New to this, would like your thoughts

[mytruck]

I was recommended to this site, so I hope someone has some ideas. This is the first time (hopefully the last) I’ve had to use WC, so please bear with me. I live in California.

I was struck on the neck by another employee throwing a package working for a UPS like company. It caused several disks to become herniated, according to my doctor, which is pressing on my nerve in the neck. This has affected my right shoulder from the base of my neck down my arm to the tips of my fingers. I have had nothing but issues from WC with really any explanation as to why. The MRIs taken showed that the damage is consistent to what happened and I have no history of a neck injury. Three doctors (two which WC chose) examined me and agreed that my injuries are the direct result of what happened at work. It has been 7 months with no treatment at all, just a box full of pills they give me that have done nothing.

I asked my attorney why the issues (too many to list and I don’t want to sound like a cry baby) and they said it was ‘normal’ as these are part of the ‘game’ WC plays. They said due to California law, they really cannot do anything about these issues and cannot get involved until I become ‘permanent and stationary’, then they can get me some kind of award. They say due to law, their hands are tied as to ‘making’ WC do anything. All I care about at this point is getting rid of the pain and problems with my right arm/hand as it has been 7 months of no relief. To me, this is cut and dry. I was hurt, with eyewitnesses, by another employee, have had NO neck or arm problems ever until this incident and have 3 doctors confirm the injury. There should be no issue to get treatment.

There is my long winded problem. Question: Is there any agency or anywhere I can go to go over issues I have had since day one? I can see if there was something fishy about or anything cloudy about what happened or if I had a history of neck problems. This is not the case. Someone has to be in charge of looking into this.

Thanks for your time any would appreciate any suggestions.

[1171]

In california medical is controlled thru use of a Medical Provider Network and Utilization Review (sometimes a special HCO plan). You can change doctors at any time to another one within the network.
you have to notify the carrier.
atty's often limit their activities to those that contribute most to fees. sounds like they are saving their efforts for settlement time; that way the fee for work performed is higher.
any issue, especially if in involves treatment denials, can be brought before the appeals board thru an expedited hearing.

the appeals board handles work comp litigation.
the audit unit will take a complaint and review the file whenever they're scheduled to do a carrier/self-insurance audit.
http://www.dir.ca.gov/dwc/Audcomp.pdf

Here is information on MPN & utilization review
http://www.dir.ca.gov/dwc/MedicalUnit/imchp.html

I'd recommend you contact a number of other attys. when there has been more then 1 atty a single fee is shared.
http://caaa.org/cs/zip/zipsearch.aspx

of course, you can contact your legislator but when a case is litigated most defer to court resolution of issues.
you can also file a complaint with the state bar if you believe your representation has been inadequate or worse.
http://www.calbar.ca.gov/state/calbar/ca...79&id=1144

[vickinat]

MYTruck,

Welcome to our forum. I'm not familiar with the laws and statues of CA, but have patience, someone will be along soon to help you. W/C is a wait,wait,wait and see game. They tend to delay proper medical treatment, while waiting to see if conservative methods (meds, pt and such) work. I hope you get the help you need before more damage is done.

You can look at the tabs at the top of this page for "info by state" which may help, while you are waiting for advice. Good luck. In my opion, your attorney should be giving you the advice you need and not just say he can't do anything because of certain laws, I would request him to tell you which laws and where you can read about them.

Take care
Vickie

Sorry, 1171 must have been posting at the same time that I was typing, she has given you great advice.

[mytruck]

Thanks for the time and suggestions. I will try them and see if I can get any kind of relief.
I feel this is an easy case to be able to get medical help. Are all WC cases this difficult as there is nothing to suggest this should be this complicated?

[jayne]

Most WC cases sail thru the system with no problems....then there are the rest of us....welcome to the forum

[mytruck]

It just gets better. After 7 months of no relief on my nerve in my neck(except 15 bottles of pills I've been told to take that hasn't worked), I finally got a date to get my epidural shot (which I hope works). All WC had to do is let the doctor know my case is open. That's it. The doctor has called for 2 weeks now and finally got a call back stating my case worker changed and she had to explain why I needed the shot, fill out paperwork and fax it to her. Still waiting for the reply from WC, even thought I have a written approval (doc says they need a verbal). Here's the kicker: The supposed new case worker assigned to my case is the same one I have had since my injury. I pulled the paperwork just to make sure and it was. Now my scheduled shot has been postponed along with my PT until my 'new' case worker gets in touch with my doctor.
There has to be something that can be done about this. Any thoughts?

[BooBoosNeck]

mytruck Wrote:It just gets better. After 7 months of no relief on my nerve in my neck(except 15 bottles of pills I've been told to take that hasn't worked), I finally got a date to get my epidural shot (which I hope works). All WC had to do is let the doctor know my case is open. That's it. The doctor has called for 2 weeks now and finally got a call back stating my case worker changed and she had to explain why I needed the shot, fill out paperwork and fax it to her. Still waiting for the reply from WC, even thought I have a written approval (doc says they need a verbal). Here's the kicker: The supposed new case worker assigned to my case is the same one I have had since my injury. I pulled the paperwork just to make sure and it was. Now my scheduled shot has been postponed along with my PT until my 'new' case worker gets in touch with my doctor.
There has to be something that can be done about this. Any thoughts?

Well I know what I would be doing, I would call the "new" case manager everyday. It is bull that you have had to wait so long. I feel your frustration and I have very similar pain. I would be on that persons "case" everyday until he or she did something. The end....

[1171]

from the previous links I posted
http://www.dir.ca.gov/dwc/FORMS/Utilizat...ntform.pdf

send a copy to your employer and the claims manager.

[mytruck]

Well I know what I would be doing, I would call the "new" case manager everyday. It is bull that you have had to wait so long. I feel your frustration and I have very similar pain. I would be on that persons "case" everyday until he or she did something. The end....
[/quote]

Thanks for your reply. I would, but I have a WC lawyer and they said I could not call and have to go through them. They do call, but leave messages and get no return calls. That's why I wanted to find out if there is anywhere I can go as this is the way it has been since day one. Most any other profession would be held somewhat accountable for not doing their job. I would think they would to some extent be also.