Hello All- I am a new member as of minutes ago. I was injured in California and I need more medical help. My w/c claims adjuster just sent me a settlement offer for my injury. My injury date is past the five year mark.
Does anyone have any information regarding claims that go past the five year mark? I believe that the injury and workers comp. process doesn't go past five years- is that true?
And if it does go past five years does that re-open the whole claim as a new one? I hope that this is making sense, but if it doesn't please reply and tell me of any other info you need to help me figure this out. I don't have an attorney either.
Any help or information that you can give me would be very helpful to me.
Thank you...
You mean you been in the work comp system for 5 years and didn't take the time to learn your State Laws and Rules?
Well that is okay, as the answers will be here.
In a general sence, a settlement means closing out a claim. But, sometimes there are cases as medical being left opened.
It does not mean reopening a case or claim.
http://www.dir.ca.gov/dwc/
what kind of settlement?
total buyout (C&R)?
stipulated PD (open medical)?
has a formal award been issued by the comp court?
do you have a disability rating?
what's your TTD status?
have you received some PD? how much?
what are the issues?
california has a couple of 5 yr time limits. the most common limits the comp court's right to change the disability portion of a formal award.
medical treatment in california is for life so many, many serious claims last much longer then 5 yrs.
you need basic information. read the fact sheets here (especially the one on Permanent disability) ---then come back and ask more specific questions
http://www.dir.ca.gov/dwc/iwguides.html
1171 Wrote:what kind of settlement?
total buyout (C&R)?
stipulated PD (open medical)?
has a formal award been issued by the comp court?
do you have a disability rating?
what's your TTD status?
have you received some PD? how much?
what are the issues?
california has a couple of 5 yr time limits. the most common limits the comp court's right to change the disability portion of a formal award.
medical treatment in california is for life so many, many serious claims last much longer then 5 yrs.
you need basic information. read the fact sheets here (especially the one on Permanent disability) ---then come back and ask more specific questions
http://www.dir.ca.gov/dwc/iwguides.html
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I will try to make this as short and to the point as I can.
My first injury was in 2005(back injury). I went back to work for another company doing the same type of work in 2006. After about a year, I had a neck injury and was taken off of work by my original workers comp. doctor from 2005.
I settled (C&R) my second claim last year. I moved last year from California to Nevada. Finding a doctor in Nevada took a bit of time because of the regulations. After finding a dr. I was with her for four months. She dropped me because all of the paperwork and laws she had to abide by. It was too time consuming for her.
Eight months later I finally find a good qualified doctor familiar with California workers comp.(Neurosurgen) and then another two months to get in to see him. He ordered a current MRI which happened to be my FIRST standing one. A standing one made sense to me since that is when I have most of my problems and pain.
1 day after the insurance company received the findings from the MRI- They send me a settlement offer before even having my doctors visit which was a week after the MRI. Because of the standing MRI findings my doctor wants to do a discogram and with the results of that possibly discuss back fusion with me.
I have NOT responded to the settlement offer from the insurance company because I want to wait for the outcome of the discogram and then take it from there.
HERE IS MY QUESTION~ When I went to see my present doctor that I have now, he opened up my file and said, " why am I even seeing you? Your QME report states that your case is closed." Also when I went to have my medication filled Express Script said my case was closed too.
Is my case closed or has it been re-opened as a new claim because of the 5 years? I am really confused by this since the insurance company
is again paying for medical testing, Doctor visits, medication, mileage, ect...
If the claim runs out, does it re-open it again with today's workers comp. laws?
Thanks
Do you have an attorney, to help you with this across States issue with your work comp claim?
I wonder is it possible, as you stated you settled your 2nd claim, that just maybe you can read that settlement. See if your first claim number was there also. And if it is, you then will find out you settled both. But, that is a maybe issue.
Bad Boy Bad Boy Wrote:Do you have an attorney, to help you with this across States issue with your work comp claim?
I wonder is it possible, as you stated you settled your 2nd claim, that just maybe you can read that settlement. See if your first claim number was there also. And if it is, you then will find out you settled both. But, that is a maybe issue.
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Nope. Two different injuries at two different companies involving two different insurance companies. Both were not settled in one settlement. I know that for a fact.
I do not have an attorney butt have spoken to several over the years the problem with my fist claim was it was field in 2005 that was when the worker comp laws changed and the awards were cut so bad that attorney due not want to touch cases like this no money in it for them bottom line.
Bad Boy Bad Boy Wrote:Well, settles that question.
Have you called the Insurance Adjuster, and ask to why your claim is said to be closed? And what do they say?
Oh on the Discogram, have you asked the surgeon about a Myelogram instead?
http://www.webmd.com/back-pain/myelogram-16147
Vs
http://www.spineuniverse.com/exams-tests/discogram
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He said what he wants is to inject a numbing agent into the disks that are injured and have me go home and do my normal stuff and see if it stops my back pain. The numbing agent is suppose to last 6-8 hours. If it does stop the back pain then he knows that I might benefit if that area of my back is stabilized.
Thanks for the info on the myelogram. I think I had one done on my neck.
you bought out and closed your second claim.
the first claim (2005) is what is still unresolved even though you switched employers and had another injury 2 yrs later.
since it was reported timely in the beginning your claim can remain open beyond 5yrs.
since you don't have legal help you may wish to contact a california I&A officer for more specific information
http://www.dir.ca.gov/dwc/IandA.html