Legal Question in Workers Comp in California

L5 S1 Back injury

I work in the medical field and was injured this year lifting a gurney. The occupational physician has determined that I should be on temporary total disability. I have been receiving disability benefits and medical care however the insurance company of my employer disagrees with the findings of my occupational physician [(who my employer told me to see) Lumbar strain as well as L5S1 Bulge and degenerative disc disease.] The insurance company wants me to see a CME. On a scale of 1 to 10, my pain level varies between 1 and 3 however I am rarely pain free. I am certain this injury was caused at work and am wondering how I should proceed. I am very afraid that if I return to work, I will damage my back further. Also, the insurance provider has given me a case manager who seems bent on getting me back to work before I am pain free. I spoke my case manager today and relayed my concerns of re- injuring my back and she said I could either return to work or settle. I have been very cooperative but at this point I now feel I am being taken advantage of by the insurance company. I greatly appreciate your reply.


Asked on 7/13/06, 11:09 pm

3 Answers from Attorneys
Phillip Cooke Law offices of Phillip A. cooke

Re: L5 S1 Back injury

The new workers compensation laws are being exploited by the insurance companies. Not only do they get to pick your treating doctor, they also get to ask you, as an unrepresented worker, to see a Qualified Medical Evaluator or QME. Once you see the QME, getting a lawyer may not help because the lawyer may not be allowed the cost of another evaluation. The time to see a lawyer is before you see a QME. A qualified workers compensation attorney can offer to have you go to an Agreed Medical Examiner or if there is no agreement to send you to a QME he or she knows to be fair.

Many of the "panel" QMEs favor the insurance company.

I reccommend that you follow your treating doctor's advice as to when to go back to work. You will earn more money if you can work and your employer will appreciate your effort.

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Answered on 7/18/06, 1:47 pm
ARMAN MOHEBAN LAW OFFICES OF ARMAN MOHEBAN

Re: L5 S1 Back injury

I THINK YOUR QUESTION REFERS TO SELECTION OF QME (QUALIFIED MEDICAL EXAMINER). I AM NOT SURPRISED AT ALL THAT A QME OR A TREATING PHYSICIAN THAT IS SELECTED BY THE INSURANCE COMPANY OR YOUR EMPLOYER WILL TEND TO MINIMIZE THE EXTENT OF YOUR WORK-RELATED INJURIES FOR OBVIOUS REASONS: 1.TO PAY NO OR VERY LITTLE TEMPORARY BENEFITS AND THEREFORE TO SEND INJURED WORKER BACK TO WORK AS SOON AS POSSIBLE AND 2. TO MINIMIZE THE SETTLEMENT VALUE OF YOUR CASE.

MANY QMES HAVE THEIR BIASES FOR OR AGAINST INJURED WORKERS THAT EFFECT THIER EXPERT OPINION. SO I HIGHLY RECOMMEND THAT YOU CONSULT WITH A WORKER'S COMPENSATION ATTORNEY. I GENERALLY RECOMMEND A AME (AGREED MEDICAL EXAMINER) AND WOULD SELECT AN EXPERT THAT IS NEUTRAL AND FAIR. FOR A FREE CONSULTATION ABOUT YOUR CASE, YOU MAY CONTACT MY OFFICE AT 213.388.7070.

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Answered on 7/18/06, 2:25 pm
Norman Gregory Fernandez, Esq. The Law Offices of Norman Gregory Fernandez & Associates

Re: L5 S1 Back injury

You need to consult with a Workers Comp lawyer. Defense QME's always minimize your injuries. You can contact me through my website at www.best.law.pro or through this system.

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Answered on 7/21/06, 6:49 am


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