Legal Question in Workers Comp in California
I got my hand broken at work in Oct 2009 and had 2 surgeries to repair the fractures. After healing I still have problems with pain, tingling, numbness and inability to grip with no strength. The WC doctor said I needed further surgery which the WC insurance denied, so he had no choice but to label me maximally medically improved. At workmans comp court they told me I had to see a QME doctor. 9 months later I finally got that appt and he agrees that I do on fact need the surgery that was denied. Since being declared MMI I have had no income and my work has no light duty for me to do. My question is this...now that surgery is recommended, will I get backpay for the last 15 months from the workmans comp insurance? Unemployment says I am not eligible for benefits and state disability says I'm not because it's been more than a year since I was hurt. We've lost nearly everything we worked so hard for because I have no income. How is it fair that I got seriously injured at work and have no compensation? Thank you for your time.
3 Answers from Attorneys
I am sorry to read about your hand.
You might be entitled to retro temporary disability, it depends. You are entitled up to 104 weeks of TD, if the QME said you were temporarily disabled for the full 104 weeks. However, this is simply general law. I would need to know more facts before I can give you a more accurate answer.
Please contact me at 1.877.505.INJURY for a free consultation.
The QME report should determine how long of temporary disability you would be entitled. Majority of QME doctors would declare you P & S on the day of your QME examination unless you clearly need additional surgeries which you may have to go back to QME doctor for a re-evaluation. Feel free to call us at 213.388.7070 for a free consultation.
Your attorney should take the QME's deposition and ask if your condition awaiting surgery left you temporarily totally disabled for all those months PLUS your attorney should request a supplemental report from your treating physician as to whether your condition was temporarily totally disabled because you actually needed the surgery and couldn't work for anyone pending surgery (back-pedalling on his first opining you'd reached maximum improvement when you hadn't)...
...if the attorney can get both docs to write you should be receiving TTD awaiting surgery, the judge would order it so the adjuster would most likely just voluntarily pay it.
HOW IS IT FAIR?? this system 'Ahhhnold' left us with when he 'fixed' workers comp is wholly unfair. it encourages adjusters to deny everything, there's virtually no penalties for refusing people care and no one will hire them still broken and unable to move.
I DON'T UNDERSTAND WHY YOU CAN'T GET UNEMPLOYMENT. If you were released to work and your employer refused to let you work, you are eligible for unemployment. You need to appeal the rejection of Unemployment Insurance and get a hearing and drag your Workers' Comp attorney to the Unemployment Hearing... you WERE and REMAIN Unemployed when the Treating Physician releases you to some form of work and the employer doesn't have that form of work available.... it's likely you put a bad answer on your application, you might want to think about re-applying if the QME and your Treating Doc won't write you were TTD during those 15 months.
I'm at 909-381-2771 if you need more help ... you're not that far from me. Sorry this is happening to you.
Related Questions & Answers
Looking for something else?
10,200 active attorneys ready to answer your legal questions today.
Featured Attorneys
Earn additional revenue and grow your business.
