Hi Beth

[Whiskee]

new status

wc claim under way. was seen by wc orthopedic doctor. he prescribes physical therapy for tendonitis.

what happens to the claim if i change employers while still being treated by wc? what do i need to do? does current employer continue to pay for treatment even when i change employers?

 

[faigele]

the insurance carrier who was liable on your date of injury is liable throughout the course of your treatment. you can change jobs if you wish, but be sure that you are following your doctor's work restrictions in the new job. a question - you say you are seeing the wc doc. is this your own doc, ie the one you chose?

 

[Whiskee]

no, the wc doctor is the one provided for me from hr wc specialist. what happens when my treatment is completed? do they close the claim? and what if my arm starts hurting again 2 weeks or 2 months later and re-open claim?

 

[faigele]

"no, the wc doctor is the one provided for me from hr wc specialist."
you can chose your own doctor and i suggest you do so, as a doctor provided by the company is going to be more inclined to try and save the company money and skimp on your treatment where possible.
"what happens when my treatment is completed? do they close the claim?"
believe me, you need to be represented - i have to say that again. but if you don't want to...when you are finished treating, the insurance adjuster will determine a permanent disability rating and pay you permanent disability according to the rating. since you are unrepresented, you will not have anyone representing you to calculate a rating on your behalf and you will be forced to accept their rating. if you disagree, you will be given the opportunity to go to a qualified medical evaluator (qme) of your choice from a list provided by the adjuster. the adjuster will calculate a rating based on that report and, possibly, assign a rating somewhere in between the wc doctor and the qme.

"and what if my arm starts hurting again 2 weeks or 2 months later and re-open claim?"

your medical care will remain open and you can return to the doctor.

the bottom line is that, without representation, you are at their mercy. sorry to belabor this point so frequently, but i see clients in my office every day who very much regretted that they did not become represented so much earlier - sometimes, frankly, it is too late to be of much help.

 

[Whiskee]

what at the end of 4 weeks and physical therapy is completed and they say i'm able to work without further treatment and say it's not permanent?

if permanent or partial, then payment offered or lifetime medical care?

 

[faigele]

if you are released to work without any work restrictions, ie, no permanent disability, you will not receive money. if you have work restrictions and, therefore, a percentage of permanent disability, you will receive permanent disability payments according to the degree of disability.

the insurance carrier will be responsible for paying for medical care for problems relating to the injury as long as those problems exist. whatever i am telling you is how things generally go, according to the labor code. there may be deviations but you will have to deal with them as they arise.

 

[Whiskee]

thanks for the info. guess we'll have to wait until 4 more weeks. i'll keep you posted.

thanks,
whiskee

 

[Whiskee]

Update & how to proceed?

Hi Beth,

California

Things have changed since I last posted. In April I filed a wc claim due to my arm becoming numb. I have received PT treatment during May and June. In July, the worker's comp specialist placed me on short term disability. In July I began Acupuncture treatment along with continued PT.

During my last visit in August, the doctor determined I was PMS w/ modification of no typing which I completely missed. I thought it was permanent restriction of 4hrs max typing and 4hrs max writing. The wc doctor said I could not return to work and ordered vocational rehab.

Once I spoke to my worker's comp specialist, I found out the doctor changed the restrictions. I requested that I continue treatment and that last doctor's visit was treated as a "regular" visit and PMS was not determined. Currently, I am still TTD.

My FLMA date is 10/13/03. My desire is to return to work with my modifications of 4hrs max typing and 4 hrs max writing. My questions are:

1. If I am determined PMS w/ 4hrs max keying, 4hrs max writing and am allowed to return to work, what happens if my arm becomes numb again? Would I be still eligible for vocational rehab even though I had chosen to return to work?

2. Once I am determined PMS, do they offer a settlement?

3. For my type of injury, diagnosed as cervical strain and right forearm tendonitis ( I think this is misdiagnosed. There is definite elbow nerve strain. I will see my own chiropractor who will conduct a nerve test.) My , how much do they generally offer?

4. How does disability rating affect future employment? Do I have to disclose the disability when applying for new employment?

5. At which point do they close the wc claim?

If someone can confirm the following:

Vocational rehab allows up to $16,000 for training. Vocational rehab pays $246/week which can be supplemented from $16,000 to bring me up to TTD rate of $602/week? Permanent disability pays only $196/week? How much do they deduct from $16,000 to see a vocational rehab counselor?

No, I haven't hired a lawyer, but have a name of one recommended to me.

Any advice, suggestions welcome.

Thanks,
Whiskee

 

[Beth3]

Whiskee, while I appreciate your confidence in me, I am not familiar with CA WC laws, so I can't answer those questions. Perhaps faigele can - I believe she is or was a WC specialist in CA.

 

[Whiskee]

Faigele, any suggestions?

Thanks Beth!

 

[Whiskee]

When to settle claim?

Update:

Filed claim 4/03, TTD 7/03-11/03, P & S 11/03 to present and receiving $246/wk plus supplement. QME exam shows no permanent disability but worker's comp othopedist shows 7% disability. Began vocational rehab 1/04 to be completed 1/05. VRA exhausts 5/28/04. Employment not yet terminated.

Timing wise, should I settle the claim before I terminate employment and before 5/28? At the end of May when VRA exhausts I would like to be legally free to work as Hypnotherapist (my vocational rehab program is hypnotherapy). I would like to settle and close the claim for lump sum.

Note: I was overpaid about $1000 supplement more than original %7 = $3800; received $4800 in error. Since QME indicates %0 disabled. Does that overpay go toward future medical? And I may in reality not receive anymore funds with lump sum?

Your advice is greatly appreciated.

Thanks,
Whiskee