Legal Question in Workers Comp in California
Appeals/Denials - how many and time limits
I worked for a company for 8 years (6-1-98 thru 6-1-2006). I filed a worker's compensation claim in April 2006; at that time I saw the company doctor and he diagnosed me with Carpul Tunnel (both hands and shoulder), gave me medications, referred me to physical therapy and put me on work restrictions (no keyboarding,etc), I returned to work and continued doing the same job for two more months, no accomodations were made for me and the restrictions were not observed, by the time the two months went by I could not move my right arm. I went to my supervisor and explained that I could not continue; she sent me back to the company doctor and he said that if the company could not accomodate my restrictions then I should be removed from my position until treatment or surgery is performed for my injury.
The Insurance Company continues to deny the claim, 1st denial: not enough information. Okay, maybe
2nd denial: employer level research diclosed inconsistencies with my off work activites. What??????? Apparently somebody at my work told the insurance company that I have a hobby or something like that????
After the first denial, I contracted an attorney July 2006. I still to this day have not received benefits from my claim.HELP
2 Answers from Attorneys
Re: Appeals/Denials - how many and time limits
Since the claim has been denied, you cannot file for an expedited hearing, as the AOE/COE issie is not resolved. At this point you need to do several things,
1) Take the company doctor report and file a Declaration of Readiness to Proceed as soon as possible. It can take months to get to court depending upon the court loction.
2) file a penalty petition for both failure to authorize treatment and failure to timely provide temporary disability.
3) send a leter demanding an increase in temporary disability benefits pursuant to Labor Code Setion 4650.
4) contact an attorney or the I&A office a the nearest WCAB for help.
5) consider a 132(a) filing for discrimination
Re: Appeals/Denials - how many and time limits
Mr. Mahurin gave you the proper advice. However, the reality is, you probably do not understand much of what he is advising since it is very technical.
The goal of an insurance company is not to help the injured worker, but instead to save money, even at the expense of the injured worker. You will remain putty in their hands without legal representation. If you�re having problems now, imagine what headaches you will be getting over the course of the next several months. They have only begun to squeeze you.
You should consider either calling Mr. Hahurin, or myself for a free consultation, whom ever is more convenient for you. My number is, 818.385.0520.
I hope all goes well for you. Good luck.
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