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3 out of 4 major injuries not reported, employer asks me to stop California WC claim
#1
Sad
20 years with the same CA employer, seriously injured (out of work for months each time) on the job 4 times but never WC filed- until this back/concussion injury which I pushed the issue to file. Lower back re-injured from non-reported injury last year, which had healed. 
6 months in WC doc say "no release this year for usual work." 
Both WC doc and chiropractor agree I need to find a different line of work (no more physical) 

Employer wants to settle privately. I don't want to start trouble but WC adjusters have been a nightmare to deal with and deny most referrals- only approved for chiro (50 visits so far) and meds like tramadol and cyclobenzapreine. I would personally rather not get addicted to meds and try alternative therapies but WC won't allow. 
The WC doc tells me lower back is now denied, upper accepted, but lower is obvious and provable. I'm at the mercy of a disorganized IC and doctor and try to be non-confrontational in general but I do feel like I've been taken advantage of bigtime and this looks to be the final curtain with this employer, I doubt I'd be hired back even if medically released. 
I really don't know what I'm eligible for, or how much trouble my employer might get in if I pursue. Any advice is greatly appreciated.
 
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#2
biggest advice is post your state. there is not one set of rules for every claim in the US.
if you are looking to settle then get an atty--one that specializes in your states comp system. most attys are good at focusing on settlement.
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
I did talk with an attorney who said they didn't have to go after the employer.
I would prefer to leave amicably yet while preserving some of my benefits.
Getting a lawyer will put my employer in fight mode is my guess.

My questions remain:
Is it possible to hire an attorney and not go after the employer for not reporting past injuries?
These injuries are related...
I don't know how to talk with my employer about this. He had told me I wasn't covered previously because we were operating tours outside of the country, which I now believe to be false, and has never taken any initiative regarding my health, so I do suspect this loyalty hasn't been a two-way thing.
 
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#4
thankx for modifying your post to include your state.
your guess is correct-employers don,t like to be taken to court.
past injuries are probably outside of the statute of limitations (1 yr) so technically they are out of reach of the law any way.
the first question you need to answer is: do they have comp insurance? the behavior you describe is typical of an employer that is not insured.
you can check on them here:
https://www.caworkcompcoverage.com/
or
http://www.dir.ca.gov/osip/sip.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.
 
Reply
#5
(03-18-2016, 12:00 AM)bumdeal Wrote: Sad
20 years with the same CA employer, seriously injured (out of work for months each time) on the job 4 times but never WC filed- until this back/concussion injury which I pushed the issue to file. Lower back re-injured from non-reported injury last year, which had healed. 
6 months in WC doc say "no release this year for usual work." 
Both WC doc and chiropractor agree I need to find a different line of work (no more physical) 

Employer wants to settle privately. I don't want to start trouble but WC adjusters have been a nightmare to deal with and deny most referrals- only approved for chiro (50 visits so far) and meds like tramadol and cyclobenzapreine. I would personally rather not get addicted to meds and try alternative therapies but WC won't allow. 
The WC doc tells me lower back is now denied, upper accepted, but lower is obvious and provable. I'm at the mercy of a disorganized IC and doctor and try to be non-confrontational in general but I do feel like I've been taken advantage of bigtime and this looks to be the final curtain with this employer, I doubt I'd be hired back even if medically released. 
I really don't know what I'm eligible for, or how much trouble my employer might get in if I pursue. Any advice is greatly appreciated.

Do you have private insurance? Anything denied can be treated through private insurance.

There is an appeal process when you are denied treatments or referrals to specialist for your accepted injuries. You or your doctor needs to appeal them. If he is not well verse in work comp and does not appeal UR denials, you are going to have a difficult time getting treatment.

There is a cap on chiropractor treatments in CA work comp per body part max 24 total for lifetime unless you have surgery. Your claims adjuster can authorize more, but it is rare.

There is also a process for denied body parts and you need to request a panel QME.

I recommend meeting with a few work comp attorney's and hire one. But before that I also recommend to google reviews after their name.
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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