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How is a WC settlement calculated in California
#11
I have letters from the insurance company along with copies of my electronic time card which can be accessed through the web stating sick hours used because waiting for workers comp approval which still reads this after 2 years of surgery.
 
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#12
I was referring to your accusation against your atty.
if you have proof that they were "bought out" or committed fraud take it to the district atty.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#13
Unfortunately I don't have hard evidence other than this atty is supposed to be very professional and It was difficult to hear back from him averaging 3+ plus weeks after reaching out to them. Also his fee was less than what I make in a month for a case that took 4 years. It just does not make any sense other than they must have been paid off to convince me to settle. I noticed a change towards the last year. There were so many things I would bring up that I wanted and knew I was entitled to and no action, I knew I was entitled to penalties for late/ delayed payments. Months with no medical treatment after I requested it over 4 months. It was all fishy. I was told they are requesting a court date to dispute the stipulations that have not been met but I was given this excuse 2 months ago, how long does it take to get a court date anyways?.
 
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#14
if they sent a letter to you or your attorney stating they were discontinuing ttd payments, then they cannot be penalized for delayed payments, I was cut off for a few months, and found out they sent a letter to my attorney, and my attorney never told me until late,,,
 
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#15
I never received payments period, my checks never read worker's comp but regular pay through my employer because I was using personal time. 326 hrs worth.
 
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#16
This is an update: well after settling back in spring my employer has failed to reimburse my lost time and in the stipulations they agreed they would also I've had little to no luck getting medical care and in the settlement it was for future medical care. I received a bill for the surgery that I had 2 years ago, the insurance company failed to pay for certain services and now I received a letter that if this is not taken care of it will go into collections and affect my credit. The insurance company has made it so difficult to get through to them, they are always transferring my case to a different agent so months have gone by. I have copies of the doctors report and my physical therapist staying that therapy has helped and that more treatment is needed/ recommended. It's been 3 months since my last therapy session on 8 visits. My doctor is suggesting another surgery but again the insurance company is making matters difficult. I'm scheduled for a hearing with the WCAB in a couple of days. What should I expect from that hearing? Your answers are greatly appreciated. Thank you.
 
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#17
both sides will present their evidence, you may be called to testify. the judge will consider all the evidence and at some time in the future issue a written decision.
it's more usual to schedule a conference before holding a hearing.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#18
I need help. My case settled last spring and I was awarded future medical. The insurance company still is giving me a hard time delaying and denying any care. I had an attorney but they have been paid for settling the case. Last month we went to the WCAB and he suggested I take over all this minor stuff and had me sign a document that would make me in pro per to represent myself. Now the insurance company is giving me a hard time again. What can I do?, I've been looking a another attorney.
 
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#19
I don't understand your decisions.
earlier you were complaining vehemently about your atty "selling you out".
then you forgot all that and decided to accept the attys advice.
and then you agreed to handle your claim yourself.
now you believe you can't handle it yourself.
you are considering trying to find an atty to handle your claim.
do you still think all the different adjusters and their denials of treatment were wrong?
you seem to no longer trust your former attys advice that you should handle your case yourself.
given all the missteps you've made why do you think you're right and the adjusters/atty are wrong?

it will be difficult to get new legal representation as there is little room for any more atty fees-- that's why your atty dropped out. of course, you can still try.
but if you can't find one and are going to handle the disputes yourself, you need to become familiar with the IMR, IBR, and utilization review rules.
I posted the links earlier. here they are again

http://www.dir.ca.gov/dwc/DWC_FAQ.htm
http://www.dir.ca.gov/dwc/MedicalUnit/imchp.html

if you are thinking about negotiating a buyout of your remaining benefits yourself, you need to calculate the value of your future medical costs and start haggling from there.


I'm not sure what advice or information anyone could offer that would help the outcome in such a situation.

P.S. you said there was a hearing last month.
what evidence was presented?
was there a decision?
was there a discussion with the carrier as to what was going to happen next?
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#20
1171 - I see that you've been an active contributing member for a long time and, I imagine you've been instrumental in helping so many of us (injured workers) just make it through one more day without losing our sanity, which is why I'm wondering why your last post in reply to pleasehelp was so abrasive. There were two excellent links and some sage advice in your last post but that information was hard to find under the steaming pile of criticism and condescension that you also included. FYI, I'm not big on posting to message boards, and I only write reviews when a product or service has been either exceptional or terrible and, even that's not often. I just know what it is to be unfamiliar, frustrated, and agitated with 'the system'. People end up blaming everyone because they don't know where the road block is.
 
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