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pysch.
#1
With regard to the psychiatric component, please be advised that you are
barred from any psychiatric permanent disability, because you were employed
less than 6 months at the time of injury.


I got this email from C/A. Is this true? My DOI is 11/2004

I have rsd, and that is my OI. The depression/anxiety is due to the rsd/pain.

what I read say's that if you file a claim for psych. then you have to be employed 6 months, but what if the depression/anxiety is secondary to the original injury, does the 6 month rule still apply?

Claim is from California.
 
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#2
yes the pre-condition applies.
the labor code only makes an exception to the increased requirement for psychiatric injuries to those that are caused by a sudden and extraordinary employment condition;
there is no exception for consequential injuries.
they specifically said permanent disability; have they provided other benefits for your psychiatric injury?

Signature/Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information.........
 
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#3
(08-18-2014, 08:05 PM)1171 Wrote: yes the pre-condition applies.
the labor code only makes an exception to the increased requirement for psychiatric injuries to those that are caused by a sudden and extraordinary employment condition;
there is no exception for consequential injuries.
they specifically said permanent disability; have they provided other benefits for your psychiatric injury?

When you say "Other Benefits" what do you mean? They have approved for me to see a psych. and I have seen him 3 times.

it seems to me that the law means to file an original claim for psych, you must be on the job for 6 months. I filed for psych. 8 years after the original injury. Seems like that would be ratable.

My original injury was rsd to the lower extremities, since 04, the disease has spread to include back shoulders hands wrists, these are ALL being rated, and is secondary to the original injury. Why am I not allowed to be rated for psych?

 
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#4
since you don't meet the 6 month requirement I'm surprised they are paying for psychiatric care.
technically/literally you can probably be rated for the psych component they just don't have to pay any benefits for it.
Wal-Mart Stores et al., v. W.C.A.B. (Garcia) (2003) said there is no basis for allowing the court to invent another exception to the 6 month requirement when the legislature clearly only allowed the one for sudden and extraordinary.
the court can't make new laws.
Signature/Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information.........
 
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#5
This is their reply "Regarding the psychiatric component, defendants could be liable for
treatment as a compensable consequence; however, one is barred from
psychiatric permanent disability if employed less than 6 months."

They approved psych treatment in 2012. have seen him several times, and am approved to keep seeing him.

I guess the 6 month rule still applies

thank you for your help 1171.
 
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#6
I was repped in 2010 att. agreed to AME with DA. I've been unrepped since 2012. The DA recently retierd, new att on case.

Do I have to return to AME, or can I ask for panel, since both att gone.
 
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#7
The defense attorney leaving is not relevant (IMO).This was a topic of discussion on another site. Those on the defense side stated no, however a person on the applicant side believed yes you may get a PQME if no longer represented.

I would request a panel from the state and see if the defense objects. If the defense refuses to allow it ask for a hearing and let a judge decide.

There is always a risk of receiving a panel of 3 defense doctors.

If you are near the end of your claim this may not be allowed. QME/AME's only opine on ratings and if the injury is work related. They no longer have any input on medical treatment. If you have been rated, I do not see why this would be beneficial.

I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#8
Thanks California_help. I have this issue resolved now.

The CA says NO.

California law says this,

(a) Whenever a comprehensive medical evaluation is required to resolve any dispute arising out of an injury or a claimed injury occurring on or after January 1, 2005, and the employee is represented by an attorney, the evaluation shall be obtained only as provided in this section.

My injury was in 2004, so this does not apply too me, or anyone else injured before 1/1/05
 
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#9
On the 15% increase, (which the CA said last week, than I am eligible for)

Does that apply too TTD or to final rating?

They have me rated for lower extremities at 56% which they have paid. I am still seeing qme/aqme for lower extremities, still not rated.

 
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#10

Q. What if my employer does not offer me work?

A. If you were injured between Jan. 1, 2004 and Dec. 31, 2012, and your employer has 50 or more workers, and you are not offered regular, modified or alternative work, your weekly PD benefits will be increased by 15 percent once that offer is made.

If you were injured between Jan. 1, 2004 and Dec. 31, 2012, and your employer has fewer than 50 workers, and you are not offered regular, modified or alternative work, your PD benefits will not change.

If you were injured on or after Jan. 1, 2013, your permanent disability benefits will not change if you are not offered regular, modified or alternative work, regardless of the size of the employer.



http://www.dir.ca.gov/dwc/WCFaqIW.html#ReturnToWork

Signature/Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information.........
 
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