Legal Question in Workers Comp in California

Lifetime Medical

I was injured in 1987. I hade surgery on my neck. I had nerve damage and was rated 39,2% disabled. I choose lifetime medical and wrote a letter that said I wanted to choose my own Doctor. The insurance company said ok. I had another surgery 1n 1996 on the smae disk in my neck. The insurance company went bankrupt and Cambidge took over their claims. they said the law has changed and I have to go to one of their clinics and see a doctor thats not even a specialist. I thought when I signed for the settelment they could not change it. Can they?


Asked on 5/23/07, 6:32 pm

1 Answer from Attorneys
George Shers Law Offices of Georges H. Shers

Re: Lifetime Medical

They probably can not change the terms of the settlement, but I doubt the settlement said anything except you were entitled to life time medical treatment without saying how that treatment was to be obtained or from whom. The law used to be that after 30 days you got to choose your own treating Dr.; I do not know what it says now, but I would ask the WC carrier why thye do not want you to go to a specialist who can treat you properly instead of someone who may cost more in the long run because they are not able to give as good treatment. If they still say no, ask they to prove they have the right to change an agreement entered into before the law was changed; if they can not come up with an cases or Board decisions saying that, tel them they have failed their burden to show that they can ignore prior law and terms of treatment implicit in the prior settlement agreement.

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Answered on 5/30/07, 9:39 pm


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