Legal Question in Workers Comp in California

Hi, I live in California. I have a WC case open. In 2010 I injured my lower back helping a co-worker as she ran over her foot with her electric scooter. I lifted approximately 450lbs. I developed a herniated disk and had to go through PT and later that year a surgery to remove hernia between L4 and L5. My primary Dr. have written a PR4 to workers comp and have given me a 13% permanent disability rating with future medical care for my injury and a comp of $12,500. My adjuster have mail me forms to be signed by me in order to be approved by the Worker's Compensation Board Judge. I still have pain in my lower back and I develop numbness after being standing or walking for more than 20 mins. My Dr. said it may never go away. My questions are: Does this seem like a fair deal? Am I being treated fairly from WC? Should I seek legal representation now before signing any paperwork? Thanks.


Asked on 7/24/12, 12:05 pm

2 Answers from Attorneys

Alison Gude, Attorney Law Office of Alison J. Gude

There is no way to determine whether your doctor has accurately determined your disability or whether the insurance company is offering you a fair deal without reviewing your medical records. I strongly encourage you to consult with a workers' compensation attorney in your area. You may locate one by going to www.caaa. org.

All initial consultations with workers' compensation attorneys are free.

In the alternative, I'd be happy to speak and/or meet with you. I can be reached at 415-655-6789.

Good luck!

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Answered on 7/24/12, 5:01 pm
Nancy Wallace Nancy Wallace Atty at Law

No, 13% for a failed back surgery does not sound like an accurate rating of your actual permanent disability.

Actually, it sounds like the very bare minimum the treating physician could have written about your spine! It sounds like you let the adjuster pick a treating physician and the treating physician wrote the report to make the adjuster happy.

WHY DID YOU NOT OBJECT TO THE FINDINGS OF THE TREATING PHYSICIAN?

The insurer will pay for a Qualified Medical Evaluator, an independent opinion. You don't need a lawyer to get a QME.

I'll be the adjuster has sent you a few REQUEST FOR PANEL QME forms already! Check the mail you've received from the adjuster...they mail those forms with just about every notice and letter.

Tell the adjuster you're not ready to sign the forms. Tell the adjuster you are requesting a Panel QME.

then mail the Request for Panel QME for Unrepresented Worker form -- completed -- to that PO box in Oakland on page two of that form.

THEN -- AND THIS IS MOST IMPORTANT -- you do NOT pick the doctor from the list of three or you'll probably pick another insurance jerk

YOU LET AN ATTORNEY experienced in workers comp pick for you. Maybe Ms. Cude in San Francisco there would pick from the list of 3 docs.

If you can't find anybody up there, Ill pick for you: [email protected]

When you are Unrepresented, you can choose any of the three doctors, so there is probably one guy on the list (upcoming) who isn't "In Bed" with the Comp Insurance companies.

BUT IF you get an attorney and then get the list of 3, you don't have such freedom. REpresented workers have the attorney 'strike' one doctor, then the Adjustor strikes the nicest doctor, and you're left with the weird guy in the middle nobody knows about.

So it's a bad idea to get an attorney first then get a panel of QMEs. GET THE PANEL OF QMEs first, and pick the best buy from the list...then AFTER that QME writes the report, you can go get an attorney.

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Answered on 7/24/12, 7:11 pm


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