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  1. #1
    Join Date
    Feb 2007
    Posts
    12

    Default Insurance Company Claims Lack Of Evidence Of Work-Related Injury

    Since my other thread got sidetracked, , I will continue it here.

    I did receive two payments from SAIF, the IC. At that time I also received the notification that they were not taking my claim due to lack of evidence to show I had a work-related injury.

    I have an appointment to talk to a lawyer Tuesday, and an appointment with my doctor Thursday. That's four days from now.

    They have cut me off, is there anything else I could be doing?

  2. #2
    Join Date
    Dec 2006
    Posts
    2,165

    Default Re: Next development, Shoulder Question, Injured Again, Continued

    Fishman, sorry we hijacked your original thread...just trying to add some "levity"...perhaps Steel will share her "winnings" with you.

    On a serious note, make SURE that BOTH your attorney AND your Doctor understand EXACTLY HOW you sustained the work-related injury. Your atty may also want to know WHO may have witnessed it, as well, so start thinking about these things.

    Who did you FIRST see for the injury, and do you KNOW what the Doc said? Tomorrow, fax an authorize for release of your medical records to ANY doctor who saw/treated you for your injuries, and ask that they be faxed back to your ASAP. You NEED to know EXACTLY what any Doc has said about the RELATIONSHIP between your claimed work injury AND the work you were performing at the time.

    If the Doctor has NOT made a CLEAR causal (direct) relapshionship between WORK being the CAUSE of your injury, this MIGHT explain WHY they have cut you off...for now.

    When you see your Doc this week, make SURE he CLEARLY DOCUMENTS that this IS a work-related injury and WHY. He should back up his opinion with SCIENTIFIC LITERATURE that SUPPORTS the mechanism of injury as bering work-related, the diagnoses and his final opinion.

    Perhaps this is where your attorney can help you and your Doctor, Fishman, so discuss this with him.

  3. #3
    Join Date
    Feb 2007
    Posts
    12

    Default Re: Next development, Shoulder Question, Injured Again, Continued

    1) Doctor says tendinitis, not a tear, I have an appointment for physical therapy and a second opinion.

    2) I have had surgery on both knees, one is due for replacement soon. Broke arm. Had surgery on shoulder long ago and now it is the injured one again. I am 61 years old and have to admit it's time to retire. I have asked my union to send me the paperwork for retirement with disability.

    It takes months to finish the process, but what effect would starting this paperwork and getting started to retire have on my WC claim?

  4. #4
    Join Date
    Jul 2015
    Posts
    41

    Default Re: Next development, Shoulder Question, Injured Again, Continued

    This is a very old post....BUT. I would like the answer to that question too. My case is nearly ten years old now and I continued to work (in extreme pain , family to support) It got so bad I could barely walk any distance ore sit or stand very long. My body was finally giving out. I put in for a disability retirement. It only took 5 months for the whole process. My employer informed Calpers that they agreed with my disability and restrictions, and that I should retire with a disability (gives options to return if 'cured'). Calpers IME said that I was substantially incapacitated from performing my current job. (desk job). I have been retired since August 18th,2015. QME said no heavy work or heavy lifting, then in another paragraph said regular work. Also, in another paragraph, stated that my lumbar spine was not PS. How will all of this affect my case? Thanks for your help.

  5. #5
    Join Date
    Mar 2010
    Location
    chicago
    Posts
    517

    Default Re: Next development, Shoulder Question, Injured Again, Continued

    I went thru my union and got disability for a short time. I had 30 yrs in the union and was 60 so I retired with pension in tack. I also applied and received ssdi 100% diasbaled so I went on medicare. just turmed 65 so my ssdi medicare went away and now am on medicare. it was not the way I wanted to retire but its worked out for me you need to have,and KEEP all copies of doctors reports. youre entitled to copies he has more paper wins good luck

  6. #6
    Join Date
    Jul 2015
    Posts
    41

    Default Re: Next development, Shoulder Question, Injured Again, Continued

    I was denied SSDI. In reconsideration stage now. Currently getting small disability check from work and SDI through the state. That will be running out soon. I have not received ANY money from WC. So far, the QME gave me 35% on my rateable injuries. 8% was from a previous shoulder injury. That case went well and closed out with future medical (that's a laugh). How did your retirement affect your Case? I have not received TD because I continued to work until I could work no more. Like I said, I have received NOTHING.

    - - - Updated - - -

    Should have mentioned that I am not yet PS on Lumbar spine. Dr. trying to get Neuro and Ortho for cervical and lumbar currently.

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