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  1. #1
    Join Date
    Apr 2020
    Posts
    2

    Default Being Changed from Td to Pd During the Shelter in Place Covid19

    Hi, I was injured on the job in nov 2018, then placed on TD in Feb. 2019. Lots of tears in my right shoulder. Hired an attorney. Had surgery in Aug. 2019 Performed PT 24 sessions. in Jan.2020 I was sent to a QME doc. who closed my case and sent paperwork to the ins co. who went by what he said and took me off TD and placed me on PD. I am still seeing the surgeon who performed the operation and I told them what they did and he said he will make that decision. Because of the shelter in place and because the surgeon still has me on the restrictions that the QME doc placed me on I cannot go back to work nor am I able to pay my Mortgage or bills. My question is how can the insurance company do this during a crisis and without the permission of the surgeon? I have attempted to get a hold of my attorney but because of the shelter in place I cant reach him. state:CA

  2. #2
    Join Date
    Oct 1971
    Posts
    5,139

    Default Re: Being Changed from Td to Pd During the Shelter in Place Covid19

    Glen
    in Jan.2020 I was sent to a QME doc. who closed my case and sent paperwork to the ins co. who went by what he said and took me off TD and placed me on PD.
    Because of the shelter in place and because the surgeon still has me on the restrictions that the QME doc placed me on I cannot go back to work
    You're entitled to PD benefits based on your final disability rating until the disability is paid out.
    If you're able and available for full time work and are laid off because of the Trump virus, file for unemployment - you should see a $1,200 stimulus check within in the next 6 weeks, that will help a little.

    How much will I be paid for my permanent disability?
    A. PD benefits are set by law. The claims administrator will determine how much to pay you based on three factors:
    Your disability rating (expressed as a percentage)
    Date of injury
    Your wages before you were injured.

    Q. How and when are PD benefits paid?
    A. PD benefits are normally paid when TD benefits end and your doctor indicates you have some permanent effects from your injury. The claims administrator must begin paying your PD payments within 14 days after TD ends. The claims administrator picks which day to pay you and will continue to make payments every two weeks until a reasonable estimate of your disability amount has been paid.
    If you have not missed any work, PD payments are due when the claims administrator learns the injury has caused a permanent disability.
    https://www.dir.ca.gov/dwc/WCFaqIW.html#55

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Apr 2020
    Posts
    2

    Default Re: Being Changed from Td to Pd During the Shelter in Place Covid19

    My TD payment was 3500.00 a month, my PD is $1160.00, which will run out in 3 months. The restrictions from the QME were no lifting over 25lbs and 10lbs overhead for one year. So if my money runs out what do i do then?

  4. #4
    Join Date
    Oct 1971
    Posts
    5,139

    Default Re: Being Changed from Td to Pd During the Shelter in Place Covid19

    Quote Quoting Glen View Post
    My TD payment was 3500.00 a month, my PD is $1160.00, which will run out in 3 months. The restrictions from the QME were no lifting over 25lbs and 10lbs overhead for one year. So if my money runs out what do i do then?
    Man has struggled with that dilemma since the beginning of time, If I could answer that I'd be a millionaire.
    Call your lawyer, see what he advises - I have no idea of what his game plan is or the facts of your claim.
    Shelter in place should have nothing to do with contacting your lawyer, they still have telephones and teleconferencing capabilities - they've used those methods of contact before the Trump virus.

    I still say file for unemployment, you've got nothing to lose.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

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