Problems Getting Benefits, Terminated By Employer

[cannon77]

Located in Phoenix, AZ first off.......
I was injured on the job 12-5-2011, thought it was nothing major and continued to try and work the rest of the week since we had a very light work load. My industry is HVAC and refridgeration service & repair. After trying to work the rest of the week, the pain continued to get worse by the day. My supervisor knew of the injury as soon as it happened. The weekend after the initial injury, I contacted the owner of the company and he said to go to a Concentra clinic. I contacted the clinic and they told me it was a 5+ hour wait and with a back injury I would be better off seing a chiropractor or back specialist. Based on that, I found Emergency Chiropractic that was open 7 days a week, called them, explained what happened and got in that day (Sunday). They did the typical questions about how I got hurt, took x-rays and proceeded to treat with a very minor adjustment followed by taking me out of work unitl we could get an MRI approved by the IC. My treatments with the chiro continued daily for the next week and my pain level never got better but maintained the current level (8to9 out of 10) At the end of that week, the owner of the company called the chiro office and demanded I be placed on light duty and that I was not really hurt (documented in my records) The chiro placed me on light duty with very tight restrictions. With my very first service call, those restrictions were not honored, I was not supposed to be in any position for more than 15min at a time......I had to make a 2.5hr drive to Tucson, AZ from Phoenix, do a service call and then drive 2.5hrs home. By the end of the trip, I could not walk, could not sit and the the pain was at a constant 10!!!The following morning I went to my appointment with the chiro and he stated he cant modify my duty due to the request of the employer. I was seen daily by the chiro and I finally got my pain meds started, Naproxen and Somas. At the end of the first "light duty" week (Friday) I was sent to Tucson AGAIN!! Out of fear of being fired if I refused, I made the drive and again, ended up at a constant pain level of 10. I was called at 7pm that night and told I needed to do a service call on Saturday at 9am. I let my supervisor know that I was going to be on my meds due to the pain and its going to be very hard if not impossible to take the call. He made it very clear that I had to take it.......

I do not take any medications EVER!!! I wont take asprin for a headache, so the meds they gave me were way worse on me than your average person. I took the meds as prescribed and could barely move the following morning, I was 30min late to the service call and my suppervisor was waiting when I got there. He informed that I was fired and gave me a ride home and let my get my tools out of my van (how nice, jacktard) Up to this point, I had never had any issues at work, I continued to receive praise and told what a great job did (have emails to prove it) Then out of the blue, I am late to one call due to the meds and injury and I am fired on the spot?? Complete BS! I was contacted the following Monday and told that I had stole tools from the comapany that were in the van. I disputed it with the owner and he screamed, yelled, belittled me, called me a liar and accused me of not really being injured (speaker phone with witnesses) My thought is this.....he tried to have me on light duty just to fire me and get the claim denied since I dont work there any longer......can they do that?

Here where the claim is at so far, After two months of chiro treatments, the pain never gets better, seems only worse. We requested an MRI 12-15-2011 Did not get it approved unitl 1-15-2011. After the MRI was done, the Dr. that did the MRI report sent a copy to me and my Chiro. His determination was that I had chronic issues with disc buldges from L1 to S1 and some accute issues at L4-L5 that were causing my main pain. Two months after the injury, I got a letter for a IME appointment. I go to the appointment and the douche asks me a ton of questions, then only checks my knee reflexes, pin prick down the fron of my legs, measures my calfs and has me stand then pushed his thumb in between L4 and L5 very hard and nearly put me on the ground. We wait for his report (90 days now) and he goes back and forth in his letter saying, I was hurt and the chiro was needed but not making it better and I need other treatment. Then he says I was never hurt, then I was hurt but not on the job, seriously?? WTF is this guy thinking?? He shows a whole lists of tests he did (none of them but two he really did) and says I can return to work full duty. By this time, walking was becoming very difficult at best, could sleep due to the pain, could do any of my normal activities I did daily before the injury. Needless to say, I was getting much worse!!! (Forgot to mention, they increased my meds to Naproxen, Somas, Tramadol and Vicodin) Even with all the meds, the pain was getting worse and they denyied the claim. Chiro stopped treating and I hired a atty ASAP!! We filled the appeal and are now waiting for a hearing date........

After I hired my atty, he found a orthopedic specalist that would see my on a lien basis to help with my case. The new ortho was sent all of my records in advance as well as the IME report and a digital copy of the actual MRI films. Same thing, he asked me a bunch of questions, then started his own exam. With each one he did, he asked if the IME did the same thing......each time I told him "NO" He just kinda chuckled and said "Well it says he did in the report" After about 7 tests, achillies reflex, pin prick all over both legs, walking on toes, walking on heels, to name a few. He stopped the tests and told me there is something MAJOR going on. Said it looked like the results of a herniated disck but the MRI didnt show one. He tested a few more issues and looked throught the MRI images again. After a few minutes, he yells BINGO, calls three other Ortho surgeons and has them look at the films online. It took each of them about 2-3 minutes to see the issue and they all said the same exact thing. I have a ripped disc between L4-L5 and possible between L5-S1. He then noted that the IME stated he READ the MRI report but did not look at the images himself.......one of the Surgeons my ortho called is the owner of the clinic that did the MRI and wasnt too happy that "The young Dr. missed that" So the new Ortho typed up a very nice report and faxed it to my atty and he in turn sent it to the IC. Still dont have a court date either.....

Here is where my questions begin. I have asked my atty most of these and I am hoping to only back up what he has told me as well as what I have researched online.....

According to state law, the IC only has 21 days to accept or deny a claim, they took over 30. How does that factor in?

I missed more than the required 7 days and was never paid a dime. IC claims they were waiting on MRI results that they took too long to order. How does this work?

My treatments have stopped and I am getting worse and worse by the day. This is surely going to make it harder to recover. What can I do?

I was fired while on light duty due to the owner demanding I be placed on light duty. Will this effect anything in my claim since now I am unable to work at all?

If I read the WC law correctly, they will have to back pay from the last day worked on full duty until the day of the first check with monthy payments following that?

According to three Drs. it is not likely my back will ever get better and never to the point I can do the only job I know how. The same three have told me that I will more than likely be rated at total disability due to my back and now the nerve damage in my left leg. How does this work out monetary wise with a WC claim? I have done some research on this but it is not clear. Looks to me like the back is maxed out at 75% aww for 500 weeks? and the Leg is 66.66% for 50 weeks? I was making $1000 per week flat rate at the time of the injury is that helps at all??

Thanks for any help understanding this stuff. There is a lot more going on here but I will spare you the agony of reading it all. The mental side of it 10X worse than the physical, I have a wonderful fiance who is standing by my side and between us both we have 5 girls. I have been the sole provider for all of us and now we have nothing coming in. I feel depressed, worthless and a long list of other things, where can I turn for help with these types of issues?

[BvIA]

I have asked my atty most of these and I am hoping to only back up what he has told me as well as what I have researched online.....

Listen to your attorney... he has the file, knows the laws that pertain to your situation... doubt anyone on a message board is going to try to "back up" or verify what your atty may have told you, nor should anyone second guess your attorney. That's what you are paying a potential fee for... if you don't trust your atty, you can change at any time...there will be but one fee.

My treatments have stopped and I am getting worse and worse by the day. This is surely going to make it harder to recover. What can I do?

Find a Ortho Dr/surgeon willing to treat on a lien basis...or pay out of pocket. The chiro apparently isn't doing any good, may be worsening the condition.

I was fired while on light duty due to the owner demanding I be placed on light duty. Will this effect anything in my claim since now I am unable to work at all?

Could be harrassment/discrimination for filing the claim... burden of proof is on you, talk to your atty.

I have done some research on this but it is not clear. Looks to me like the back is maxed out at 75% aww for 500 weeks? and the Leg is 66.66% for 50 weeks? I was making $1000 per week flat rate at the time of the injury is that helps at all??

Disability benefits are predetermined by law... doubt you will be 100% 'disabled' due to this injury, even if you can perform some type of sedentary work. Could be offered some VR services if you cannot return to your pre injury job function.
Don't count on a "life pension" from this. WC just doesn't work that way but for the most serious of injuries.
If you feel you will be off work more than a year, you should apply for SSDI. That can take a lengthly time to navigate the appeals process though.

If I read the WC law correctly, they will have to back pay from the last day worked on full duty until the day of the first check with monthy payments following that?

Probably. Depends on what the judge orders at hearing.

My thought is this.....he tried to have me on light duty just to fire me and get the claim denied since I dont work there any longer......can they do that?

Your ER is the insured party, once they file a claim with their WC carrier, the ER doesn't make decisions on whether or not benefits may be due. That's up to the carrier. Acceptance/denial of a claim is not dependant upon continued employment.

The chiro placed me on light duty with very tight restrictions. With my very first service call, those restrictions were not honored, I was not supposed to be in any position for more than 15min at a time......

When you are released to a light duty/modified work status, the restrictions are on you, not your job, your ER is not required to monitor your activities. That is your responsibility...you are the one claiming you cannot do your job functions due to the injury... when you continue to work outside your restrictions, you're basically waving the 'red flag' that you are not as "disabled" as you claim.
If you cannot perform the basic job function of light duty, you go back to your Dr, explain the situation, and get returned to a TTD status.

I feel depressed, worthless and a long list of other things, where can I turn for help with these types of issues?

Pain can be/is depressing... talk to your Dr about your feelings. Do not discuss your concerns about lack of money coming in, or the delay/denial process in the claim... that depression is not compensable.

Listen to your attorney....

[complwyr]

The Chiro you saw is corrupt. You should talk to your lawyer about whether to file an ethics complaint against him with the state chiro licensing agency. Otherwise, on all these other issues, your lawyer is the best guide. And your state may have a law pertaining to the firing, which appears to be retaliatory. Ask your lawyer about that.

[cannon77]

Thank you for your responses. As far as SSDI, do I need to worry about age restrictions? I am ony 34
Curious also to know why complwyr says "the chiro I saw is corrupt" My pain level was maintained while seeing him and got worse when they denied my claim and I had to stop seeing him?
How would I go about an ethics complaint and what is to be gained from that? Would it be the same as a malpractice suit? If this the case, can I not file against the IME Dr. as well? He based his denial on the MRI reading from another Dr. and did not look at the MRI himself. The IME is a orthopedic surgeon as well as the other four Dr's who actualy look at the MRI images and saw the problem. Due to his denial and lack of treatment due to his denial, my pain has got worse and spread to more areas of my back as well as further down my leg. I have no doubt that if my claim was not denied, I would be much better off and getting the correct treatment without further damage from my spine crushing nerves and such.

When it comes to the wrongful termination, I have to find a second atty since mine only deals with injury and WC cases. I will be looking into a few consultations to see where I stand on that issue. Funny thing is, today I got an email from my atty and it had a rather funny attachment. It was a hand written letter from one of the employees from my former employer. Looks like they threatened his job and now his story has changed from "dont worry, I saw what happened and I will tell them the truth" to "Brian never complained of any injury until days later" and a ton of other BS. He is going on and on about me requesting time off to pick up my girls from out of state, unable to reach me for service calls and a ton of other lies. Best part is, all the dates he is claiming all this happened was while I was on NO DUTY status, and I have all the proof I need to show the Dr. had taken me out of work during the dates he is talking about. What a tard-nugget, HAHA!!

The reason I posted here was in hopes of finding someone who has knowledge of Arizona WC laws. There are still a lot of questions my atty has not answered for me and some that he has. I am doing tons of research and looking to others to see what insight they may be able to add. To be honest, my family is suffering along with me and I would like to know what to look forward to in terms of a monetary value for what I am suffering through.

A bit more info about my injury.....The info I have so far is that I have Ostioarthiritis (sp check) throughout my low back due to the type of work I have always done. I have buldging discs from L1 to S1 with two ripped discs. The lumbar area is only going to get worse. According to the Orthopedic surgeon that truly looked at my MRI and found the issues, feels very aprehensive that I would gain anything from operating. He thinks my best bet is to do selective nerve blocks and injections. In his opinion, I will be 100% disabled due to the state that of my back and nerve damage in my leg. Not sure what to do at this point.......Still waiting on the IC to reverse their denial

[BvIA]

To be honest, my family is suffering along with me and I would like to know what to look forward to in terms of a monetary value for what I am suffering through.

There isn't any money for pain/suffering. You are compensated, or pay PPD idemnity benefits based on the % of impairment due to this injury. PPD is payment for reduced earning capacity, or ability to compete in the open labor market. There are no monies for future lost wages.

The reason I posted here was in hopes of finding someone who has knowledge of Arizona WC laws. There are still a lot of questions my atty has not answered for me and some that he has. I am doing tons of research and looking to others to see what insight they may be able to add.

No problem with that...however, message boards are generic at best, responders here for IW"s just like you for the most part, relying on the same research you have been doing. And/or personal experience with their own claims. Your specific questions should be answered by your attorney...oft times, there are no guaranteed results in a WC claim. In fact, seldom if ever.

As far as SSDI, do I need to worry about age restrictions? I am ony 34

If you've been working for 10 years, and have 40 quarters/points of qualifying wages....you should apply. You have 5 years from your last day worked.

In his opinion, I will be 100% disabled due to the state that of my back and nerve damage in my leg.

You can be 100% disabled while you treat/recover from a work injury, once you are stable, or MMI has been reached, you'll be rated for Permanent Partial/Total Disability, That is what your PPD indemnity will be based on. If the law provides for a max of 500 weeks, that's all you're entitled to.

[cannon77]

So here is the latest chapter in my WC saga......
As I posted before, I found a ortho doctor willing to see me on a lien basis. This is the same doctor that found the real problems that the IC IME was to stupid to find....oh wait, he didnt even look at the images, just agreed with the clinic tech that wrote the imaging report. Any way, based on the findings in the imaging and the areas of pain along with the loss of feeling in certain spots down my left leg and into my foot, the ortho set me up to do a few nerve root block injections. First was between L4, L5 and the second at L5, S1. This was done on friday at around 9:45am. I had to take a valium an hour before so I dont really remember much except when hit the nerve with a needle.....DAMN THAT HURT!!!!! Once I got home, I iced it on and off for the rest of the afternoon. Meantime, I could feel the pain getting worse and worse as the novacaine started to wear off. By 8:00pm, my back was in twice as much pain as it was before. I had a little pain in my left foot before hand but now, with every step I take, I have the "pins & needles" pain. Kinda like the pain you feel when your foot is asleep and you bump it while its "waking up". At this point, I am getting pretty worried that the injection may have damaged something or caused more issues?? I will be talking to the ortho on monday, dont think I will be a good candidate for a second round of those injections!!

Lets move forward to saturday afternoon........
I got an email from my atty today saying that the IC atty contacted him to see if I would like to settle my case before all the depositions and court. He says this will save the IC a lot of money even though they know they will win in court. WTF IS HE SERIOUS?? So let me get this right.....The IC truly thinks they will win this appeal based on the report of one IME that did only did 4 of the 15 tests he claims in his false ass lying scam of a report!! My wonderful atty seems to just want to end this now and get his cut and move on? Did I mention that I found 3 different laws that the IC, the IME and the ER all broke? I sent my atty the link to the laws located on the states website, his response was "well we can only wait for the court date" REALLY? Why do I, the injured worker, not trained in this type of law, have to teach my LAWyer about the damn laws? As far as I am concerned, he is an asshole and will be replaced this coming week. All that he has done is NOTHING!!! I have asked him numerous questions about certain laws, procedures and other issues. His answers are allways half assed at best, he is no way concerned with my well being or winning this appeal. His email to me was asking what I wanted to demand as a settlement amount. He also expected me to do HIS job AGAIN and collect all the medical bills to this point and had a list of about 50 questions, all of which he has the answers to in all of his paperwork. I just responded with a nice butt chewing and reminding him that HE WORKS FOR ME!! I also asked him whos side he was one since he doesnt seem to wanna fight for me at all.

In short (haha) I told him to demand $100,000 disability settlement with all medical paid, past present and future. See how that goes over
Just pisses me off that I have to go through this nightmare. Not sure why my atty would trust anything the IC atty has to say? Did he really think they would call and tell him, look we were wrong and you will win in court, so please, take this ridiculous amount of money and our most sencere appology........YEAH, thats gonna happen!

[cannon77]

Well my worthless atty has been fire and removed from my case. I now have appointments with two other firms. One of which has to former WC judges on staff, see if that helps any? In KNOW it cant hurt any, HAHA!!

[complwyr]

If you plan to treat your next attorney the way you treated the last one, you will soon be doing this without any legal help. Giving your attorney an unreasonable settlement demand to make on your behalf one day and firing him the next day because you think he has not accomplished anything for you is real funny. Maybe he will send you a fee lien.

And he said 'wait for the court date' because your position is based entirely on credibility--yours vs. the doctor's, and it is pertaining to things that are entirely within the doctor's purview. Your lawyer can't do anything to help you without a hearing if that is your best argument. Credibility gets tested in court, not on phone calls between the insurance company and your lawyer.

You apparently think you are going to show up the IME doctor because you think your testimony will be enough to show that the doctor lied. Good luck with that. Let us know how that turns out.

My final word of advice to you is this: Most experienced lawyers will not consider taking on a client who has had two previous lawyers. That is because having had two lawyers already almost always means "I am a very difficult, disrespectful, and totally unreasonable client."

[cannon77]

Really? I am the issue here? DONT THINK SO!! oh and I have only had ONE atty.
Let me make it simple.....my former atty refused to take depositions, work on any discoveries, would not follow up on an issues that would of easily helped my case. When my claim was started, the original adjuster called me for a phone interview as well as the other two employees that were on the job with me. After the recorded interview, she stated that what I had told her was "Right in line with your co workers" She then ended the phone call telling me "Your TTD payments should start in about a week or two" After the two weeks passed I called the same adjuster back to find out what the delay was. I was told that my adjuster was terminated and my case was given to another adjuster for review.

Keep in mind, this was all over a month before their IME request and the WCIC had allready authorized all my treatments and meds. It was going as it should have until the original adjuster was terminated. I am within my rights to ask my atty to look into that issue, being told I was getting TTD, then they fire the lady and then screw me over. I also asked him to find out about the recorded interviews that the three of had to do. His response was "I dont think it will help much and they probably wont release them" HHMM, REALLY? it wont help?? I have a copy of a hand written statement from the same two co workers dated two weeks AFTER the recorded interview, stating they knew nothing about my injury.........Pretty sure it would help my case!!!Yeah, looks like I am the problem, I did it, it was all me.........sorry everyone for using my freedom of speech and feeling like I am the one getting shit on!!

What a joke, I have enough issues in my life. Like loosing my home, our only car, cable, power, phone and everything else. We are trying to sell everything we have to get together money and save what we can. When your kids and family are suffering like mine are....then come back and run your mouth about ME being the problem!!

[cannon77]

Well after some research, I may have found the RIGHT attorney for my WC case. After a few consultations, I was at my last one and as soon as I started talking to the attorney, it was a sure fit. He looked at a few of the documents I had emailed him ahead of time and turns out......he is good friends with the IC attorney as well as the Judge on my clase. He sounded like this was a typical case for him and he mentioned making a few calls to get the ball rolling and get the denial overturned without the hearing. I called him this morning to see what I needed to bring him in order to sign the paperwork to hire him. I was told he was talking to the doctors on my case as well as the IC attorney to get my claim denial fixed. I was then told that there was no need to give away 25% of my income to him and he is going to do all he can for me and only as a final resort, will I have to "hire" him for my case. In his words, my claim is "cut and dry and there is NO WAY their attorney and the Judge will let this slide" I will still have my depo in a few days and once their attorney talks to me and goes through all the medical records, my new "friend" said the IC attorney will more than likely force the IC to start TTD payments and authorize proper treatment..........See how it goes, but it sounds better than what I was being told before!!