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  1. #1
    Join Date
    Apr 2007
    Posts
    66

    Default Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    I have worked for a public education institution 8 years thru June 1, 2006. I filed a claim for workman's comp in April 2006, the company doctor told me I had carpul tunnel both hands and put me on restrictions; gave the infor to my work, but I continued to do the same job (without any modifications!. I got so bad I had to stop working(end of June 2006). My claim has been denied twice. I consulted an attorney July 2006 and I am appealing the denial.


    I had Nerve conduction test in August 2006; saw the AME examiner February 9th 2007. All Doctors I have seen have verified that I have Severe Carpul Tunnel both hands. I have been off work since end of June 2006; My attorney says that I will begin to see some money soon, I have called her within the past three weeks, 6 times, she doesn't call me back. Haven't heard anything from the Insurance Carrier either. All sick leave and vacation are used up!! ANY SUGGESTIONS?

    DESPERATE and pretty soon homeless IN CALIFORNIA

  2. #2
    Join Date
    Oct 2006
    Posts
    294

    Default Re: Workman's Compensation Nightmare For Carpult Tunnel Diagnosis

    Quote Quoting ENFUEGO View Post
    I have worked for a public education institution 8 years thru June 1, 2006. I filed a claim for workman's comp in April 2006, the company doctor told me I had carpul tunnel both hands and put me on restrictions; gave the infor to my work, but I continued to do the same job (without any modifications!. I got so bad I had to stop working(end of June 2006). My claim has been denied twice. I consulted an attorney July 2006 and I am appealing the denial.


    I had Nerve conduction test in August 2006; saw the AME examiner February 9th 2007. All Doctors I have seen have verified that I have Severe Carpul Tunnel both hands. I have been off work since end of June 2006; My attorney says that I will begin to see some money soon, I have called her within the past three weeks, 6 times, she doesn't call me back. Haven't heard anything from the Insurance Carrier either. All sick leave and vacation are used up!! ANY SUGGESTIONS?

    DESPERATE and pretty soon homeless IN CALIFORNIA

    Apply for your SSDI yesterday.. It at least will help keep food on the Table

  3. #3
    Join Date
    Feb 2007
    Location
    California
    Posts
    87

    Default Re: Workman's Compensation Nightmare For Carpult Tunnel Diagnosis

    Did you use your EDD benefit for SDI?

    Make sure your attorney stays on top of the AME to get that report in. From 2/9 he is approaching 60 days and that is too long. It should only be 45. They can and will take longer if someone does not stay on top of them to get the report out.

    Hopefully the AME will get his report out and it will confirm that the CTS is work related, and that you have been TTD for this past 9 months, and that you need certain treatment on industrial basis so that you can get some releif.

    Once the AME report is in, you should get that money started ASAP, with a large back pay for your TTD.

    Try to hang in there.

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Workman's Compensation Nightmare For Carpult Tunnel Diagnosis

    It usually takes about as long to get an AME report back as it took to get the appointment in the first place. There is a time limit (45 days unless a request for extension is made and agreed to by the parties) for QME's, but no time limits exsist for AME's.

    You should file for your SDI benefits immediately. Your doctor must sign the application. You may get these benefits until your case is accepted, and then SDI/EDD will put a lien on your case and will be reimbursed for any money they advanced. But you need to protect your dates of entitlements. If you are off work too long you won't have any qualifying wages to base a benefit on. This will also protect your EDD benefits should you need them.

    If your doctor let you continue to work with restrictions, your ER should NOT have allowed you to do so unless they could accomodate you. It was also your responsibility to not perform the same work you said was the reason for your injury. There probably won't be any repercussions due to this, but keep it in mind once you are released to go back to work...

    Once the AME report issues, there may still be a problem, and your attorney should be filing a DOR for expediated hearing to determine AOE/COE. It can take a couple of months to get a hearing date due to the backlog at the WCAB. Talk to him about filing this now.
    It isn't unsusual not to get return calls to your messages..if there isn't anything to report...you won't get a call. AA's don't have the time with their own caseloads to return all the calls they get. If they did, there wouldn't be time in the day to handle the cases, including yours.

    You can file for SSA/SSDI, but these benefits have a much higher threashold than WC. It must be expected that you are unable to perform ANY gainful employment for a period of 12 months or your that your condition end in death. Pretty difficult to qualify. But file anyway, again to protect your dates of entitlement/onset. It can take up to 6 to 9 months or longer to get SSDI.

  5. #5
    Join Date
    Feb 2007
    Posts
    64

    Default Re: Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    apply for state disability they should back pay you call today
    http://www.edd.ca.gov/

  6. #6
    Join Date
    Apr 2007
    Posts
    66

    Default Re: Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    It has now been two months, (2-9-07) 60 days, that I saw the AME and he told me that the insurance company would have to approve my claim with his report! My attorney received the preliminary report from AME on March 12, 2007, this is when she told me I should see some $$ soon, my mistake was I didn't ask when.

    I really cannot get any answers from my attorney. Do you think my employer is aware of any updates? Do you think I should call the AME for a copy of the report?

    Unfortunately, we don't pay into State Disability. I have paid into a private disability insurance, but I am afraid to submit a claim to them in fear it will jeopardize my Work Comp claim?

    Any suggestions?

    I'm hoping to get some answers on Monday, I have made a telephone appointment with my attorney.

    CPS in California

  7. #7
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    You must be afraid because you don't know the law and are guessing.
    Under california law income from a private disability policy is not considered wages from employment and would not jeopardize work comp payments any more then drawing vacation or sick leave.

  8. #8
    Join Date
    Apr 2007
    Posts
    66

    Red face Re: Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    Yes, I am afraid. I'm also afraid I will lose everything I ever worked for; house, credit worthiness, cars, etc.

    Also, my supervisor has scorned me because I filed the claim, she acts like if it is a personal attack on her. I know that if it wasn't for what she told the Workman's Compensation insurance in an interview, my claim probably would of been approved from the start.

    Anyway, I know that my situation will not be the same when I return to my place of employment. My biggest concern now is to have my claim approved and start to received some benefits, so that we have a roof over our head.

    thanks for the information
    CTS in California

  9. #9
    Join Date
    Apr 2007
    Posts
    66

    Unhappy Re: Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    Well here is the update my attorney has given me today.

    After my AME(2-9-07) the report was received and verified that my CPT is definitely industrial, just like all of the other doctors and reports and the Nerve test before (4 reports now)!

    But guess what? my attorney now says that the adjuster refuses to pay me benefits on my claim until he brings the AME in for a deposition???? Which I don't understand if the Insurance Co was in agreement with the AME. My attorney told me she filed for an expedited hearing as of today?

    Any suggestions on what happens next? How long this process could take?

    Anyone

    CTS in California

  10. #10
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Workman's Compensation Nightmare For Carpal Tunnel Diagnosis

    Make sure you ask for penalties. While they are entitled to see the written report and a reasonable time for issuing a check they cannot stall forever.

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