Legal Question in Workers Comp in California
Hello, I am a Police Officer. I was placed off work last Nov, 2013 for a hip injury. During the next few months I had seen my Dr. who in turn referred me to a hip specialist. Hip Replacement was reccommended. While I waited to see the specialist work comp sent me to their Dr who returned me to work half a day. The other half, 5 hours was work comp, 4850 time. I worked from June 16 through Sept 8 until the day before my replacement. I have been off since and work comp now says that my 4850 time is exhausted. How can this be if it does not go by a calendar year. I have 165 hours of work time that excluded days off I had taken from June to Sept. Does this not still tack or credit on after the Nov anniversary date?
1 Answer from Attorneys
The "KITTEL" decision limited 4850 payments like Temporary Disability payments, 104 weeks from the time they start (even if they stop and re-start and even it they are paid partially). Your description indicates these were only paid ONE year, so it seems you would win in a hearing to have the 4850 payments resumed plus penalties for unreasonable refusal to provide disability payments.
I do NOT see here you have medical reporting from the WORKERS COMP primary treating physician writing clearly that you remain Temporarily Totally Disabled as the result ofr the 2013 on-the-job injury (no, notes from your personal doctor don't count). IF YOU DO NOT HAVE A report from a primary treater in the Medical Provider Network clearly showing Temporary Total Disability, YOU NEED THAT REPORT IMMEDIATELY.
IF YOU HAVE an MPN DOCTOR's report showing TTD status for dates beyond the dates the adjuster has issued payment, Try writing the claims adjuster and note you will request the Judge award Sanctions under Labor Code 5813 for a tactic designed solely to harass because adjusters there MUST know two years -- 104 weeks -- of 4850 benefits are due.
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