Notice of Occupational Disease or Illness. Make a copy of everything you give your supervisor. According to the CA-2, since you have lost time, file a CA-7 concurrently to reflect all leave used to the point of filing. If you have used more than one type of leave, you will also have to file a CA-7b. About one week after filing, you should call your Shared Services dept.(unless you still have Injury Comp)The # for Shared Services is 1-866-772-7723. Follow the prompts. Like I said, most people are unaware. Do not blame your supervisor when they don't have a clue. If you have questions, write back. DOL is slow. They are just now changing their systems in order to improve. I do see some improvements, but they are still slow.

Re: WEstern ny district

William Wilt on 4/02/04 at 15:33 (148314)

Mailman,

In item 15 i put ' I did notify my supv by telephone that i would not be able to do my job because of the condition. After no success with the podiatrists i had seen i decided to see a foot and ankle specialist who is board certified and now i am submitting the claim' Is this okay?

The podiatrists did not want to say my injury was work related as they knew it was but did not want to represent me in filing a claim to OWCP. My union rep told me i had up to 3 years to file a claim and a board certified foot and ankle guy is better than podiatrist according to DOL.

Re: WEstern ny district

William Wilt on 4/02/04 at 15:35 (148315)

Also would you send DOL a copy of denial letter from USPS for light duty request or leave this out? thanks for your apprecietd advice

Re: WEstern ny district

Mailman on 4/02/04 at 22:23 (148336)

Let me tell you from experience, if you are not going to a ortho surgeon who has treated other fed employees, you are going to get screwed. My first doc had NEVER had a fed patient. I ended up paying lots of bills for which he had pre-approval letters. His office was incompetent. He was a good doctor, but I got sick of paying bills each time OWCP requested I get all my records and attend a second opinion appt. I do not like your answer in block 15 As far as the denial on light duty, the DOL has nothing to do with that. Until you file a claim CA-2, you have absolutely no recourse. The po does not have to accomodate light duty. They do, however, have to accomodate limited duty or let them just sit home and receive a tax-free pay check. No limited duty employee is ever denied a job even if they have to sit at a desk and answer one phone call per day. As I feel that you are probably one of a few on this board who has this type of question, I have set up a hotmail account. I hate to see people go through what I had to go through. I would be much more better off physically had I know how to cut the red tape. (email removed)

Re: Answer in block 15

William Wilt on 4/03/04 at 11:49 (148355)

Whats wrong with my answer in block 15? What would you write? You have a better answer? I need to know before i submit it.

Re: Answer in block 15

Mailman on 4/03/04 at 20:46 (148373)

You are not really answering why you are unable to file your report within 30 days.
Your answer should be. As I have previously seen two podiatrists for this work related condition, I found that I would receive better treatment from a board certified orthopedic surgeon due to a more vast medical knowledge by a professional in that field. Dr. _____ is a pilar of the medical community and as such is extremely busy. As Dr. ______ is in the business of diagnostics and conservative treatment, as well as performing surgery, it was imperative that I receive his part of this Report of Occupational Disease so that the OWCP will have all the necessary information to determine the viability of my claim.

Maybe a little long winded. It is easier if I know your circumstance, but this is the best I can do with what I have been give. Whatever you write, do not assign blame except to your having fulfilled the rigorous duties of your position.

Have you signed any 3971's? If you have, you need to make sure that in the comment box that you write 'IOD Not FMLA' As soon as case is approved, you may and should checkmark the 'other' box and write 049 as well as IOD not FMLA

Re: 3971 question please

Tony Frary on 4/04/04 at 18:07 (148397)

mailman,

I have been out on approved FMLA for 4 months now and might be returning to work next week in a LIGHT DUTY capacity not limited duty as my claim has not been approved yet. My question regarding the 3971 when my supv presents it to me is should i sign it as FMLA if my case is not approved yet as an occupational disease or refuse to sign it untill the claim comes through then put iod on it? thanks f or all your help.

Re: 3971 question please

Mailman on 4/07/04 at 01:41 (148513)

As a precautionary method, I would sign 'IOD, pending review by OWCP' in the comment section. It took less than 30 days for my review. Technically, FMLA is also used in the event of OWCP, but certain people are not aware of this. As I have plenty of hours, I always sign that way in the event that I need FMLA at a later date. Since I was able to schedule my time off for surgery, my leave was approved in advance. It is all really a technicality. If you have no more than three occurences in the past rolling year, I would sign as regular leave, not FMLA. If you took off 4 straight months and have doc to back it up, it is only one occurence. As long as you are not a leave abuser, and your supervisor is not aware of FMLA regulations (most are not),don't request FMLA. Apparently they don't have too much of a problem or they would have sent you out FMLA paperwork since you have been gone so long. In the event the your case is approved, immediately file a CA-7 for Leave Buy Back and stay on top of it. You will also have to file a CA-7 if you took more than one type of leave or there was a holiday which fell during your absence.

Re: My FMLA is approved!

William Wilt on 4/07/04 at 07:07 (148514)

Mailman,

I have been out on FMLA as it is already approved, so I still have to sign the 3971 as FMLAnot IOD? The comment box says do not enter medical information. How are you doing after TTS surgery? Are you progressing and do you think you'll carry again?

Re: My FMLA is approved!

Mailman on 4/07/04 at 11:21 (148523)

William, in the comment box, put 'IOD, pending review' Like I said, technically, time off in 049 (OWCP) status does count against FMLA. But since most supv. don't know, you can usually not request. If you can get your supv. to approve leave in advance you don't need to request FMLA. If you ask for leave in advance and your supv will only accept if it is FMLA, that would be the only time I would request FMLA. If you have no problems with attendance, it can help you in the future to have FMLA available. But don't forget, you will need to have the minimum work hours to be eligible. IOD is not medical info It means 'Injured on Duty'
I am not progressing well and I know I do not believe I will ever carry again.

Re: Sorry to hear that

William Wilt on 4/07/04 at 13:43 (148538)

Hey mailamn,

I'm sorry to hear that you are not progressing , as this TTS is indeed a risky procedure. I have a 47 year old fellow carrier who had bilateral TTS surgery and was not a success. I feel bad for him because he is such a great guy. He now walks like he is walking on glass. I have been told by my Foot and ankle ortho that i have a component of TTS , but not full blown yet i do have tenosynovitis of the FDL and FHL tendons with minimal nerve irritaion confirmed by EMG/NCV studies. The neurologist told me not to chance the surgery since he thinks it is more capable of doing harm and the nerve is supposedly not completely entrapped, but it sure feels like it does. I do not have numbness, or tingling just intense inner ankle pain and is present even when sitting. I only been carrying 9 years and to think I dropped out of the ASP program a year ago now i'm dealing with this problem. If i only knew this would happen i would of stayed in ASP program, but i really loved carrying and talking to customers on route and being able to be on my own without dealing with 40 carriers 10 clerks upper management, customers and for only $1500 more a year. I also have a family and since having young kids i looked forward to having those bid vacations and as a supv you don't get too much time off. I hope it works out for you and thanks for the info. Do you mind if i email you instead of posting here? You said youre from Cincy, you a Bengals fan?

Take care.

Re: Sorry to hear that

Mailman on 4/10/04 at 02:07 (148635)

William,
please email me at (email removed) Just figured out how do see mail in this account. Can't believe all the postal people. Well, I mean, I can understand why are jobs cause this sort of thing, I just didn't expect that a support group/board would have this many of us.
I am not a football fan at all. Have you thought of 204B? We have many 204B's because no one wants to put up with the BS that the supervisors do. All the perks of being bid and you get overtime pay. Our supervisors work 6 days every week. The 204B's make more money and can tell them to shove if upper mgmt. makes them mad. Many limited duty go to the Plant to 204B. The best of both worlds.