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Is this Legal? ( Northern California) long
#1
My cousin was injured on the job about 3 weeks ago.

She had been working at her job for a little over 2 months, and they were just starting to train her on some heavy machinery to move product in and out of the thrift store where she worked.

On the day of the accident, her trainer was running later ( by an hour) and she was told to just "do it". Not wanting to lose her job, she operated the machinery, lost control of it, and it knocked her down hard.

When she reported the incident to the Assistant manager, he asked if she was okay, and she replied I don't know. He told her to continue work.

Two hours later, she was feeling ill and was in pain to the point she couldn't stand. The Assistant Manager asked if she was okay, and she replied, no. I don't feel so well. He then asked if she could stay and continue her 12 hour shift as they were short handed but he would let her sit down the rest of the day. She said she didn't know if that would work because she was in pain it made her ill.

He then asked if she needed to see a doctor, and she said yes. Instead of taking her to the hospital he told her to wait while he tried to call the manager. about a half hour later he asked if there was anyone she could call to take her to the emergency room. She called me.

When I arrived 20 minutes later she was slumped in a folding chair in obvious pain as the assistant manager had her filling out the injury report. He asked if she would be in the next day, and she said maybe. That's when I stepped in and told him it would be up to the doctor as she could be seriously hurt.

I asked the Assistant manager where to take her, it was sunday, the workers comp emergency room Concentra was closed. And he told me to take her to the local hospital across town.

While at the hospital he health declined. Her words slurred, she had trouble talking and keeping a conversation and was constantly about to drift off to sleep. The doctor said she was pretty bruised on her whole left side, took her to x-ray and sent her home an hour later with the instructions for a follow up the next day and to stay home for three days. By the way she was acting, and the pain she was in, I believed it to be more than just a "bruise."

I put her to bed and went to her work to deliver the hospital diagnosis. Her Assistant manager stated her Manager would be in contact with her that night, and that everything was squared away.
When my cousin told her manager what happened, and the plan for the follow up the next day, the manager said fine.


At the follow up, the new doctor was not pleased at all with the ER diagnosis. The doctor stated it was in her professional opinion this was more than a bruise, but would need new x-rays once the swelling went down. the follow up doctor sent her home with the orders of not returning to work for another 2 weeks.

My cousin called her manager and informed her the news. Again she was told it was fine and to please get better soon.

Three days ago, My cousins Workman's comp rep called her to tell her that she was looking at forfeiting the workman's comp because she went to the local hospital and to the hospital follow-up, and not to the on of their doctors where they handle all workers comp claims. My cousin told the rep in detail every thing that happened and that she was never informed of where to go, just to follow doctors orders. The rep then told her that she would look into it, but to make up for the lost time and to get back on track, she would need to go see a doctor that they chose that day. In five hours she would have to travel 4 cities away to a kaiser facility to be re-examined.

She agreed and called me, but I was out of town and would not get back in time. She then called her Manager who stated they could not take her because it was against company policy. IN a last effort, she called the Assistant manager who was off that day, and he agreed to take her down and home.

At kaiser, the attending Dr diagnosed her with a herniated disc. And she would need to take 5 more days off work and then be released on modified duty of 80%.
Again she contacted her manager and gave the update, and called the workman's comp rep and relayed what she was told.

Today her HR department called her to tell her that because she went to 1.) the local hospital the first time 2.) the local hospital follow up physician and 3.) the kaiser doctor, and not the Concentra Emergency room, she had forfeited her right to worker's comp.

My cousin was almost in tears as she relayed the entire story out AGAIN about who she had instructions from to go where she went, who she talked to, and every step since the incident.

The HR department rep told her they would look into it, but if it did turn out she lost the right to workers comp, she will be responsible for paying all the medical bills, and she would be terminated from her job because workers comp would not protect her and she would have been a "no-call, no-show" for three weeks.

My cousin said she wanted to talk to her manager, and the HR rep told her not to until after they figure out what to do about her situation.



Is this at all legal? I made sure when talking to the Assistant manager that he told me where to take her for the ER visit, and I was the one who asked him if she was okay on the follow up with that doctor.
No one anywhere on the line of people I talked to said she couldn't be doing this until after the fact;


What needs to happen from here? Any advice or ideas will be of great help
 
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#2
getting treatment outside the Medical Provider Network does not negate work comp coverage for the claim.
more on rules for use of MPNs is here
http://www.dir.ca.gov/dwc/MedicalUnit/imchp.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
Get her a lawyer NOW if their games are this bad at the beginning its only gonna be worse....
........I love cats, I just cant eat a whole one by myself......







 
Reply
#4
(11-07-2014, 03:14 AM)injuredandconfused Wrote: My cousin was injured on the job about 3 weeks ago.

She had been working at her job for a little over 2 months, and they were just starting to train her on some heavy machinery to move product in and out of the thrift store where she worked.

On the day of the accident, her trainer was running later ( by an hour) and she was told to just "do it". Not wanting to lose her job, she operated the machinery, lost control of it, and it knocked her down hard.

When she reported the incident to the Assistant manager, he asked if she was okay, and she replied I don't know. He told her to continue work.

Two hours later, she was feeling ill and was in pain to the point she couldn't stand. The Assistant Manager asked if she was okay, and she replied, no. I don't feel so well. He then asked if she could stay and continue her 12 hour shift as they were short handed but he would let her sit down the rest of the day. She said she didn't know if that would work because she was in pain it made her ill.

He then asked if she needed to see a doctor, and she said yes. Instead of taking her to the hospital he told her to wait while he tried to call the manager. about a half hour later he asked if there was anyone she could call to take her to the emergency room. She called me.

When I arrived 20 minutes later she was slumped in a folding chair in obvious pain as the assistant manager had her filling out the injury report. He asked if she would be in the next day, and she said maybe. That's when I stepped in and told him it would be up to the doctor as she could be seriously hurt.

I asked the Assistant manager where to take her, it was sunday, the workers comp emergency room Concentra was closed. And he told me to take her to the local hospital across town.

While at the hospital he health declined. Her words slurred, she had trouble talking and keeping a conversation and was constantly about to drift off to sleep. The doctor said she was pretty bruised on her whole left side, took her to x-ray and sent her home an hour later with the instructions for a follow up the next day and to stay home for three days. By the way she was acting, and the pain she was in, I believed it to be more than just a "bruise."

I put her to bed and went to her work to deliver the hospital diagnosis. Her Assistant manager stated her Manager would be in contact with her that night, and that everything was squared away.
When my cousin told her manager what happened, and the plan for the follow up the next day, the manager said fine.


At the follow up, the new doctor was not pleased at all with the ER diagnosis. The doctor stated it was in her professional opinion this was more than a bruise, but would need new x-rays once the swelling went down. the follow up doctor sent her home with the orders of not returning to work for another 2 weeks.

My cousin called her manager and informed her the news. Again she was told it was fine and to please get better soon.

Three days ago, My cousins Workman's comp rep called her to tell her that she was looking at forfeiting the workman's comp because she went to the local hospital and to the hospital follow-up, and not to the on of their doctors where they handle all workers comp claims. My cousin told the rep in detail every thing that happened and that she was never informed of where to go, just to follow doctors orders. The rep then told her that she would look into it, but to make up for the lost time and to get back on track, she would need to go see a doctor that they chose that day. In five hours she would have to travel 4 cities away to a kaiser facility to be re-examined.

She agreed and called me, but I was out of town and would not get back in time. She then called her Manager who stated they could not take her because it was against company policy. IN a last effort, she called the Assistant manager who was off that day, and he agreed to take her down and home.

At kaiser, the attending Dr diagnosed her with a herniated disc. And she would need to take 5 more days off work and then be released on modified duty of 80%.
Again she contacted her manager and gave the update, and called the workman's comp rep and relayed what she was told.

Today her HR department called her to tell her that because she went to 1.) the local hospital the first time 2.) the local hospital follow up physician and 3.) the kaiser doctor, and not the Concentra Emergency room, she had forfeited her right to worker's comp.

My cousin was almost in tears as she relayed the entire story out AGAIN about who she had instructions from to go where she went, who she talked to, and every step since the incident.

The HR department rep told her they would look into it, but if it did turn out she lost the right to workers comp, she will be responsible for paying all the medical bills, and she would be terminated from her job because workers comp would not protect her and she would have been a "no-call, no-show" for three weeks.

My cousin said she wanted to talk to her manager, and the HR rep told her not to until after they figure out what to do about her situation.



Is this at all legal? I made sure when talking to the Assistant manager that he told me where to take her for the ER visit, and I was the one who asked him if she was okay on the follow up with that doctor.
No one anywhere on the line of people I talked to said she couldn't be doing this until after the fact;


What needs to happen from here? Any advice or ideas will be of great help

There are new rules in California about seeking treatment within the medical providing network. Your cousin needs to consult a work comp specialist attorney now. I know some firm in central CA but not Northern CA. Here is a link to input her address and find a work comp attorney. They are free consults and may take a % of any PD award she gets no higher than between 9%-15% of that. They are worth it.

https://www.caaa.org/index.cfm?pg=FindaLawyerDirectory

Your cousin should ask for a copy of the company's medical provider network for a list of doctors. Her company is not responsible for taking her to a doctor. She should keep track of the mileage to and from each doctor.

Tell your cousin to stay strong and learn about her rights after a work related injury. Many questions can be answered here.

http://www.dir.ca.gov/dwc/dwc_home_page.htm

 
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