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CA WC system prisoner for over 10 years HELP needed
#1

Broke my neck at work, State of CA.
2 surgeries that proved useless.
Used up all my savings.
Continuous rounds of Doctors being paid, but no decisions for helping me.
Had to move, as monthly payments are below $700 per month.
Current (and 3rd insurance company) refuses to reimburse mileage (9 months waiting), or provide the necessary letter to be given to Medicare to receive additional monies.
Not allowed to work and can't for that matter.
Attorney beyond useless.
Had a QME a year ago.
Being ignored to death.
Has anyone gotten out of the system after 10 years and how did you do it?
Help, help ANY help would be appreciated...
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#2

Your case is litigated. You need to have the judge decide issues and order needed benefits.
If you don't/can't represent yourself, talk to other attys and think about switching.
You can search for cal attys here:
Caaa.org

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

(03-23-2017, 09:04 PM)1171 Wrote:  Your case is litigated. You need to have the judge decide issues and order needed benefits.
If you don't/can't represent yourself, talk to other attys and think about switching.
You can search for cal attys here:
Caaa.org

Thank you for the response...  Litigation imply's having been to court which I have never been, but perhaps the Atty has on my behalf and not included me in that bit o information right along with everything else he can't or won't do or say.  Have called 2 other Atty's in the past 18 months and they wouldn't touch the case due to my having and have had the same atty for the duration.  Nor did they offer the info on how to switch if that was possible. Didn't know the Atty could be "fired" either.  Years ago the conversation about this case was a buyout was coming soon which would allow me to find a Doctor to fix my back and get me out of the constant pain.  Since then, the silence has been deafening.  How do i get my Atty to get me before a Judge? or can i go around the Atty (doubt this) and petition the court directly and if so, on what grounds?  Cruelty, abandonment of principles, betting on the come, greed?...  Also, most likely not...  All tortured humor aside..  Any suggestions are so very appreciated...
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#4

Your case is litigated because you have an atty. They can,t get a fee unless they file with the court from day one. If you want to represent yourself you file a substitution of attorney__form36 or a dismissal of attorney form with the court and the carrer, and your attorney ----form 37.
Forms and court rules are here. http://www.dir.ca.gov/dwc/forms.html

After he's off the case you pick up his litigation folder so you or your new atty have a record of the documents filed with the court. As well as any notes etc.

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

(03-24-2017, 09:17 AM)1171 Wrote:  Your case is litigated because you have an atty. They can,t get a fee unless they file with the court from day one. If you want to represent yourself you file a substitution of attorney__form36 or a dismissal of attorney form with the court and the carrer, and your attorney ----form 37.
Forms and court rules are here. http://www.dir.ca.gov/dwc/forms.html

After he's off the case you pick up his litigation folder so you or your new atty have a record of the documents filed with the court. As well as any notes etc.

Smile  First clear direction I have had in years.  TY
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#6

You are welcome. Glad I could help.

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
#7

(03-23-2017, 07:03 PM)vmc dak Wrote:  Broke my neck at work, State of CA.
2 surgeries that proved useless.
Used up all my savings.
Continuous rounds of Doctors being paid, but no decisions for helping me.
Had to move, as monthly payments are below $700 per month.
Current (and 3rd insurance company) refuses to reimburse mileage (9 months waiting), or provide the necessary letter to be given to Medicare to receive additional monies.
Not allowed to work and can't for that matter.
Attorney beyond useless.
Had a QME a year ago.
Being ignored to death.
Has anyone gotten out of the system after 10 years and how did you do it?
Help, help ANY help would be appreciated...
What type of surgeries did you have on your neck?

What do you mean by no decisions for helping me? Is your primary doctor making requests for treatments and are they being denied by utilization review?

Did you move out of state? The only reason why they may not reimburse you for mileage is if your employer has a medical treatment network and you are seeing a doctor who is not in it. If this is the case they can ignore his requests and not pay you any mileage. Do you know if your employers work comp carrier has an MPN and if your treating doctor is in it and who picked your doctor? If he receives a denials does he appeal the denial or do you?

Are you currently receiving Medicare and SSDI? The work comp carrier does not have to settle with a compromise and release and do a Medicare set aside, it is up to them. If you are not seeing a doctor in their MPN then they may have no reason to settle.

Who sends in your mileage requests, you or your attorney? Ask your attorney to fie for an expedited hearing over late mileage. He ca do that.

QME's are very limited and now only do ratings and decide extent of injury and future medical, but they no longer can make medical determinations. Everything has to go through the utilization review process and if it is denied you or your doctor can do an internal UR appeal and if that is denied do an IMR request. Has this been happening? Being ignored and being denied treatment are two different things. The new rules suck in our state with treatment requests with the UR and IMR system. If you or your doctor is not appealing denials, you may not be receiving very much treatment.

Have you tried having an in person or phone appointment about these things with your attorney, and expressed you want out of this system and would like him to try and negotiate a compromise and release?

Has your claim settled with a stip with open medical at any point?

If you are looking to hire another attorney I recommend calling more than a few. I recommend calling at least 20-30. You should google check their reviews first. You may want to google your current attorney to see if he has good or bad reviews. This may be a communication issue, as you cannot force an insurance company to get a MSA and close out your case.

You can also try and represent yourself and you can get help with an I&A officer. I have a feeling soothing is going on...either not seeing doctor in your MPN, or something else.

Buying the Christopher Ball California workers compensation book, but make sure it is the most current edition as laws changed regularly.

This is a good website that may answer most of your questions.
http://www.dir.ca.gov/dwc/InjuredWorker.htm

Best of luck 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.
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