California Worker's Compensation - Help For Injured California Workers

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  1. #1
    Join Date
    Nov 2009
    Posts
    9

    Default What To Do After Exhausting Worker's Comp and Disability Benefits

    HI guys,
    I could really use some advise or anyone input from people who may been threw this..

    I been disabled now for well over 4 years.Was on workers comp for the 2 years or 104 weeks at that time i ran out i started temp disability after it run out workers comp added a another 10 g. to the temp account and i been pulling it every 2 weeks now for last 6 months but in next month i will run out of it.What do i do now.I am still ongoing treatments i been diagnose with Reflex Sympathetic Dystrophy and Complex regional pain syndrome (CRPS) i have had a million test therapy now having nerve blocks done.I am taking 100 mg morphine pills along with necrotic sleeping pills muscle relaxers i have been on allot of very hard drugs that really don't help that much at all.Now i am very worried along with not being able to work we may run out of any funds i have 2 kids and a wife .My wife from the UK never worked here so its hard and i just cant believe that they will leave me without any funds what so ever.I worked my hole life well until i got hurt IM almost 40 years old and unable to much of anything.I have applied for SDI about 2 1/2 years ago maybe 3 have had both denial letters and a few letter saying that my case been transfer to here and there now its in san Francisco close to were i live.I have a layer who says next step is the judge but not sure how long till we see him its been like a year since last denial letter.I just don't know what to do now waiting to see the judge but we wont have no income soon and just don't know what we can do...any advise will sure help thanks..

  2. #2
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,930

    Default Re: to Advise I Have Exhausted My 104 Weak W.c and Temp Disibility

    Here is a link that "might" give you some assistance with your SSDI application:

    http://www.disabilitysecrets.com/

    Be sure to pay special attention to the section concerning submitting a "Dire Need Letter" to the SSA. After an eighteen month wait my husband did so and within less than a month from the time it was submitted to the atty and forwarded to the SSA his benefits were awarded, with full back pay to the date of his entitlement (less of course the first five month waiting period) AND he did NOT even have to attend the ALJ hearing that was already on the schedule. His file went to the ALJ almost immediately when they received the dire need letter. We had cash in hand within two weeks and the full back pay within a month after notification of the ALJ's decision.

    Good luck. Take care & be well,

    Steel
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  3. #3
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: to Advise I Have Exhausted My 104 Weak W.c and Temp Disibility

    I been disabled now for well over 4 years.Was on workers comp for the 2 years or 104 weeks at that time i ran out i started temp disability after it run out workers comp added a another 10 g. to the temp account and i been pulling it every 2 weeks now for last 6 months but in next month i will run out of it
    Looks like you are drawing PPD/Permenant Partial Disability advances on that indemnity... and yes, once that is paid out, there is nothing left in your claim but future medical.
    Not much point in going to any hearing...a judge can't order more money/benefits paid.
    There is no law that says you must be paid cash for the medical... and with RSD, you probably should not contemplate cashing out those benefits.

    SDI should have been applied for right away post injury...if only to protect your date of entitlement.
    That said however, the problem you are likely facing now is not only the length of time before application, if you are eligible for SDI and TTD or TPD, or PPD benefits at the same time, EED will take an offset to the SDI...you can't be paid benefits from two sources for the same injury and same time periods.

    With a WC claim, once your condition is stable, or MMI has been reached, you're PTP will evaluate and rate you for PD/WPI, that rating determines what or how much in additional benefits may be due.
    If you cannot return to your pre injury job, a SJDV/voucher would be provided for retraining or job placement services.
    This could happen too, as in your case, when you exhaust the 104 weeks of TTD
    At that point, the presumption is you would return to some type of gainful employment. That of course is up to you.

    You should make application for SSDI right away...it takes some time to navigate the system and appeals process.
    Everyone applying for SSDI will be different, different qualifiers, different and unique medical situations... so try not to make comparisions there. It would be a good idea to have an SSA atty help you with the application.
    I just don't know what to do now waiting to see the judge but we wont have no income soon and just don't know what we can do
    Based on the info you provide here... be prepared for there not to be any more weekly cash benefits... it appears those have been paid out. Unless you are eligible for SDI and 52 weeks of benefits, or approved for SSDI, unfortunately there are no more cash benefits available to you.

  4. #4
    Join Date
    Nov 2009
    Posts
    9

    Default Re: to Advise I Have Exhausted My 104 Weak W.c and Temp Disibility

    Hi Agin,
    I have all ready applied for SDI over 2 years ago to be honest the statements above this reply are very confusing kind saying IM screwed and as a worker my hole life ill end up on warefair.In just 2 weeks edd witch is what IM getting now temp disability will be out of funds and i was asking what can i do.there must be something i can do.I also goto be entitled to something with workers comp as i been told by many doctors and specialist that i will never work again not what i was doing and with the medications you must take there just no way you can work a job it would be dangerous to you and others.Everything a bit scary as i do have kid and a wife.I just wish i could go to work it would fix everything but no doctor will release me.I am still not permeate and stationary after 4 years doctors refuse to PS me although mostly IM just taking different meds and have nerve blocks done.Some talk of having a major Sergey witch they said is taking out ribs that may or may not help me.I am in constant pain all the time and just asking if there is anything i can do before me and my wife and kids end up in the streets.Thanks for all your reply it helps allot thank you...

  5. #5
    Join Date
    Mar 2011
    Posts
    291

    Default Re: to Advise I Have Exhausted My 104 Weak W.c and Temp Disibility

    you can request permanent disability advances from the carrier but they are not required to pay them until you are Permanent & stationary.

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: to Advise I Have Exhausted My 104 Weak W.c and Temp Disibility

    The info is not meant to be discouraging.. you need to apply for SSDI/Social Security Disability Ins benefits, and do it now.
    Based on the info you provide here...there are no more comp dollars for you... and you are likely out of SDI/State Disablity Ins benefits... SDI is not broke, just your account is exhausted, at least until you are able to return to work and pay into the system again.

    .I also goto be entitled to something with workers comp as i been told by many doctors and specialist that i will never work again not what i was doing and with the medications you must take there just no way you can work a job it would be dangerous to you and others
    You'll be paid disability impairment benefits, based on your PD/WPI rating. Your Dr or PQME/AME can write a report even with an estimate of that now, and the CA can begin to advance those benefits.
    You said before though... i started temp disability after it run out workers comp added a another 10 g. to the temp account and i been pulling it every 2 weeks now for last 6 months but in next month i will run out of it... that would indicate the CA did make an estimate of the indemnity you may be due, and... added the 10K to that amount as an accommodation to you in anticipation of a higher rating. At this point, it's not likely more cash would be added until you reach MMI.
    The only way you would be paid any additional indemnity or even a life penison is IF your rating were to be in excess of 70% (at the reduced rate), life pension of 100% PD, at your orginial TTD rate.
    ... just asking if there is anything i can do before me and my wife and kids end up in the streets.
    Apply for SSDI. Go to County Social Services and get help to apply for any/all other benefits you/your family may be eligible for. You can't get that from a message board... but the people there will help you if possible.

    You could also request a SJDV/voucher based on the estimated PD/WPI rating, and see if you have transferrable job skills where you could possibly work from home. There may be jobs available to you, even sedate in nature...if you can work at your own pace at home... you'd at the very least become productive again. That itself would go a long way in lifting your spirits, and possibly your pain levels. Depression secondary to chronic pain is also often due to the feelings you are presenting now. Talk to your Dr about a referral to pain manaagement clinic.

  7. #7
    Join Date
    May 2011
    Location
    Sonoma, CA
    Posts
    2

    Default Re: to Advise I Have Exhausted My 104 Weak W.c and Temp Disibility

    When you start to get down to the last of your payments of WC money do this - Apply for State Disability and also SSD/SSI (social security disability/social security insurance), you might be able to collect both. Talk with a lawyer or see if there is a way to check to see if your area has a judge perform a class once a month for people like us and it is setup for you to ask question of any kind and you really are supposed to get wonderful advise from the judge at these meetings opened to you. This is where you the system helps you. We have access to one of these here in Santa Rosa. But if you have a lawyer, they can’t know you have one for they will have you leave the forum. Love the fact that they are there to help you with your case. Up in Santa Rosa it is once a month at 10AM near his chamber.
    One way or another you should get money from one of them. I was denied State Disability (they didn’t go back far enough on my time line), but got SSD and waiting for SSI to kick in. Also if you applied for LTD (long term disability) pay when you got hired you can get that started as well. You will have to have your doctor fill out a couple forms for each, but it is worth it. When you also get on SSD/SSI you will get a chance to get Medicare as well for a fee, and it is worth it in case you really need help you are covered. Only drag you get paid once a month. Start this NOW!!

    Still awaiting for an answer right now regarding my LTD and have been working on this for over 2 years. Had to bring in an attorney on this one was well since the answer they gave me was no answer, gave me no finding or how they based it the decision. They only stated that they never received my medical records from Kaiser and they tried to use that same answer, but this time when I refiled I sent in a CD with all o=f my records and he tried to say he never got it and someone else told us they did. Pays to have this extra little bit taken out of your cheek when your health become compromised. Really glad I signed up for it.

    It seems to make a difference when you bring in a lawyer to help you out in your case(s). Just like WC Attorneys, they only get paid when you do, so no loss if you lose the any money, you owe them nothing. Smartest move I have ever made with my cases. For LTD Lawyers it is not the same. Have needed to pay this one as I go, and he has been nice about how much to pay him since he knows I am not getting that much right now as it is. Make them work for you, get the advice you need and make sure you’re really happy with your doctor and if needed get a second opinion!! Call, call, call, email them and get them moving for you if they are not. That is what they re here for, best way to get the system work for you. Also make sure they pay for all you medical for when you settle…don’t rely on you to get the proper care, stick it to them! I plan on it.
    Make sure all your records are in date order and make sure you have everything you need, x-rays, MRI’s, pay stubs everything. YOu may not be able to talk with your case workers and such when you get a lawyer, but it is worth it in the long run.
    Last edited by LadyDragonfly; 05-25-2011 at 10:17 AM.

  8. #8
    Join Date
    Jul 2008
    Location
    California
    Posts
    1,863

    Default Re: What To Do After Exhausting Worker's Comp and Disability Benefits

    I recommend applying for SSI (supplemental security income). This is not SSDI social security disability. You do apply for it at your local social security office phone number 1-800-772-1213. You can apply over the phone. This is income based.

    I also recommend contacting your SSDI attorney and ask him if he can request an emergency hearing due to your financial situation regarding your SSDI. Another member on this board (see Nippers posts) was able to get a hearing within a few months from SSDI when her attorney requested it.

    I also recommend you apply for food stamps, which is now called the Cal Fresh program. The forms to apply are on this web-site.

    http://www.dss.cahwnet.gov/foodstamps/

    There are food banks, help with paying utilities etc located on this site, just click California. http://www.patientadvocate.org/report.php?p=42

    If you feel comfortable letting me know what area of California you live in (do not give me your city just county) you can send me a private message, and I will look up resources for you.

    ---------- Post added at 01:20 PM ---------- Previous post was at 01:06 PM ----------

    Quote Quoting LadyDragonfly View Post
    When you start to get down to the last of your payments of WC money do this - Apply for State Disability and also SSD/SSI (social security disability/social security insurance), you might be able to collect both. Talk with a lawyer or see if there is a way to check to see if your area has a judge perform a class once a month for people like us and it is setup for you to ask question of any kind and you really are supposed to get wonderful advise from the judge at these meetings opened to you. This is where you the system helps you. We have access to one of these here in Santa Rosa. But if you have a lawyer, they can’t know you have one for they will have you leave the forum. Love the fact that they are there to help you with your case. Up in Santa Rosa it is once a month at 10AM near his chamber.
    One way or another you should get money from one of them. I was denied State Disability (they didn’t go back far enough on my time line), but got SSD and waiting for SSI to kick in. Also if you applied for LTD (long term disability) pay when you got hired you can get that started as well. You will have to have your doctor fill out a couple forms for each, but it is worth it. When you also get on SSD/SSI you will get a chance to get Medicare as well for a fee, and it is worth it in case you really need help you are covered. Only drag you get paid once a month. Start this NOW!!

    Still awaiting for an answer right now regarding my LTD and have been working on this for over 2 years. Had to bring in an attorney on this one was well since the answer they gave me was no answer, gave me no finding or how they based it the decision. They only stated that they never received my medical records from Kaiser and they tried to use that same answer, but this time when I refiled I sent in a CD with all o=f my records and he tried to say he never got it and someone else told us they did. Pays to have this extra little bit taken out of your cheek when your health become compromised. Really glad I signed up for it.

    What is your LTD attorney doing? I would hope that he is also filing a bad faith action against your LTD carrier. Whenever you send important documents, or anything to LTD carriers send it certified mail return receipt. This way you have proof it was sent. I would start looking for law firms(not single practicing attorneys) who practice in bad faith law suits against LTD carriers, and hire them. You may need to hire a different LTD attorney...because it should not take that long. (IMHO) Only 6% of LTD denials are even disputed by people. It is a numbers game with LTDcarriers. Theyare betting you will not fall in the 6% that fights for your money. There have been multi million dollar awards against bad faith denials from LTD carriers.....



    It seems to make a difference when you bring in a lawyer to help you out in your case(s). Just like WC Attorneys, they only get paid when you do, so no loss if you lose the any money, you owe them nothing. Smartest move I have ever made with my cases. For LTD Lawyers it is not the same. Have needed to pay this one as I go, and he has been nice about how much to pay him since he knows I am not getting that much right now as it is. Make them work for you, get the advice you need and make sure you’re really happy with your doctor and if needed get a second opinion!! Call, call, call, email them and get them moving for you if they are not. That is what they re here for, best way to get the system work for you. Also make sure they pay for all you medical for when you settle…don’t rely on you to get the proper care, stick it to them! I plan on it.
    Make sure all your records are in date order and make sure you have everything you need, x-rays, MRI’s, pay stubs everything. YOu may not be able to talk with your case workers and such when you get a lawyer, but it is worth it in the long run.
    Take care.
    Last edited by kelly38; 05-25-2011 at 12:11 PM.

  9. #9
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: What To Do After Exhausting Worker's Comp and Disability Benefits

    I recommend applying for SSI (supplemental security income). This is not SSDI social security disability. You do apply for it at your local social security office phone number 1-800-772-1213. You can apply over the phone. This is income based.
    When you apply for SSDI, SSA automaticlly will determine IF you are eligible for SSI...Social Security Supplemental Income. You must be, over 65, blind, and/or disabled to qualify for asset based SSI benefits.

  10. #10
    Join Date
    Jan 2012
    Posts
    2

    Default Re: What To Do After Exhausting Worker's Comp and Disability Benefits

    Is he able to get Unemployment?

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