hello, i am new and this is a great site and i hope anybody can help me. if a person was off work for more than a year (work related injury), workers comp accepts claim, goes back to work deemed permenant and stationary and reaggrivates the injury again doing my job as directed, what covers the time off then? my doctor is getting approval to do surgery and he took me off work a week ago for 6 more weeks. my comp specialist at my work called me and says because i was off for more than a year i exhausted my benefits and comp will not pay for this additional time off. i have an attorney and am waiting to hear from him soon. they are restoring my lost time from last year so do i use that to cover me so i get paid? i have R wrist/hand carpal, some nerve damage and a syndrome i can't pronounce. i know over a year is a long time off for this type of work injury but because i filed workers comp my regular insurance wouldn't cover the surgery so i'm feeling the pain for quite some time. has this happened to anybody else? thanks for any replies. this is in CALIFORNIA. times are rough right now I am thinking of asking my doctor to let me go back to work and tough it out until i have the surgery.
aggravations are considered new injuries.
file a new claim.
there is a 104 week limit for TD; there could be a dispute as to whether the time off is for the prior injury or the aggravation.
IDL is an public employer based alternative to Temporary disability; your agency controls whether IDL is paid or not.
this could be a complex situation best left for your atty to deal with.
hi, thanks for the info. the doctor didn't write the note to say " aggrivation" for my injury.maybe i should have used another term. i was feeling my condition getting worse, i called in sick and made the appointment. and after examining me he just took me off work ( a note with the same injury types and codes) until he gets approval for the surgery. i spoke with my lawyers office today and they said that i should be getting temporary disability or whatever pays 2/3 of my gross pay. they are going to call the adjuster and get this straight. i was on SDI all of last year and this is why i don't understand why my work comp specialist (i am a state employee) says my workers comp bennies were exhausted. i do know that they (comp) have to reimburse SDI for paying me all the time i was off. maybe that is what she means, who knows. my work will use any time i have on the books to try to pay me a full check this month but are saying no pay while i am off for the last part of the 6 weeks. if they approve doesn't comp take the first 3 days of my time and then pay the rest if off after 14 days or more? thanks again, i read somewhere that you are the ca comp expert!!
only one waiting period per injury so unless this is deemed a second injury you should not have another 3 days with no pay.
the carrier is required to give written notice if denying disability payments.
I can see why there is confusion when the doctor said you were permanent and stationary and now says you are not ---especially when they want to do surgery.
as I said, there are time limits for disability and IDL depending on your date of injury.
Once they restore your SDI account you should be able to draw on it again until the issue gets clarified.
P.S.
I believe IDL is limited to 52 weeks. you should have gotten information on your IDL benefit when it began. review it.
if you've exhausted IDL you may still be eligible for TTD although it's capped at a lower amount.
hello again, you are a huge help and i thank you very much. my original date of injury is oct-08. don't people who are deemed p&s ever go back to work and get worse? even though we are at maximum improvement we still have the injury and the chance for it becoming bad again. this is the part i probably never understood. when can i apply for SDI if need be? what is temp disability? is it the one that pays 2/3 your gross?
doctors make mistakes.
some conditions allow for good days and bad days but essentially the condition remains the same.
medicine is not a precise science.
you can apply when doctor disables you. SDI will likely file another lien.
both temporary disability and permanent disability use a 2/3 calculation but the maximum is much lower for permanent.
I'll check the 2008 law but I think the TD time limit was 104 weeks within 2 yrs.
1171, thanks again! expert advice as always. i am supposed to hear from my attorney tomorrow on this. they are going to get a hold of the adjuster and and give me the details. they and i believe i will be able to get benefits one way or another, just don't know which one i will be recieving. i understand the medical part, everybody's body reacts different in healing and in getting hurt. i just want this to get fixed and get on with my life. i will check back to see if you have any more info and will post my results after my attorney finds out. thanks very much again!
curley2 Wrote:1171, thanks again! expert advice as always. i am supposed to hear from my attorney tomorrow on this. they are going to get a hold of the adjuster and and give me the details. they and i believe i will be able to get benefits one way or another, just don't know which one i will be recieving. i understand the medical part, everybody's body reacts different in healing and in getting hurt. i just want this to get fixed and get on with my life. i will check back to see if you have any more info and will post my results after my attorney finds out. thanks very much again!
there is an interesting caselaw that determined that the 104 weeks doesn't start until the first TD check is issued so even though it's been 2 yrs you may still be eligible for TTD.
your atty will know about it; but it could be awhile until your situation is clarified.
Be well.
hello 1171, i read where a voucher for retraining could be issued if an injury is bad enough to change careers and take a different type job if the doctor and everybody agrees. does a person still recieve benefits while being retrained for another type of work? how does this work? thanks again, curley