California Worker's Compensation - Help For Injured California Workers

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  1. #1
    Join Date
    Mar 2010
    Posts
    21

    Default Doctor Wont Give Work Restrictions

    Injured State: California
    Injured Date: June 2009
    Name of Injury: Carpal Tunnel Syndrome (CTS) Bilateral
    Profession: Customers Service Representative
    Age: 29

    I was injured back in 2009 and diagnose with CTS. I was given restrictions of 20 minutes every hour to work and get 40 minutes off to relax BOTH hands due to major tightness, numbness and tingling. (Feels like typing on needles). My employer was unable to accommodate those restriction and set me home for 4 months.

    Went through a number of PT sessions, 2 injections, and pain meds, all in which did not help. Surgery seems to be the only options to pursue. Within the 4 months we went through surgery on the left hand and I have to say was a success. After 4 days of the surgery (02/01/2010) Dr wanted me to go back to work on regular duty. (Which I was unaware of till 03/01/2010). On 03/02 saw Dr and was told to make use of the left hand now to get it up and running again. This is understandable. He also stress I still have CTS and recommend surgery on the right hand and wanted me to work with no restrictions. This is what I dont understand. NO RESTRICTIONS..

    I work in a fast pace environment with a production level to meet for the company and individual. I spoke with him and was told to work as a healthy employee and soon will have surgery. We argue for 40 minutes with no success. I went back to work the following day with major pains and numbness unable to type and move the mouse. Still there were no restrictions. Ive called 3 times and spoke with my employer and WC company, all in which directed me to the Dr. Ive made a request to my Nurse Case Mgr to find another Dr for my restrictions. She said WC would not allow another Dr and only that Dr can only provide restrictions. I left work early today because of the pain to my right hand.

    I need some help, my STD job protective periods have run out but my employer will not let me go due to the volume of work. Supervisors and Mgr are working to get me back to work HEALTHY. Dr will not listen to my cry nor would WC. I dont know what to do. I cannot quit this job; I am the only person working in my family and have a mortgage to pay. I feel like Im being force to quit my job.

    My questions:

    Is there a law that would protect me from something like this?
    Can I request another Dr for my work restrictions?
    What are my best options right now?
    Should I be thinking about a WC lawyer?

  2. #2
    Join Date
    Jul 2008
    Location
    ca
    Posts
    863

    Default Re: Doctor Wont Give Work Restrictions

    Quote Quoting tyes45 View Post
    Injured State: California
    Injured Date: June 2009
    Name of Injury: Carpal Tunnel Syndrome (CTS) Bilateral
    Profession: Customers Service Representative
    Age: 29

    I would be carful about giving out too much personal information about you or your claim on a public site.

    I was injured back in 2009 and diagnose with CTS. I was given restrictions of 20 minutes every hour to work and get 40 minutes off to relax BOTH hands due to major tightness, numbness and tingling. (Feels like typing on needles). My employer was unable to accommodate those restriction and set me home for 4 months.

    Went through a number of PT sessions, 2 injections, and pain meds, all in which did not help. Surgery seems to be the only options to pursue. Within the 4 months we went through surgery on the left hand and I have to say was a success. After 4 days of the surgery (02/01/2010) Dr wanted me to go back to work on regular duty. (Which I was unaware of till 03/01/2010). On 03/02 saw Dr and was told to make use of the left hand now to get it up and running again. This is understandable. He also stress I still have CTS and recommend surgery on the right hand and wanted me to work with no restrictions. This is what I don’t understand. NO RESTRICTIONS..

    I work in a fast pace environment with a production level to meet for the company and individual. I spoke with him and was told to work as a healthy employee and soon will have surgery. We argue for 40 minutes with no success. I went back to work the following day with major pains and numbness unable to type and move the mouse. Still there were no restrictions. I‘ve called 3 times and spoke with my employer and WC company, all in which directed me to the Dr.

    Your company is correct here. They do not give restrictions, only the doctor can.

    I’ve made a request to my Nurse Case Mgr to find another Dr for my restrictions. She said WC would not allow another Dr and only that Dr can only provide restrictions.

    Your nurse case manager is full of shit. In California you have the right to change treating doctors up to 3 times. Now I will fill you in about nurse case managers...

    They work for the insurance company/ your employer. Their primary goal is to limit the costs of your claim. I would not ask her to change your doctor, as she would most likely send you to one that is friendly to the insurance company.

    I would ask if your employer or insurance company is part of an MPN (medical provider network). If she says yes, I would ask her for the internet access link to your MPN. There you can look through a list of doctors, and you can pick another hand surgeon from that list.

    If your employer or their insurance carrier does not have an MPN...then you can treat with any doctor who does workers compensation.

    If you are happy with the doctor you have now, then just disregard the above, but know that the nurse case manager is looking out for your employers interests, and not yours, no matter how nice she may act.


    I left work early today because of the pain to my right hand.

    I need some help, my STD job protective periods have run out but my employer will not let me go due to the volume of work. Supervisors and Mgr are working to get me back to work HEALTHY. Dr will not listen to my cry nor would WC. I don’t know what to do.
    You have every right to change treating doctors. If you need help with that, come back to this site after you request access to your MPN.


    I cannot quit this job;
    I do not recommend you quit your job. Do not quit.

    I am the only person working in my family and have a mortgage to pay. I feel like I’m being force to quit my job.
    No one can force you to quit, in fact if you do this may affect your benefits. If you need another surgery for example, and quit your job, your employer does not have to pay you TTD benefits. Whatever you do do not quit your job.


    My questions:

    Is there a law that would protect me from something like this?
    Yes, as I mentioned above, you can switch doctors. If you choose to stay with this doctor, your employer is going to follow his work restrictions.


    Can I request another Dr for my work restrictions?
    Not another doctor just for your work restrictions, but you can change treating physicians.

    What are my best options right now?
    Consult with a work comp attorney ASAP

    Should I be thinking about a WC lawyer? YES!
    Yes. Yes. Yes. This is the link (below) to the California Applicant's Attorney's Association. Once you open it, just fill in your zip code and it will show you a list of work comp attorney's near you. You don't have to pay for a consultation, in fact applican'ts attorneys are only paid by a % of your PD (permanent disability payments) or your settlement.

    http://caaa.org/cs/default.aspx
    Last edited by InjuredGypsy; 03-08-2010 at 02:57 PM.
    Never doubt that a small group of thoughtful, committed citizens can change the world...indeed...its the only thing that ever has - Author Margaret Mead

  3. #3
    Join Date
    Mar 2010
    Posts
    21

    Default Re: Doctor Wont Give Work Restrictions

    Thanks a million for your help. I've been extremely worried about this issue for quite some time now and NOW have found a place that I am not a lone. I guess I was a too concern and went over board on the info provided. Im currently working with admin on the case. Thank you again.

    I knew something smell funny a while back ago when the Nurse and WC try to limit me to PT. Things just didnt feel accomodating anymore but more forcing to see a provider.

    Anyhow, is there a penal code or section where I can read about the options of choosing Dr's or in fact more in detail about our rights in this topic?

    As for lawyers, i'm really looking foward to see one by this week, but a little concern about fees. I cant really afford paying anything. I know you mention about the free consult, but more worry over how little this case may be. I just feel there wont be any actions on the lawyers part due to size of the case. Basically i just want my restrictions untill my surgery is over with and done.

    I'll keep you posted on the MPN later on today.

  4. #4
    Join Date
    Jul 2008
    Location
    ca
    Posts
    863

    Default Re: Doctor Wont Give Work Restrictions

    Hi tyes45,

    I commented above about personal information just because anyone can read this site, including insurance companies. You did not do anything wrong.

    http://www.dir.ca.gov/dwc/InjuredWorker.htm

    and here http://www.dir.ca.gov/dwc/MPN/DWC_MPN_Main.html

    If you click the above link, and scroll down the page, there is another link about MPN's. We don't know yet if your employer/WC insurance company is part of an MPN. If they do have an MPN, and did not notify you properly, they may have lost medical control. If you have any problems with navigating through the above link, let me know.

    You do not have to worry about paying a work comp attorney. They only get paid between (9%-15%) of any PD award, or compromise and release settlement. Nothing is paid out of your own pocket.

    If you do not get an attorney, you should call your local work comp board and ask to speak with an I&A officer (information and assistance officer) whenever you have any questions about your claim. The numbers for that are also located in the above link.

    A book that can be a great resource is California Worker's Compensation by Christopher Ball. There are numerous editions, just make sure you have the most current, as the laws are constantly changing. You can also check out this book at your local library.

    I think you may have a good chance of hiring an attorney, since you have had surgery, and will have another. This tells me your injury is substantial, and you should receive some PD rating. A PD rating (permanent disability) is what attorney's are paid on with work comp claims. Injured workers do not have to pay these attorneys out of pocket (illegal).
    Never doubt that a small group of thoughtful, committed citizens can change the world...indeed...its the only thing that ever has - Author Margaret Mead

  5. #5
    Join Date
    Mar 2010
    Posts
    21

    Default Re: Doctor Wont Give Work Restrictions

    Upsetting news.
    Just spoke with my adjuster and was told my company and WC do not operate on a MPN, but a State Panel QME. Any further authorization for another Dr will have to come from that list. (Which will be mail to me soon.) As for choosing Drs, I was told I had NO OPTIONS since this Dr IS the treating physician. Even with the new authorization for a new Dr, the process will be DENY due to prior surgery on the left hand. Which makes no sense for them to send me the State Panel QME when everything will be DENY..

    As for payments goes, checks have been distributing from WC Ins. Since Ive been out so long it was merged with STD on the 12 week protective leave. Never heard of the PD, because I did not feel I was permanently injured. I honestly dont know where the funds are coming from whether its PD/STD/TTD, what I knew I was receiving funds and it was coming in regularly from the WC insurance. (another mistake not keep track.)

    The links you provided took me directly to the IA which I am calling NOW to gather more info and in search for a direction to proceed. Thank you again InjuredGypsy, I will continue to keep you in the loop of my journey.

  6. #6
    Join Date
    Jul 2008
    Location
    ca
    Posts
    863

    Default Re: Doctor Wont Give Work Restrictions

    They are still lieing to you that you cannot change primary treating doctors. It is California state law that you can change primary treating doctors up to three times.

    It is a good thing you are not in an MPN. This means you can choose any doctor who treats work comp injuries, and abides by those rules.


    I am going to pm (private message) you info for a doctor/work comp hand surgeon, but I don't know if you are near him.
    Never doubt that a small group of thoughtful, committed citizens can change the world...indeed...its the only thing that ever has - Author Margaret Mead

  7. #7
    Join Date
    Mar 2010
    Posts
    21

    Default Re: Doctor Wont Give Work Restrictions

    Just spoke with IA unit, they were very helpful and understanding. A consultant will give me a call in 2 business days on how to proceed with this. Unfortonately, she mentions these things happens all the time.

  8. #8
    Join Date
    Jul 2008
    Location
    ca
    Posts
    863

    Default Re: Doctor Wont Give Work Restrictions

    Yes, unfortunately work comp insurance companies try to take advantage/screw injured workers all the time.

    I sent you a private message, don't know if it can help you or not.

    Quote Quoting tyes45 View Post
    Upsetting news….
    Just spoke with my adjuster and was told my company and WC do not operate on a MPN, but a “State Panel QME”. Any further authorization for another Dr will have to come from that list. (Which will be mail to me soon.)

    Good thing for you that you now know since they do not have an MPN, you do not have to pick from any list they send you. You can treat with any doctor who accept work comp patients. In fact I would be a little weary of picking a doctor from the list they provide you, the lieing ass*&^%$. (sorry for the language but you are being lied to, and it pisses me off.)


    As for choosing Dr’s, I was told I had “NO OPTIONS” since this Dr “IS” the treating physician.

    You are being lied to. You can change treating doctors up to 3 times.

    Even with the new authorization for a new Dr, the process will be DENY due to prior surgery on the left hand. Which makes no sense for them to send me the State Panel QME when everything will be DENY..
    I hope you click the link for attorney's I sent you above, and hire one.
    As for payments goes, checks have been distributing from WC Ins. Since I’ve been out so long it was merged with STD on the 12 week protective leave. Never heard of the PD, because I did not feel I was permanently injured.
    This can be confusing. If you have had surgery, then you should have some permanent disabilty from that (IMO). An I&A officer, or work comp attorney will be able to explain the PD better than I. Yes, some people do have a zero% PD rating, but I have not heard of someone who has had surgery have a zero rating.


    I honestly don’t know where the funds are coming from whether it’s PD/STD/TTD, what I knew I was receiving funds and it was coming in regularly from the WC insurance. (another mistake not keep track.)

    The links you provided took me directly to the IA which I am calling NOW to gather more info and in search for a direction to proceed. Thank you again InjuredGypsy, I will continue to keep you in the loop of my journey.
    I am so relieved you contacted an I&A officer, I still recommend consulting with a few WC attorneys.
    Last edited by InjuredGypsy; 03-09-2010 at 10:03 AM.
    Never doubt that a small group of thoughtful, committed citizens can change the world...indeed...its the only thing that ever has - Author Margaret Mead

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