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Giving up Medical in Settlement
#11
I had no idea ca wc was this bad, I had read about it but didn't know it was such bias reviews. It is truly ashame for a injured worker let alone be in a state that just gave them more le-way.
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#12
so sad the laws allow them to treat us this bad. I can understand there are people out there that cheat the system but delaying treatment can cause even more pain and suffering along with more permanent injury. Make a law that puts stiff fines on the cheaters but give us a quick system to settle the disputes so treatment is not delayed for those that need it
 
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#13
Here's the link to CA IMR decisions thus far:

http://www.dir.ca.gov/dwc/IMR/IMR_Decisions.asp


They open as PDF files that you can scan through and read. Yes, some of them are just ridiculous things workers are asking for like a new mattress because of a back injury. Come on folks! However, most medical treatment from simple prescriptions to major surgeries are being denied time and time again.

The process of an IMR review takes 90 - 120 days to get a decision. Note that the IC's are not sending in full medical docs as required under the law and are getting away with this handedly. No one to complain to and even if you tried to go to a judge you are barred unless you can site material fraud in your case.

The whole premiss behind IMR was to free up the comp court judges here in CA. I don't see that happening at all. They are still packed with attorneys from both sides.

IMR is a disaster and workers have virtually no right of appeal once a paper reviewer issues a decision regarding the denied treatment they are trying to get. Thank Jerry Brown and the legislature for this mess.
 
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#14
(11-26-2013, 11:31 PM)sl380mbz Wrote:
(11-26-2013, 09:59 PM)Bummer Knees Wrote: I settled and did not keep the medical open, big mistake!

I received $4,600. for my medical. What I did not know is health insurance will never cover my knee because it was a work injury and I received a cash settlement.

So think hard, will the money you are receiving cover your future medical needs for life?

I have talked with my regular insurance and they said all would be covered. Also, with the ACA coming into effect, insurance companies cannot deny coverage for existing conditions. Might talk to your insurance company about that.

Don't be the farm on this ever being covered through private medical insurance! You are asking for money to settle your claim from WC. Your private medical carrier can come after those funds to treat your WC injury at any time... even with the new regulations under ACA.

My private carrier went after my employers WC carrier and eventually recovered their payments for my WC injury. The put a lien on my case to recover all their money and required me to sign docs so they could recover any future items put through my PMI on this WC injury.

This is similar to what Medicare does when they require set asides. They are not going to let you get a windfall award on your medical and force them to pick up the tab for future treatment.
 
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#15
Don't always think of a mattress for a back injury as asking for something out of left field. Where should the line be drawn? Many thing I once did now I can't like mow the yard, clear the snow off the drive, pickup my grand kids. Now if I got a nice settlement maybe I could see covering this stuff but when they are not going to settle with me and when my pay is based on my income in 2005 with no cost of living hows this fair. And my pay is only 2/3rds of what I made without over time because it was not forced. But in my department if you didn't work it they did force you, and I worked at least 20 hours of overtime a week for the whole year before I got hurt. Now I'm not saying I should be given a new car every year and have a full time employee taking care of my yard and other things I can't but how is it far when because of this injury I have to pay for things I can't do myself and they can get by paying me so little to try and live on. I once liked to get out a go to things like hamfests and other outdoor things that now are mostly impossible because of the walking.

Okay I've stopped many times to reread this and was going to delete it but decided not to. No we don't deserve the world handed to us but I don't see why our lives have to change so much because we were doing our job. It's just sad once you get hurt you are treated like second class citizens because of that.
 
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#16
the the original work injury maybe "no fault" under the law but how injured workers are treated or not treated after the injury sure is.
our society can and should do much better for those members that are not part of the 1%.
let's hope that those politicians and legislators who improved health care for Americans will also do what's right for injured workers.
hopefully workers comp insurance improvements will be on their agenda in the coming years.
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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#17
(11-28-2013, 11:23 AM)Manley2 Wrote: Don't always think of a mattress for a back injury as asking for something out of left field. Where should the line be drawn? Many thing I once did now I can't like mow the yard, clear the snow off the drive, pickup my grand kids. Now if I got a nice settlement maybe I could see covering this stuff but when they are not going to settle with me and when my pay is based on my income in 2005 with no cost of living hows this fair. And my pay is only 2/3rds of what I made without over time because it was not forced. But in my department if you didn't work it they did force you, and I worked at least 20 hours of overtime a week for the whole year before I got hurt. Now I'm not saying I should be given a new car every year and have a full time employee taking care of my yard and other things I can't but how is it far when because of this injury I have to pay for things I can't do myself and they can get by paying me so little to try and live on. I once liked to get out a go to things like hamfests and other outdoor things that now are mostly impossible because of the walking.

Okay I've stopped many times to reread this and was going to delete it but decided not to. No we don't deserve the world handed to us but I don't see why our lives have to change so much because we were doing our job. It's just sad once you get hurt you are treated like second class citizens because of that.


I think were treated far worse then second class citizens. I agree completely with what your saying. Even though I settled I was still thrown under the bus so to speak. My wife and I both worked for the same company (she is still there), delivering products in the northern wi and just in the UP. I made good money for the area $835.00 per week, but I also did all the repairs on our trucks and maintence. Now that I cant work I cant even change the darn oil, or change tires when needed. Last year alone it costed us almost $7,500 just in labor for repairs, thank god my son does 90% of the outside work around the house. My settlement will pay out for 20 years but $2,000 less than what I was making a month this also don't include my side jobs I used to do that we couldn't figure in because of most of it was cash. When I was first injured wc treated me well, and even rented me a hospital bed , shower chair, and all kinds of stuff for my needs. Once they found out that I would never return to work, is when they turned against me and treated me like a criminal.
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#18
I can tell you a good mattress is great if you have a back injury. We were lucky enough to buy the sleep number mattress a month or 2 ago they are nice while I want and need a firmer mattress than Bill does, this way we can select what is best for us.
........I love cats, I just cant eat a whole one by myself......







 
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#19
I get about 30% of what I did before I got hurt since they don't figure overtime. And then you add in having to pay somebody to mow the yard and then pray if it snows we don't have to get out. And not much gets done around the house without help from family. There are many other places for help and you need to find them to get by for sure. Now yes we can be just as greedy as anybody else but all we want it to return to as normal a life as we can but I'm sorry that doesn't happen. I understand WC costs companies money and the sad part is they don't do the right things to help control the costs. I know of an employee where I worked that about every few years he wanted money and would get something like a broken arm at work and the company would gladly hand him $20,000 to settle. He would tell you this it what happened and he told me of 3 different times he did this. The former case manager didn't do anything to stop this and now gets a nice retirement from them. Now people come along and really get hurt and they don't understand why it costs so much money. They also do things to keep this under wraps. When I returned to work the one gal asked her boss about all my lost time and he said no we don't have to show him being off for 5 months as lost time.
Was talking to somebody just the other day that asked how my case was going. Told him it looked like they were never going to settle with me and he said they can't do that. Told him the way it really goes and he was surprised. Now the only good thing is he can help us out now he understands things.
 
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#20
I'm with you Jayne, I need a firmer mattress. We have the California king size with a pillow top. We purchased it jut months before my accident, we had to put a blanket under the sheet on my side to help stiffen it up. From constantly laying on my right side it has now formed like a pocket formed to the way I sleep. Although its nice to keep me still at night, its a killer when trying to get off it in a quick hurry when the leg cramps/spasms hit me.. This is on our to buy list to replace the bed and will be one we can adjust separately.
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