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  1. #1
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    Jul 2010
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    Unhappy Assaulted at Work by Customer

    I work as a shift manager for well-known national company. The store I am employed by is open 24hrs a day. I work the overnight shift so I can attend physical therapy (which is only available during normal business hours). Early yesterday morning, I was abiding by company policy and CA state law by declining to sell tobacco products to two 18-25 year-old hispanic males who appeared to be gang members. Were it any other type of merchandise, I would have simply let them take/steal the product so I could stay safe. But, knowingly giving the tobacco products to someone you believe may be under 18 is illegal. I was polite, but firm. One of them hit me extremely hard in the face. I stayed to complete the 7 hours left on my shift because none of my coworkers were awake to come assume my duties. There was substantial bleeding from and around my eye. I received emergency medical care about 12 hours after the incident. X-rays revealed no fractures, but I am expected to do a follow-up exam with a company-sponsored physician (i.e. one who may be in bed with my employer's claims administration company).

    I already suffer from chronic pelvic pain and back pain from a pinched nerve in my lower spine. My physician reluctantly cleared me for work when I began suffering from this condition (I was 17 at the time; 5 years ago). I have since then graduated with honors with a BA in Business. I was unable to find another job, so I kept my position with this company. My employer could not accommodate/schedule me around physical therapy visits, forcing me to work the dangerous overnight shift. There is NO security on duty during my shift. The degenerate vermin who assaulted me appeared to be gang members. I am in a great deal of pain, even more than the pain I was in before the incident. I fear for my life because these gang members now know me - my manager elected to put my first AND last name on my name tag even though official company policy was to do away with last names in the workplace.

    I do not feel safe and never want to return to either that store or that shift ever again. I am willing to work a different type of job/position, provided I my physical therapy visits can be accommodated. I would even sacrifice the therapy for assurance of my safety (i.e. NOT working at that particular store). How can I secure - *with certainty* - temporary disability benefits while I look for another job? I can't sleep, I have lost my appetite, and constantly fear for my safety. The emotional trauma accompanying the physical wound has made me unable to every return to that position.

    I do not want a company-sponsored physician to simply write "There's nothing wrong with him." Because that is NOT true. What do I need to do to make the emotional/psychological pain and suffering evident to him? I have to see a company doctor within the next 1-2 days. Why can't I see an objective doctor who is not an advocate of my employer? I have had suicidal thoughts and have been extremely depressed because the one job I could work while attending physical therapy is now no longer safe. Being assaulted at work defeats the whole purpose of working at that store, and during that shift. What do I do?

    --Claims administration is being handled by Sedgwick CMS. After reviewing other posts about them, I am even more concerned.
    Last edited by Cole10; 07-13-2010 at 01:45 AM.

  2. #2
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    Apr 2010
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    110

    Default Re: Assaulted at Work by Customer

    There is not a lot you can do; work or quit your job. You can ask them to change your shift or the store but they do not have to. You will not get them to pay your wages while you look for another job; forget about that idea. Also it is unfortunate but if you try to get a psychological claim you are looking at something that is going to make your life a living hell. They will go over your life with a fine tooth comb. Anything that has happened in your life will be fair game. Any fight you have ever been in or if your parents ever spanked you. Expect that to be brought up. Then expect that to follow you for the rest of your life.
    The best thing for you to do is go back to work and keep your panic button on your belt and hit it at any sign of problem. For something that just happened last night you are claiming a lot of symptoms. Expect them to give you a hard time about it and expect them to deny your claim.
    Last edited by crispy1; 07-13-2010 at 02:25 AM.

  3. #3
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    Default Re: Assaulted at Work by Customer

    Thanks for the reply, but the "panic button" you mentioned is pure fantasy. The gang member told me explicitly that they "owned this place" and would "f*** us up before the sheriff arrived." It took over 15 minutes for them to arrive after being attacked. Company policy prevents me from carrying a firearm while on duty. It isn't safe there. I'm not safe there. I didn't make the decision for the company to have no security, even in this urban area; nor did I make the decision to have my first and last names on my name tag (the wearing of which is mandatory per company policy).

    Also, nearly every resource I have read said that mental disorders caused by physical injuries are often covered. Although the incident has gravely frightened me; I was also injured! Had I not been harmed, there would be less of a reason to "fear" for my safety. Anyone can fear for their safety. Those who have actually been attacked - and are unable to find accommodations removing them from the harmful situation - should have advocates!
    Last edited by Cole10; 07-13-2010 at 02:42 AM.

  4. #4
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    Feb 2007
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    Calif
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    Default Re: Assaulted at Work by Customer

    You file a DWC-1/First Report of Injury with your employer, claiming WC benefits. They are required, under law, to provide you with medical treatment. First you must be noticed on how/where to seek that treatment, in writing. If that is not done prior to the injury, ie at the time you were hired, Or at the time you file the claim and request medical treatment, you may be able to treat with a Dr of your choice.
    The ER/TPA (Sedgewick CMS is a Third Party Administrator for a legally self insured ER) is permitted to control the medical in a claim, and send you to a physician of their choosing for the first 30 days. After that you can change Dr/PTP.

    You should just assume a Dr is 'in the employers pocket' just because s/he may be in the MPN/Med Provider Network. There are lots of Dr who agree to accept and treat industrial injury. The MPN just means they have agreed to a fee schedule, and use the requried treatment guides in formulating a plan to treat your injury. Those are adopted by the DWC Adm Dir, and required under the statutes/labor code. MTUS/ACOEM are the presumptive guides. You must have a PTP to write a request for treatment. Otherwise, the TPA doesn't even have to respond to another Dr.

    You are not going to be paid 'temp disability' benefits while you seek another job. TTD/TPD is paid only when your Dr says you cannot work due to the injury. UI is paid when you are ready willing and able to accept suitable employment if offered.
    You should apply for SDI/state disability ins benefits now. These will be paid during any delay/denial period you may be eligible for TTD/TPD benefits.
    I already suffer from chronic pelvic pain and back pain from a pinched nerve in my lower spine. My physician reluctantly cleared me for work when I began suffering from this condition
    If your Dr, or the WC PTP can make a connection of a pre exsisting condition, or prior injury to your work injury, that could be a compensable consequence to your claimed injury/body part.

    All of your physical/mental complaints must be substantiated by medical evidence. And substantive reasoning by a Dr/PTP for your claim to be accepted.
    Sounds like you are being delayed/denied at this time, and a PQME is necessary. This should be given to YOU to select the specialty, and Dr to act as PQME. NOT the TPA.

    If your PTP feels there is necessity for psych counseling or evaluation, that will have to be addressed in a request for treatment. OR, you can add the psych claim to your orginal DWC-1. Think very carefully about this approach.
    Why can't I see an objective doctor who is not an advocate of my employer?
    Because WC doesn't work that way. You are asking the ER to pay for your medical treatment, you follow the comp rules, or you are certainly free to treat with a Dr of your choice, and pay out of pocket. You can't use your own insurance to pay for industrial injury. They will deny the bills once its' known, and there are rules too for billing a IW for treatment by any provider.

    If you need more direction you should contact an I&A officer at the WCAB, or an attorney. IMHO... Id be talking to a few AA/Applicant Attys...today.

  5. #5
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    Default Re: Assaulted at Work by Customer

    Quote Quoting Cole10 View Post
    Thanks for the reply, but the "panic button" you mentioned is pure fantasy. The gang member told me explicitly that they "owned this place" and would "f*** us up before the sheriff arrived." It took over 15 minutes for them to arrive after being attacked. Company policy prevents me from carrying a firearm while on duty. It isn't safe there. I'm not safe there. I didn't make the decision for the company to have no security, even in this urban area; nor did I make the decision to have my first and last names on my name tag (the wearing of which is mandatory per company policy).

    Also, nearly every resource I have read said that mental disorders caused by physical injuries are often covered. Although the incident has gravely frightened me; I was also injured! Had I not been harmed, there would be less of a reason to "fear" for my safety. Anyone can fear for their safety. Those who have actually been attacked - and are unable to find accommodations removing them from the harmful situation - should have advocates!

    Whether it is safe or not really does not enter the picture. You either work where the company wants you to or you quit. Those are your only two choices. If they are making money off the store, Do not expect them to shut it down. Also some one has to work there. Be it you or some one else. If you have a degree and days off I would suggest You be looking for a differant job.
    You also make the statement that everything you have read says mental problems from an injury can be covered. That makes it sound like this is something you have been planning for a while. If that just happened yesterday, it is unlikely you would have been reading the books the first day. I could be wrong, but I would not make that statement to any one else.
    Mental problems developed from the injury can be covered but if you try to go that way, you really need to understand what you are opening your self up to. They will go over your history from the day you were born. Anything in your history is fair game, from the school bully to how long you wet the bed as a baby. What you do really makes no differance to me. I just want you to understand what is behind the door before you open it.
    Last edited by crispy1; 07-13-2010 at 07:53 AM.

  6. #6
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    Jun 2007
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    339

    Default Re: Assaulted at Work by Customer

    First of all you should have contacted the manager and had them come down immediately to the store. You were physically assaulted and suffered an injury so you should have received immediate medical attention.

    At this point you have received treatment for your physical injury and are scheduled to follow up on it. That is what you should do. On to your mental status. You were assaulted. As anyone who has ever been assaulted can attest to you may be suffering some mental issues as a result. This needs to be addressed ASAP. Quite possibly you could suffer from some ptsd. You need to seek immediate medical attention for this.

    I find it interesting that every time someone mentions a psychiatric injury they are warned about the implications of filing a WC claim. They are told that their lives will be analyzed from day one to the present. To some degree that is true. I can only speak from my own experience. Having had a psych claim and having had that claim accepted and treated I feel that I might have a little perspective. Yes you will give a history and yes there will be some personal questions. I can only say that in my own case it was not as terrible as many here say. Nobody asked about school bullies or bed wetting. And if they did so what. We all have experienced life. Many times they only ask the questions to determine how honest you are being. To say your life up until that point has been perfect would be a lie and raise a flag of suspicion.

    I was asked about my family and relationships with my family members. I was asked some very superficial questions about my childhood and my parents. My relationship with them and my siblings. In other words I was asked what one would expect for a psychiatric evaluation. Now fortunately I was not abused as a child. My family relationships are fairly good. No one has a perfect life and I am no exception. There have been bumps in the road and I was completely honest about them.

    Now on to the long term ramifications. Again for myself there really have not been any real problems. At least as far as this following me around everywhere I go. No one has ever asked me about. I have gone on with my life and function quite well. It is not on any job application. For the most part unless I bring it up no one is aware of it. Actually the details of the medical records for my psychiatric treatment are more difficult to access than the ones for my physical injuries. Even the patient is not given the complete reports from the Psychiatrist. A diagnosis is provided and that is about all that anyone gets.

    I have gone on very long but I feel that people need to understand that mental injuries do occur. They can and should be treated. Too often it seems even the IW community treats this issue as if everyone who suffers such an injury is a faker and malingerer. I find this interesting that on the one hand so many IW's complain and fight about this same mis perception when it comes to the physical injuries. On the other hand the minute a mental injury is mentioned they are quick to jump and perpetuate the notion that many if not most are faking it.

  7. #7
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    Jul 2010
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    12

    Default Re: Assaulted at Work by Customer

    Quote Quoting BvIA
    You file a DWC-1/First Report of Injury with your employer, claiming WC benefits. They are required, under law, to provide you with medical treatment.
    I have done this; I filled this form out at the ER.

    Quote Quoting BvIA
    First you must be noticed on how/where to seek that treatment, in writing.
    I have not been noticed. I haven't received any mail, nor have I been called by the TPA. I have left the TPA's office several voicemails (at the particular office that handles my company's claims). When I call the incident reporting hotline to ask them where I should be treated, they say there is no record of the store that I work at (nor of any other stores near where I live). Other reps have said their "system is down," or that they are "upgrading their software." The reason I'm getting anxious is that the ER physician said I have to follow up within two days, but did not indicate where. They said the TPA would notify me.

    Quote Quoting BvIA
    You must have a PTP to write a request for treatment.
    Thank you; I will ask the PTP, whoever it may be, for this request.

    Quote Quoting BvIA
    You are not going to be paid 'temp disability' benefits while you seek another job.
    So the PTP determines that someone is fit/unfit to work *anywhere* *period* Is this correct? They cannot determine that someone is simply unfit to return to work at [their specific occupation]?

    Quote Quoting BvIA
    You should apply for SDI/state disability ins benefits now. These will be paid during any delay/denial period you may be eligible for TTD/TPD benefits.
    I plan to do this, but shouldn't I have some kind of documentation from my PTP confirming my eligibility? Or should I apply right now, before even hearing a word from my TPA?

    Quote Quoting BvIA
    Sounds like you are being delayed/denied at this time, and a PQME is necessary.
    Yes, I do feel like I am being delayed. And that makes me nervous, because if the ER physician is correct in their belief that I only have a 2 day period to follow up, I can *easily* believe the TPA is intentionally dodging my calls and witholding information simply to ensure that I *will* miss this window.

    Quote Quoting BvIA
    IMHO... Id be talking to a few AA/Applicant Attys...today.
    Thank you for the advice. At the time that I posted this topic, I also floated it out on an aggregate lawyer site, and to a few local WC places. I have barely been able to keep up with all the email! Since the incident was capture on a tape, a police report filed, and a cashier witnessed the attack; they all believe I have a pretty strong case.

    - - -

    Quote Quoting crispy1
    You either work where the company wants you to or you quit. Those are your only two choices. If they are making money off the store, Do not expect them to shut it down. Also some one has to work there.
    This is all patently obvious. I never said I wanted them to shut the shop down. "Someone has to work there." HUH? Did you honestly think that I believe having employees in a store is OPTIONAL? What jewel of olde tyme wisdom will you bestow on us next? Perhaps you'll clarify, claiming that you simply want to make us all aware that if companies didn't have to hire and pay employees, they wouldn't have to (as if that's not obvious to the most casual observer).

    Quote Quoting crispy1
    If you have a degree and days off I would suggest You be looking for a differant job.
    No kidding! I looked HARD during my senior year at school. Everyone would only hire people with experience (i.e. people who weren't fresh undergrads). I compromised and stayed at the job I worked at while in school. It pays the bills. Then I moved to the overnight shift so I could attend physical therapy. If I am awarded disability benefits, it seems unethical for me to start looking for a "differant" job.

    Quote Quoting crispy1
    You also make the statement that everything you have read says mental problems from an injury can be covered. That makes it sound like this is something you have been planning for a while.
    How in the world did you draw that condition? Who PLANS to get assaulted at work? What planet are you on?

    Quote Quoting crispy1
    If that just happened yesterday, it is unlikely you would have been reading the books the first day.
    It's unlikely by whose standards? YOURS? I haven't read any books. Anyone with half a mind can jump on Google and start looking into this. I understand mental injury claims raise suspicion. I *get* that TPAs would be hesitant to hastily write checks for them. I was physical and mentally injured. Those are terms I learned after looking into MY RIGHTS as an injured worker. Do you believe that the minute someone starts using jargon that they're somehow being devious? Are you an attorney? I don't see how you could have *ever* passed the bar given the peculiar characteristics of your reasoning. Still, I appreciate the time you took in composing a reply to my post.

    - - -

    Quote Quoting frustratediw
    First of all you should have contacted the manager and had them come down immediately to the store. You were physically assaulted and suffered an injury so you should have received immediate medical attention.
    I would not have been able to get ahold of my manager. He doesn't keep his cell on at night. Plus, it is not company policy to close and abandon the store unless you are hauled off in an ambulance. I declined after the first responder / EMTs said that I would "live until the end of my shift."

    Quote Quoting frustratediw
    At this point you have received treatment for your physical injury and are scheduled to follow up on it. That is what you should do.
    That's the thing; I'm *not* scheduled to follow up on it. The ER physician said that I do need to follow up on it, but that the ER doesn't choose where. My TPA has not notified me. They won't return my calls. My boss doesn't know, either.

    Quote Quoting frustratediw
    As anyone who has ever been assaulted can attest to you may be suffering some mental issues as a result. This needs to be addressed ASAP. Quite possibly you could suffer from some ptsd. You need to seek immediate medical attention for this.
    How can I seek immediate medical attention? I know I can't give a medical office my insurance cards. What do I do; simply show up at a psychiatrist-of-my-choosing's office and tell them "It's workers comp." I don't even know who my rep/agent/adjuster is!

    Quote Quoting frustratediw
    Having had a psych claim and having had that claim accepted and treated I feel that I might have a little perspective.
    Thank you. It's encouraging to hear from experienced, intelligent users (whether they are lawyers, or IW's who have been through similar situations).

    Quote Quoting frustratediw
    No one has ever asked me about. I have gone on with my life and function quite well.
    That's also encouraging. Thank you for the input. May I ask how long your "treatment" took before you were able to go back to a "normal" life?

    Quote Quoting frustratediw
    Too often it seems even the IW community treats this issue as if everyone who suffers such an injury is a faker and malingerer.
    Thanks for articulating this. In some ways, it's a relief.

    - - -

    As I said, I know mental injury claims are suspicious - and that the moment an IW displays the slightest degree of intellectual tenacity, they are suddenly viewed as trying to "game the system" or scam an insurance company. In my case, THIS IS NOT TRUE. I am not lazy. I am not looking for a handout. I am a dedicated employee, possibly a borderline workaholic - and my boss, coworkers, and subordinates will all attest to that. I love all of them, and would *NEVER* even entertain the thought of filing a fraudulent claim, as the cost would ultimately be passed onto them (even if not directly). HOWEVER, as a lucid, conscious, intelligent being... I can tell with certainty that the assault has messed with my personality, peace of mind, thought processes, and body chemistry. I simply want to become aware of my rights, and I sincerely thank all of you for helping me accomplish that.

  8. #8
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    Default Re: Assaulted at Work by Customer

    WC is not about 'rights'... it is about paying benefits, treatment and wage loss, due to the ER liability for work injury/illness.

    You were treated at the emg room, and require follow up... you choose a Dr/PTP in the TPA MPN, doing that will at least provide a Dr familiar with the comp system, and how to access treatment faster. Also with less hassle to you. YOu can get a MPN list for your zip code from the TPA web site.

    There is a work injury specialist list here http://www.injuryspecialists.com/locations.php or here http://www.willowmedicalgroup.com/MPN_List.html

    Sedgewick is not the easiest TPA to deal with. But there are good Dr's in the MPN's. Just select a Dr and make an appt. You shouldn't have difficulty finding a PTP within 35 miles of your residence.

    IMHO...I would NOT file a 'psych" claim...you can get a referral from the PTP for evaluation and counseling if necessary. It would be doubtful you'll have residual mental impairment due to this instance...there is no reason to open your entire life, including how may times you may have had sex with an animal. Or how other issues in your life may contribute to your mental state, and that is basis for apportionment to cause for rating purposes.

  9. #9
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    Jul 2010
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    12

    Default Re: Assaulted at Work by Customer

    Thank you again, BvIA. The attorneys I have spoken with (directly, on the phone; not through an assistant or email), all want to pursue a psych claim. I am only in my early twenties, and even taking my previous medical problems into account, they don't think anything indicates a previous mental condition.

    The personal qualm I have, and it's aligned with your theory - is that it's simply too soon to tell whether or not there is any permanent disability. I can see the case for temp, although I am not qualified to tell if my mental injury is "clinical" (i.e. reasonable fright vs. an acute stress disorder). I mentioned this to each attorney. All of them didn't feel a distinction had to be made. I pressed them hard for answers but couldn't get a straight answer. Reading between the lines, it appears that even if my emotional/psychological state changes/improves, they are saying it's in my best interest to imply that it hasn't. I am simply not comfortable doing this.

    However, BvIA - You recommended consulting with an attorney. What can they do for me if I don't wish to file a psych claim? That is what the ones I have spoken are zoning in on. Thank you again for your replies.

  10. #10
    Join Date
    Sep 2009
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    12

    Default Re: Assaulted at Work by Customer

    Since you are the victim of a crime, you're able to file a Victim Compensation Program application. This program can make up the difference between your wages and what you receive from worker's comp, if you're not able to work due to your injuries, either physical or emotional. Here is the link to the application: http://www.boc.ca.gov/victims/howtoapply.aspx
    It's very common to experience PTSD after a traumatic experience like this. I wish you the best.

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