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Ca Adjuster will not pay Workers Compensation Benefits on Approved Claim. What to do?
#1
Hi, the Adjuster has lied about sending money since Nov 2017, they refuse to pay my brother his Workers Compensation check. Which forms do I need to fill out to go before a judge and ask for Workers Compensation benefits? Also they refuse to provide PTP doctor, what forms are needed to get a PTP because his lawyer has not answered any questions in months. My goal is to learn as much as I can to help my brother and find another attorney. So far no attorney will accept his case because they do not want a split-payout.


What can I do to get penalties too, is a four month wait on a approved claim qualify for penalties?
 
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#2
You have no standing before the court; you are not yet a party to the case.
Once you have been appointed guardian or conservator you may act on behalf of the injured worker.
There are no forms to get a ptp; the injured worker makes an apt with any doc in the MPN.
http://www.dir.ca.gov/dwc/mpn/DWC_MPN_Main.html

If you want to get involved with your brothers claim, My advice is get yourself an atty who can work to get you appointed conservator/guardian.
In the alternative, have your brother direct his atty to request the court to appoint you guardian/conservator.

As you have found out, you have no authority in another person's litigation.
You can't sign anything, agree to anything, receive anything, settle any thing, change anything, on someone else's claim until you are legally authorized to do so.
please research anything on conservatorship.
is it confusing?

Maybe if you hear it from another source.....
You can Contact the Information & Assistance Officer nearest you
http://www.dir.ca.gov/dwc/IandA.html
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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#3
(02-08-2018, 02:20 PM)Billy Miller Wrote: Hi, the Adjuster has lied about sending money since Nov 2017, they refuse to pay my brother his Workers Compensation check.  Which forms do I need to fill out to go before a judge and ask for Workers Compensation benefits?  Also they refuse to provide PTP doctor, what forms are needed to get a PTP because his lawyer has not answered any questions in months.  My goal is to learn as much as I can to help my brother and find another attorney.  So far no attorney will accept his case because they do not want a split-payout.  


What can I do to get penalties too, is a four month wait on a approved claim qualify for penalties?

Your brother ( or someone that maintains power of attorney ) needs to make an appointment with the lawyer to discuss those concerns. If not possible send a letter discussing those concerns , Return receipt request. 

The lawyer has entered in to a contractual agreement (with your brother)  to provide services in the Workers Comp Arena. This includes benefit recovery . Find out what the lawyer has to say in all fairness. Might have a good reason ? Are you sure you brother is owed financial benefits ?

If you cannot get anywhere ..send the lawyer another letter instructing the lawyer to calendar the matter with a Declaration of Readiness to proceed for benefits and penalties. After all they were hired to do this.

If the lawyer does not follow the reasonable instructions of his client and will not do the job contracted to do. File a complaint with the state BAR of California for a possible breach of fiduciary duty. That'll get the lawyers attention.

http://www.calbar.ca.gov/Attorneys/Condu...sional-Con

This is a common problem in workers comp unfortunately. I can only speculate as to why . Frustrating I know !!

First , try to be fair. If no success: ( I would just burn the lawyer) I have no patience for this problem , Had it too many times. . Keep the lawyer on the case and make them do the job they agreed to. Works for me Smile My lawyer hates me , but my lawyer is on the ball . Lol !

Don' t fire the lawyer without another one substituting in first .The new lawyer will notify the old lawyer and request your file. There is a form that needs to be filed with the court as well.

Doctors are selected form the MPN list. Its very common for an attorney to select a PTP/ Doctor for an injured worker. They know who should be a fair doctor. They can't refuse an MPN doctor.

It's very doubtful you will find another lawyer. But like 1171 pointed out you have no standing .This is not your case.

Check out the DWC Information and Assistance offices .

I am just an injured worker as well.

Good luck
 
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#4
P.S........
You can however have your brother be given a mental status exam. With a medical opinion of incompetency your county department of social services will allow you to file for welfare benefits on behalf of your brother.
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.
 
Reply
#5
(02-08-2018, 02:20 PM)Billy Miller Wrote: Hi, the Adjuster has lied about sending money since Nov 2017, they refuse to pay my brother his Workers Compensation check. Which forms do I need to fill out to go before a judge and ask for Workers Compensation benefits? Also they refuse to provide PTP doctor, what forms are needed to get a PTP because his lawyer has not answered any questions in months. My goal is to learn as much as I can to help my brother and find another attorney. So far no attorney will accept his case because they do not want a split-payout.


What can I do to get penalties too, is a four month wait on a approved claim qualify for penalties?

There could be a few different reasons why this could have happened. If your brother is not treating with a doctor in the MPN they may ignore the doctor. Your brothers doctor needs to write he is TTD every month to receive TTD.

In the mean time he can apply for state disability benefits through EDD.
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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