Legal Question in Workers Comp in California
I work @alameda county probaton dept. I fell in the parking lot in 1999 and injured my hip, back, and spine. I filed a claim w/WC I went to see a QME and determined that my hip replacement was caused by the slip and fall, and it was decided in my favor along with all the other injuries; and settled for $32,000, out of which I had to pay the lawyer, Edd, Kaiser hopital. I was pro-per because WC says its a NO FAULT system and the judges are fair when you represent yourself. I asked the judge about my future medical care and benefits, and he said "Don't worry about it you will have Kaiser medical to take care of any future medical"; so it was settled by compromise and release. When I asked the judge why I wasn't allowed to collect WC benefits and had to accept State disability he said it was all the same and if I had received WC benefits I would not have been eligible for the settlement. Since I've returned to work my doctor put me on part-time and when I tried to get supplemental benefits I was denied, stating my case was settled. Also, Its my understanding I can't receive temporary disability, Permanent disability, social security, or long term disability benefits. I've been on my job 19 years and always thought I would be taken care of if I were hurt. The judge never told me I would not get any of the benefits that injured workers receive so they can keep some of their bill paid. I'm going under and mistreated by the system. I've been a good employee for the county all these years. Can I file for reconsideration? Can my case be re-opened? I believe the judge didn't disclose all the information I needed to make a clear decision about the settlement.
1 Answer from Attorneys
Labor Code Section 5410 says that an injured worker cannot reopen a claim more than five years after the injury. I believe you stated your injury occured in 1999, so the statute of limitations applies. I am not sure why you were forced to pay Kaiser, as you had an admitted work injury the carrier should have been responsible to pay, adjust, or litigate the kaiser billing. I am also surprised that you were forced to pay back EDD. They only way this happens is if you are found permanent and stationary retroactively, meaning EDD has paid State Disability while you were permanent and stationary. It would appear you QME was not as helpful as you thought.
At this point you might consider filing for social security. You are allowed to work and receive social security. If you are a county employee, you should still have medical. If you have been working a while and were just put on half time, consider a 132a discrimination claim, or perhaps filing a new claim and seek a challenge under the Diminished Earnins Capacity.
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