Legal Question in Workers Comp in California
If I was out on 4850 for an injury and then cleared to go back to work, and the injury returns and I have to have surgery does my claim start over? As I have already used 9 months doing rehab and cortisone shots but noww I have to have surgery.
2 Answers from Attorneys
No. It will not start over However, other benefits will become available. The real issue is whether or not you sustained a new injury. As a defense attorney I would look to Benson and try to establish a new CT, thus preventing any possiblity of a 100% injury and getting two injuries as opposed to one. It keeps the settlement significantly lower given the dynamics of the PD chart. As an applicant I would look for an aggravation or exacerbation of the first injury and no apportionment to a new CT, thus a bigger settlement.
Regards
Ron Mahurin
Your claim isn't closed so it doesn't start over.
Your doctor created a HUGE problem for you.
A two-year clock for 4850/Temporary Disability payments began ticking the day first 4850 began. EVEN IF you need more later, if 24 months clicks by, the public agency owes you no more 4850/TTD after 24 months from that first payment.
Say your first 4850 payment came in May 2012, then stopped January 2013. THE EMPLOYER (OR YORK) ONLY OWES YOU TEMPORARY DISABILITY PAYMENTS UNTIL MAY 2014, then gets to cut you off with nothing...even if you are in the middle of surgery.
That's the brilliant scheme your State Senators came up with. Doesn't help employees or employers ( but it makes a couple insurance companies rich).
Since you have a doctor who's an idiot and sends a person needed back surgery to full duty in a dangerous safety-sworn post, CHANGE TREATING PHYSICIANS IMMEDIATELY AND GET A REQUEST FOR SURGERY FROM THE NEW SURGEON IMMEDIATELY.
If this boob insurance doctor is willing to release you to full duty when you really need a spine surgery, he's 'in bed' with an adjuster and not working in your best interest.
Get the web link for your comp insurer's Medical Provider Network and find some spine surgeons or neurosurgeons on the list. THEN DO A LOT OF RESEARCH at healthgrades and vitals.com and physician review sites.
I agree with counsel you likely have two separate claims: a specific AND a continuous trauma covering the little micro-trauma 'overuse' incidents for the past year...
AND a good Certified Specialist Attorney could do all this for you.