Hello There, Guest! Login Register
Index    |     Search    |     Members    |     Help

Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
Labor codes
#1
Is there a labor code for ttd benefits?

I read lc 4650 but that’s only if the claim was not denied.

Lc 4656 c (2) says that injury after 2008 recieves 104 weeks of ttd within 5 years of doi. The sdi period is counted if employers shows that they reimbursed edd.

Is there a caselaw or lc that I can use to demand for benefits?

My claim has been accepted and everyone from carrier does not have an answer to when they accepted my claim. The manager and their attorney says I’m eligible for ttd and the adjuster says no benefits whatsoever. The Vp says only medical and no ttd.

I want to object to msc hearing because there are no reports. My concern is if i object to the msc, I will not have a chance to have the judge decide on this matter.
 
Reply
#2
Hi I am not sure I understand what you are asking is this for penalties or are you writing a letter to request payment of TTD?
https://law.justia.com/codes/california/...4664/4656/

This is how to request penalties on failure to provide benefits (including TTD) and it gives an example how to fill it out.

https://www.dir.ca.gov/dwc/educonf12/5814/penalty.pdf

This is info on 5814 penalty.

https://www.avvo.com/legal-guides/ugc/pe...ed-workers

https://www.dir.ca.gov/dwc/educonf12/5814/penalty.pdf

The DWC website search engine has a lot of info on TTD etc. You just need to place it in the search engine.

"Automatic, Self-Imposed 10% Penalty for Late Payment of Disability Indemnity
Given the importance of disability indemnity in California workers' compensation, even the slightest delay in payment can be devastating to injured workers and their families. In that regard, the California Labor Code provides for an automatic, self-imposed 10% strict liability penalty against employers for the untimely payment of disability indemnity. Section 4650 of the Labor Code provides that if any temporary or permanent disability indemnity payment is not made on time, the amount of that untimely payment shall be increased by 10% automatically. That is, the 10% increase shall be applied to the late payment without application by the injured worker.

and

"Unreasonable Delay or Refusal to Pay Compensation
Section 5814 of the Labor Code states that "[w]hen payment of compensation has been unreasonably delayed or refused, either prior to or subsequent to the issuance of an award, the amount of the payment unreasonably delayed or refused shall be increased by up to 25 percent or up to ten thousand dollars ($10,000), whichever is less." The penalty for unreasonable delay or refusal is not limited in applicability to a narrow set of benefits. Rather the payment of any benefits available to injured workers in California workers' compensation can be increased by application of this penalty provision (e.g., temporary disability indemnity, permanent disability indemnity, medical care, interest, death benefits)."

It sounds like the judge wants to wait until the new QME opines on TTD. I still think it would be a good idea to take this info down to the WCAB and site down with I&A officer. It sounds like you are in a good spot with medical evidence. Make sure you google the panel QME list before picking a doctor. Best to you.
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.
 
Reply
#3
In response to your earlier question on if the insurance carrier has to notify you on things like acceptance of a claim this may help you in the future (if you are interested but pick your battles).

https://www.dir.ca.gov/dwc/BenefitiNotic...Manual.pdf


This talks a little bit more about penalties under labor code 5814 and the obligation of the adjuster to provide benefits. It sounds like you have attempted to go above the adjuster and discuss this with her supervisor? Sometimes a threat of a penalty will do it, but since the judge has stated to wait until QME report not sure if this is the best way to go now. I hope you can get legal representation so you do not have to deal with this crap.

http://www.rjylaw.com/penalties-labor-code-5814.html
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.
 
Reply
#4
(11-06-2018, 06:56 PM)California_Help Wrote: In response to your earlier question on if the insurance carrier has to notify you on things like acceptance of a claim this may help you in the future (if you are interested but pick your battles).

https://www.dir.ca.gov/dwc/BenefitiNotic...Manual.pdf


This talks a little bit more about penalties under labor code 5814 and the obligation of the adjuster to provide benefits. It sounds like you have attempted to go above the adjuster and discuss this with her supervisor? Sometimes a threat of a penalty will do it, but since the judge has stated to wait until QME report not sure if this is the best way to go now. I hope you can get legal representation so you do not have to deal with this crap.

http://www.rjylaw.com/penalties-labor-code-5814.html

Thank you California help. I really appreciate these information but I’ll be lucky to survive another month of this. All the extra stuff the IC is doing is not helping with my depression and anxiety. I may have to raise the white flag soon.

After 20 months they are investigating from the beginning again. Thus delaying again or they can simply deny again. There is nothing I can do and watch. How does this system allow this behavior? Even though I filed for penalties, the judge has to approve it. He’s already chosen to ignore me. Then he let the defense schedule msc knowing there’s no report.

I’ll read it and hopefully get me new life.
 
Reply
#5
It sounds like he has not ruled either way yet. This work comp system moves very slow. Don't let this stuff get to you. All you can do is try your best, but a lot of this stuff can be so negative. Concentrate on getting healthy and returning to work (maybe not at your employer). It is more important than penalties etc.

I assume you have tried calling applicant attorney's from the CAAA link? You do not have a denied case so I think getting an attorney would be a lot easier now.
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.
 
Reply
#6
(11-06-2018, 09:28 PM)California_Help Wrote: It sounds like he has not ruled either way yet. This work comp system moves very slow. Don't let this stuff get to you. All you can do is try your best, but a lot of this stuff can be so negative. Concentrate on getting healthy and returning to work (maybe not at your employer). It is more important than penalties etc.

I assume you have tried calling applicant attorney's from the CAAA link? You do not have a denied case so I think getting an attorney would be a lot easier now.

Its just that all these attorneys and judges have worked together the last 20-30 years. I’m sure they have all work together at some point in time. What is fustrating is they are using the law to delay benefits.

This can be stretch out for years. I don’t understand how the carrier can reinvestigate again after it’s been accepted. I can understand if it was the firsts 90 days but it’s been 21 months. I’m sure they will find some excuse to delay even if this pqme writes a favorable report
 
Reply
#7
(11-06-2018, 06:56 PM)California_Help Wrote: In response to your earlier question on if the insurance carrier has to notify you on things like acceptance of a claim this may help you in the future (if you are interested but pick your battles).

https://www.dir.ca.gov/dwc/BenefitiNotic...Manual.pdf


This talks a little bit more about penalties under labor code 5814 and the obligation of the adjuster to provide benefits. It sounds like you have attempted to go above the adjuster and discuss this with her supervisor? Sometimes a threat of a penalty will do it, but since the judge has stated to wait until QME report not sure if this is the best way to go now. I hope you can get legal representation so you do not have to deal with this crap.

http://www.rjylaw.com/penalties-labor-code-5814.html

California-Help,

I read part of the benefits notice manual but I’m having difficulty relating it to my claim. On page 18, it mentions when to send and reasons. Would this be the same if the claim was originally denied?

I received one letter of denial of benefits during the early stages of my claim. It says that my claim is being denied because of no substantial medical and legal evidence my alleged condition to the lumbar spine resulted from employment.
Our investigation determine that you employer question the report of an I witness injury. Based on your lack of reporting in a consistent manner your credibility is in question. Based on information obtain in our investigation, you condition was a result of a personal action and they are not compensable under labor code 3208.3.

I don’t know where or how any of that is related to a slip and fall. There was a coworker there that helped me up and he was the one who told me I slip on a wet floor. I recall him wiping the floor when he helped me up. He reported the injury and I went to the Er.

I was terminated and I never heard Fromm anyone again. I saw a qme last September and from what one of the claims manager said it was accepted after the qme report. Since then, I have never received anything from IC.

They would always say Its denied and I need to settle to get any benefits. During my hearing i overheard that my claim was was accepted so the following day I called and demanded to know when it was accepted. They emailed me the accepted letter dated the same day. It does specifically say what it was covered or denied. It just says you are eligible for one or more of the benefits.

How do i know when the 14th day starts if they gave me 4 different dates?
 
Reply
#8
I have no idea why the IC is doing the things they are in your case. I still recomend an attorney or I&A officer to help you with these issues. You have complex issues and it is very difficult to answer on a message board, also I am not an expert. This is a search engine to find workers compensation attorney's near you.
https://www.caaa.org/index.cfm?pg=FindaLawyerDirectory

Some attorney's go from one side of the fence to the other, but from what I have seen most stay on the side they started on (but not always). It is a small community in work comp and not uncommon that some of the attorney's and judges have worked on opposing sides previously. This can be beneficial to the injured worker as well if the judge trusts and is familiar with his attorney.

I would not worry so much about who knows who and more about how they are as an attorney, how they or their paralegal will be communicating with you and if they have decent reviews from past clients. The number one complaint I read from injured workers is their attorney does not call them back.

Hiring an attorney can drag out a claim. It depends on the attorney. If you want to close out your claim quick you did receive an offer. You just need to weigh out what is important to you and if you want to spend the time needed to try and get the benefits you feel you deserve. This system moves slow and is complicated.
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.
 
Reply
#9
(11-07-2018, 01:33 AM)California_Help Wrote: I have no idea why the IC is doing the things they are in your case. I still recomend an attorney or I&A officer to help you with these issues. You have complex issues and it is very difficult to answer on a message board, also I am not an expert. This is a search engine to find workers compensation attorney's near you.
https://www.caaa.org/index.cfm?pg=FindaLawyerDirectory

Some attorney's go from one side of the fence to the other, but from what I have seen most stay on the side they started on (but not always). It is a small community in work comp and not uncommon that some of the attorney's and judges have worked on opposing sides previously. This can be beneficial to the injured worker as well if the judge trusts and is familiar with his attorney.

I would not worry so much about who knows who and more about how they are as an attorney, how they or their paralegal will be communicating with you and if they have decent reviews from past clients. The number one complaint I read from injured workers is their attorney does not call them back.

Hiring an attorney can drag out a claim. It depends on the attorney. If you want to close out your claim quick you did receive an offer. You just need to weigh out what is important to you and if you want to spend the time needed to try and get the benefits you feel you deserve. This system moves slow and is complicated.

In the early stages of the claim, I trusted both my employer and IC. They could have said there’s no such thing as workers comp and I would have believed them. It’s not because I’m foolish but I thought my employer would look out for my best interest. No one explained any coverage nor did I signed any forms.

With a little bit of luck, the doctor I was seeing help point me in the right direct. I never ask any questions and I went to all my appointments. When I went to see the qme, he told me not to worry and he will help me with my injury. After that, I never heard from him again. I started to ask question after that and I would encounter a world that I never knew existed. The IC and everyone that works there can lie like there’s no tomorrow. Those that don’t want to participate just won’t answer.

I’m sure they thought of me as a fool and that’s the reason for the unconventional process. The denial was fraud if you ask me but the law says I can appeal if I don’t agreee. Since my injury was neglected for so long, it left me with chronic pain.

I guess they can lie and I’ll just trust them like the early stages. I didn’t know about ttd until the IC brought it up.
 
Reply
#10
(11-06-2018, 06:56 PM)California_Help Wrote: In response to your earlier question on if the insurance carrier has to notify you on things like acceptance of a claim this may help you in the future (if you are interested but pick your battles).

https://www.dir.ca.gov/dwc/BenefitiNotic...Manual.pdf


This talks a little bit more about penalties under labor code 5814 and the obligation of the adjuster to provide benefits. It sounds like you have attempted to go above the adjuster and discuss this with her supervisor? Sometimes a threat of a penalty will do it, but since the judge has stated to wait until QME report not sure if this is the best way to go now. I hope you can get legal representation so you do not have to deal with this crap.

http://www.rjylaw.com/penalties-labor-code-5814.html

If the denial letter did not deny benefits because of my termination for cause, can they raise the issue now if it’s been more than 90 days?

Does the IC get another chance to deny benefits with a different reason that was not contested in their denial letter?
 
Reply
  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Earning Power Assessment - Labor Market Survey Report (Vocational) PAinjured 9 11,485 09-03-2012, 01:06 AM
Last Post: 1171
  Ca. labor laws modified work ? pridenme2 1 8,534 08-12-2009, 12:09 AM
Last Post: chrischris
  codes tweety00 11 3,912 04-08-2008, 09:43 AM
Last Post: vickinat
  PA Child Labor lil_conner23 7 2,953 01-22-2008, 11:21 PM
Last Post: lil_conner23
  Labor & Industry Suryey ???? backache 2 1,486 11-06-2007, 02:48 PM
Last Post: Still in Limbo

Forum Jump:


Browsing: 1 Guest(s)