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California: Prior injury private treatment / current injury WC
#11
FMLA is not insurance. It's federal law to protect your job when you are not working..otherwise you are replaced.
When you litigate The comp court decides which medical opinion is more reasonable and persuasive. Unreasonable opinions are thrown out.
Carrier only has the medical opinions to go by when making decision.
If you believe the doctors are lying,  take your evidence to the DA.
Sounds like you've already ruled against yourself.
Without medical evidence your claim has no chance; your opinion is not enough.
You can get SDI while off work for non- work injury.
They need medical opinion also.
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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#12
I am going to make a guess going by statements you have written about the doctors you are seeing, the duration they are taking you off of work and the frequency they are making you come into their office. Were you sent to this facility by your claims adjuster and is it a work comp clinic, like ( ),etc? After 30 days you can switch to another doctor within your MPN. This may be a good idea. Ask you claims adjuster for a link to their MPN network and not just a list of places she picks. If you need help with this you can call or go down to your local work comp board and ask to speak with an I&A officer.

These clinics (if you are at one) usually give opinions that benefit the insurance company (not always). Not saying they are all like this, but it may be a good idea to get out of there, to get another opinion if you are at one of these places (unknown).
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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#13
(09-03-2017, 10:48 AM)1171 Wrote: FMLA.......edit......They need medical opinion also.
That definition is consistent with my understanding of FMLA. We cannot all of a sudden take time off or call in sick for weeks and expect to retain our positions. It either has to be a WC case or I have to apply for FMLA.

I don't believe they are lying. I do suspect they scrutinize and are reluctant to acknowledge work related injuries.

When I see them in two weeks I will have to ask them to address the issue of whether they believe this just surfaced on its own or was triggered by the activity at work, then go from there.

Thank you
 
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#14
(09-03-2017, 01:36 PM)California_Help Wrote: I am going to make a guess ....edit......if you are at one of these places (unknown).
That would be correct. It is something like those. Once I know their stance on the injury being an independent flare up or aggravation triggered by work activity and the adjuster's feedback I will probably seek a different doctor/office.

Thank you
 
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#15
it's not WC or FMLA.

if your employment is not covered by FMLA, you can be replaced. if your employment is covered, you are protected for up to 12 weeks while you are out on comp then you can be replaced.
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
#16
(09-03-2017, 02:44 PM)ooWCQoo Wrote:
(09-03-2017, 01:36 PM)California_Help Wrote: I am going to make a guess ....edit......if you are at one of these places (unknown).
That would be correct. It is something like those. Once I know their stance on the injury being an independent flare up or aggravation triggered by work activity and the adjuster's feedback I will probably seek a different doctor/office.

Thank you

Yes, having you come in every 2 weeks was a dead giveaway. Most doctors have their patients return every 4-6 weeks, depending upon the injury.

If you have a prescription for physical therapy you may also be able to go to another facility for PT (if you want to).
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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