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Dad denied treatment after false negative UA. He has proof, but what can he do?

I've posted here before regarding a different question, but if any of the following looks familiar, that's because I'm including some of the same background information, albeit somewhat abbreviated.

My father has been taking methadone for ruptured discs since the 90's. For most of that time, he was prescribed 40 mg per day. On April 7th, he had a pain management appointment, and his urine analysis allegedly showed that he had no methadone in his system. First of all, I help him keep up with his pills and actually see him take them on most occasions. Secondly, he couldn't have quit taking his methadone without being in severe pain and withdrawals, and the physician's assistant acknowledged this fact and even noted in his records that my father's condition was normal. My father also told the PA that he would be willing to go get a more accurate test at a lab right then, but the PA adamantly refused to let him do this.

Less than a week before my father's next appointment, he received a certified letter from his doctor stating that he had been dismissed due to the results of the last UA. After that, my father suffered through withdrawals for several weeks until he was finally able to start going to a methadone clinic. They require him to go every single day, and it costs $16 per day. Unfortunately, they don't take insurance, so he has to get financial help from family just to make ends meet. During this time, he has twice attempted to get a new pain management doctor, but they both refused to take him, stating that after reviewing his records, they concluded that they have "nothing to offer him".

Given the severity of my father's pain, quitting methadone simply isn't an option. He's talked to several doctors about back surgery, but they've all told him that given the extent of his injuries, it would most likely make his condition even worse. To the best of our knowledge, his only viable option is to get another pain management doctor, but as long as his records include the results of his last UA, that will never happen. The obvious solution would be for him to contest the results of the UA and have his records corrected. He has a plethora of evidence in his favor, especially given the fact that those very same records say that he wasn't in withdrawals or severe pain at the time, but he's never been given the opportunity to make his case. So, what should he do? Is there some way for him to have these easily disprovable accusations removed from his records? If not, then is there some other way for him to get his methadone without being forced to go to the clinic every day and pay their outrageous price?
1 Responses
Avatar universal

My father attempted to hire a lawyer, but he refused to take his case and didn't bother to provide an explanation. However, several weeks ago, my father finally managed to convince Dr. K's office to consider his written request for corrections to his medical records. It was two pages worth of irrefutable arguments, as well as signed witness testimony from none other than myself. It was very detailed, thorough, and made exact references to statements in his records. Here's a very basic summary of the points that were made:

    1. At his last appointment, my father's urine analysis results indicated that he had stopped taking his prescription (40 mg / day of methadone) since his previous appointment exactly one month before. This has made other doctors unwilling to provide him treatment for his severe, chronic, well-documented condition, as they all require copies of his records before they're willing to consider him as a potential patient.

    2. There are many reasons that the urine analysis results could have been incorrect, from human error to a metabolic condition, but the PA explicitly refused to conduct a more accurate follow-up test, even at my father's expense.

    3. My father was clearly not in opiate withdrawals at the time of his last appointment, a fact that the PA explicitly acknowledged in his records. However, immediately following the discontinuation of his treatment, he went into severe withdrawals.

    4. It would've been impossible for my father to have completely stopped taking his methadone in the span of less than month without going into severe withdrawals which would have been evident at his last appointment, so the most plausible explanation for the urine analysis results is that they were incorrect.

    5. Furthermore, I help my father keep track of all his medications and personally observed him taking his methadone on most occasions, including the day of his last appointment.

    6. Additionally, there are many obvious errors and internal contradictions in the records that indicate the possibility of some kind of mix-up with another patient, such as frequent references to my father as a female and statements about medical procedures that were never performed.

Today, Dr. K's office sent back a denial. However, instead of a written explanation attempting to refute the arguments my father presented, the letter simply states, in a single sentence, that their reason for denying the request was that the records are accurate. That's like a judge presiding over his own trial, entering a plea of no-contest in the face of irrefutable evidence, and then acquitting himself of all charges.

Unless my father's medical records are corrected, no pain management doctor will be willing to provide him treatment. As of right now, his only two choices are to endure excruciating pain and severe withdrawals, or to make daily trips to a methadone clinic on the other side of town, which costs $16 per day and refuses to bill insurance. He's chosen the latter, which has led to financial difficulties, loss of sleep, and worsening depression.

Should he contact another health care attorney before he submits a "statement of disagreement" to Dr. K's office? If not, what else can he do to rectify the situation?
What happened to your father brought tears to my eyes. I can even begin to imagine what he went through with the withdrawals. Shame on his Dr! He should know that these tests are not always 100% accurate. I've read that they're at best 95% accurate which mean 5 out of 100 people can get a false reading. That's a lot of people.
Things have been crazy the last few years because of these new guidelines. They are not laws.Actually, your fathers primary Dr could treat his pain but I'm sure he won't. Almost no primary Dr will treat a chronic pain patient because they're too scared
It was wrong of your fathers pain Dr to deny him another test, maybe even at a different lab. Both my sister and I are in pain management. My sister because of Ra and me because of back issues. We go to the same clinic. My sister got a false test. It said there was another med in her system. This was not possible. She's been on the same meds for over 5 years. Our Dr requested another test because he knows that labs can make mistakes, Sure enough, the next test showed no other med in my sisters system, only her med.
I can think of 2 things you can try. First, do your research on wrong lab tests. Print out what information you find and take it to your fathers Dr. If he refuses to see you or read the info then the only other choice I can think of is to get .that lawyer. You may have to contact several before you find one who will take your case.
I really am so sorry your father is going through this. No chronic pain patient should have to go without care.Drs are running scared when there's no need to because like I said, these are not laws. They are guidelines that the FDA pit in to place. And now we have the CDC involved. I have no idea how they got involved in the care of chronic pain patients.
Please forgive my very long post. My heart goes out to your father, and to you too. Please start your research today and get it printed out. I wouldn't mail it, I would go there in person and ask to speak with your fathers Dr.
Please keep me up to date on how things are going.

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