Legal Question in Workers Comp in California

My doctor is trying to release me to return to work when I still have significant pain after bilateral carpal tunnel surgery, and I have another problem in my right thumb that is very painful and makes it impossible to use my hand normally. The doctor has deemed this to be non-work-related and is not treating it, even though the thumb problem makes it impossible for me to do my physical therapy as directed. Yesterday my doc told me the muscle atrophy in my thumb (caused by the CTS) may be permanent. Utilization review is denying me PT and I feel they're about to screw me over. Also I feel that the thumb problem IS work related and I couldn't return to work yet. How should I proceed?


Asked on 7/01/16, 12:26 pm

2 Answers from Attorneys

Nancy Wallace Nancy Wallace Atty at Law

IMMEDIATELY CHANGE DOCTORS. LIKE TODAY! If this insurance-friendly 'doctor' writes that you reached Maximum Medical Improvement, it will be too late...you'll be sort of 'married' to him.

YES YOU CAN CHANGE DOCTORS without prior approval from the boss or the adjuster. You just need to pick a real doctor from the insurance company's Medical Provider Network, its MPN. trouble is, the new doc you choose will not have an opening for a month, so you will go without treatment or any updated Work Status reports for a month (or more) until you see the new Treating PHysician.

You need to write a note "Election of new MPN Primary Treating Physician" with today's date and deliver it by fax with a fax transmission report so that you can prove you delivered it to the adjuster (and if you don't have the insurance adjuster's fax, get it asap).

YOU want to pick a doctor from this insurer's MPN that has a private practice, that gets patients from the internet. DON'T PICK A KAISER DOCTOR. Kaiser physicians don't write reports, just one guy writes everything for all the doctors and it's always for the benefit of the insurance company...i had a wackjob Kaiser 'Dr' return my wheelchair-bound stroke victim to full duty as a CNA!! Pick a doctor that advertises in your yellow pages and Yelp and has a nice rating on Vitals.com and Healthgrades.com.

And when your adjuster or your boss 'order' you to return to the current doctor, say "NO thanks I have a new physician and I'm not ever ever going back" because if you return, that wackjob will declare you fully healed with no thumb injury and able to perform all pre-injury duties with zero permanent disability, and you'll be fired in a month for not performing your job properly.

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Answered on 7/01/16, 12:47 pm
David Lupoff Law Offices of David B. Lupoff

Nancy is correct. However I have one more suggestion, hire a lawyer.

Good luck

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Answered on 7/01/16, 1:23 pm


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