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Release to work with restrictions but no job to return to
#1
The physician return to work voucher says I can return to work with restrictions. No sitting, standing or in one position for more than one hour. No lifting above the waste or bending.

If i dont have a job to return to, would that be considered ttd? If it does, does the 14 notice apply?

My claim is accepted for medical. Actually they have accepted all doctors reports and dates for ttd. They decide they won’t pay because I was terminated.

Ive been told that termination has nothing to do with workers compensation. Do I have to wait until the next hearing to make a decision? What’s the next step if the judge decides he doesn’t want to accept this report? The next hearing is msc and we are still disputing ttd benefits so will he postpone again if there is no agreement with the IC?
 
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#2
(11-20-2018, 09:45 PM)Lostandconfused Wrote: The physician return to work voucher says I can return to work with restrictions. No sitting, standing or in one position for more than one hour. No lifting above the waste or bending.

If i dont have a job to return to, would that be considered ttd? If it does, does the 14 notice apply?

My claim is accepted for medical. Actually they have accepted all doctors reports and dates for ttd. They decide they won’t pay because I was terminated.

Ive been told that termination has nothing to do with workers compensation. Do I have to wait until the next hearing to make a decision? What’s the next step if the judge decides he doesn’t want to accept this report? The next hearing is msc and we are still disputing ttd benefits so will he postpone again if there is no agreement with the IC?

I don't know if I understand your question. Did you receive a notice that you qualify for a voucher from your claims adjuster or did your doctor release you back to work?
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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#3
(11-23-2018, 10:58 PM)California_Help Wrote:
(11-20-2018, 09:45 PM)Lostandconfused Wrote: The physician return to work voucher says I can return to work with restrictions. No sitting, standing or in one position for more than one hour. No lifting above the waste or bending.

If i dont have a job to return to, would that be considered ttd? If it does, does the 14 notice apply?

My claim is accepted for medical. Actually they have accepted all doctors reports and dates for ttd. They decide they won’t pay because I was terminated.

Ive been told that termination has nothing to do with workers compensation. Do I have to wait until the next hearing to make a decision? What’s the next step if the judge decides he doesn’t want to accept this report? The next hearing is msc and we are still disputing ttd benefits so will he postpone again if there is no agreement with the IC?



I don't know if I understand your question. Did you receive a notice that you qualify for a voucher from your claims adjuster or did your doctor release you back to work?

I’m not sure, their attorney gave me a copy. On the top of the page, it says physicians return to work and voucher report.

Below it, it just gave the work restrictions and says I can return to work. I’m not sure if he knows I don’t have a job but I don’t have a job to return to. I don’t think that they would have something available even if I was still employed there. No sitting, standing, reaching, or bending more than one hour.

The full report will be available next week. I think the qme fax the IC this report. I told the qme that the assistant chief of claims said if I can get him to fax the work status then they will process it so I don’t have to see the judge.

This was before the adjuster sent the ttd denial letter. I’m sure the letter was to buy some time. I’m just gonna go and file a complaint on everyone. The way I see it, ttd benefits should be retro to the date of injury minus the waiting period and the amount of sdi benefits I received up until August. If they choose not to pay sdi then it will just add 52 weeks for ttd. I guess the IC is the lesser of two evil and I do not want to be on sdi.

I Think I’ll be staying in the worker’s compensation world for a little while longer. I’ll start my search for an attorney once I get the report.
 
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#4
This site should have a lot of the info you need. You can place search topics in the search engine.

https://www.dir.ca.gov/dwc/

I am not sure what you received from that attorney, but you can show it to an I&A officer.

I want you to when you have time look at these two links in case this is saying this is notice for a SJDB voucher?

https://www.dir.ca.gov/dwc/sjdb.html

If this is the case you can use that for school and there is info available in the link. If you qualify for the SJDB then you may also qualify for a one time payment of $5,000 called RTWSP. This is the link on how to apply for it online or you can apply at a kiosk at a work comp board district office.

https://www.dir.ca.gov/RTWSP/RTWSP.html

I am not sure if this is the notice you received. Hopefully there is more info in the letter if it is a SJDV.

Your situation is complex and the insurance carrier is disputing TTD due to termination. From what I read if the judge sides with them they may not have to pay you TTD. I hope he sides with you and you receive it.

I do know you cannot receive benefits from different entities for the same period of disability as wage replacement, and it sounds like you are aware of this. If you are awarded TTD from the judge it is unknown to me how that would work with state disability. The question I would ask EDD is if they are paid back and you are not able to work due to disability past the time period you were paid state disability, can you then request an additional year of state disability. The only reason why I mention this is I came across an injured worker who was in a similar situation as you with denied claim. She settled her work comp case and the carrier paid back EDD as written in her settlement. She then went back and requested an additional year of state disability. It was denied due to paperwork error and she is taking the issue to EDD judge. That is how she explained it to me, but I have not read anything about this. So I hope I am not giving you wrong info.

If your QME returned you to work with restrictions and you are no longer working at that employer, the next step is to try and find employment. If you were still employed at your job the next step would be to contact them and ask them if they can accommodate your return to work with restrictions. Your situation is different with the termination. I am also confused as I was under the impression the judge ordered a new QME to evaluate you and this exam has not taken place yet correct? Your former QME retired, was this notice from a supplemental report he wrote? It is very difficult for me to try and answer you with not knowing your case or reading the letter you received. Due to this, and that I am not an expert I would recommend driving this notice down to the WCAB and talk with an I&A officer. This stuff could be important as it may involve benefits you are entitled to (unknown). I am crossing my fingers it is notice for the voucher, so that you can apply for the second benefit above. I am not sure that is what it is.

You can also take that letter to your doctor. He can review it and explain what the restrictions are. For example sitting at an hour at a time may mean take a 5 min break or stand and then sit down again, or does it state can only sit one hour per day. The wording in the restrictions is important for you to know and understand especially if it is to return you to work. Are you feeling like you can do a job with the restrictions listed? Studies have shown the longer the injured worker stays out of work the higher the chance of permanent disability status (they never return to work). This is why doctors try and return patients to work, and it may be to see if they are able to work. It is good to attempt it is what I am trying to convey. It is usually healthier to be working, even in some pain that is bearable than to be out of the job market too long.

Crossing my fingers for you with finding an attorney.
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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#5
(11-24-2018, 06:00 PM)California_Help Wrote: This site should have a lot of the info you need. You can place search topics in the search engine.

https://www.dir.ca.gov/dwc/

I am not sure what you received from that attorney, but you can show it to an I&A officer.

I want you to when you have time look at these two links in case this is saying this is notice for a SJDB voucher?

https://www.dir.ca.gov/dwc/sjdb.html

If this is the case you can use that for school and there is info available in the link. If you qualify for the SJDB then you may also qualify for a one time payment of $5,000 called RTWSP. This is the link on how to apply for it online or you can apply at a kiosk at a work comp board district office.

https://www.dir.ca.gov/RTWSP/RTWSP.html

I am not sure if this is the notice you received. Hopefully there is more info in the letter if it is a SJDV.

Your situation is complex and the insurance carrier is disputing TTD due to termination. From what I read if the judge sides with them they may not have to pay you TTD. I hope he sides with you and you receive it.

I do know you cannot receive benefits from different entities for the same period of disability as wage replacement, and it sounds like you are aware of this. If you are awarded TTD from the judge it is unknown to me how that would work with state disability. The question I would ask EDD is if they are paid back and you are not able to work due to disability past the time period you were paid state disability, can you then request an additional year of state disability. The only reason why I mention this is I came across an injured worker who was in a similar situation as you with denied claim. She settled her work comp case and the carrier paid back EDD as written in her settlement. She then went back and requested an additional year of state disability. It was denied due to paperwork error and she is taking the issue to EDD judge. That is how she explained it to me, but I have not read anything about this. So I hope I am not giving you wrong info.

If your QME returned you to work with restrictions and you are no longer working at that employer, the next step is to try and find employment. If you were still employed at your job the next step would be to contact them and ask them if they can accommodate your return to work with restrictions. Your situation is different with the termination. I am also confused as I was under the impression the judge ordered a new QME to evaluate you and this exam has not taken place yet correct? Your former QME retired, was this notice from a supplemental report he wrote? It is very difficult for me to try and answer you with not knowing your case or reading the letter you received. Due to this, and that I am not an expert I would recommend driving this notice down to the WCAB and talk with an I&A officer. This stuff could be important as it may involve benefits you are entitled to (unknown). I am crossing my fingers it is notice for the voucher, so that you can apply for the second benefit above. I am not sure that is what it is.

You can also take that letter to your doctor. He can review it and explain what the restrictions are. For example sitting at an hour at a time may mean take a 5 min break or stand and then sit down again, or does it state can only sit one hour per day. The wording in the restrictions is important for you to know and understand especially if it is to return you to work. Are you feeling like you can do a job with the restrictions listed? Studies have shown the longer the injured worker stays out of work the higher the chance of permanent disability status (they never return to work). This is why doctors try and return patients to work, and it may be to see if they are able to work. It is good to attempt it is what I am trying to convey. It is usually healthier to be working, even in some pain that is bearable than to be out of the job market too long.

Crossing my fingers for you with finding an attorney.

It’s a different form.

https://www.dir.ca.gov/dwc/DWCPropRegs/S...133.36.pdf

They judge said that I don’t receive ttd benefits because the first qme had me at mmi. I told him that if the IC wants to use that report then I’m owed ttd for the periods before mmi. I didn’t receive sdi until after the qme supplemental report. I know it’s a bit odd to receive sdi after the mmi date but the supplemental report was submitted almost 9-10 months after the evaluation date. The I&A officer told me that judges rarely agree to the qme’s mmi date if he submitted his report that late and would use the date he sent the supplemental report. The judge didn’t hesitate to tell me no and the I&A officer is wrong. They have never done that before.

When I was arguing the ttd benefits for the gap that I did not receive any income, the judge argued that I can only get that if I settled. I told him I don’t want to settle because my qme appointment was the following week. Then he told me I’m not entitled to benefits because my claim was denied. Then the IC’s attorney blurted out that my claim is an accepted claim. He still didn’t want to award any benefits with these facts and suggested if I want to receive any benefits then I should take their offer. After I declined, he said to wait for the new qme report. He also told me that me being terminated has nothing to do with workers comp and ttd is a medical issue. Their attorney agreed also.

After the hearing, the IC made every attempt they could to try and get a favorable report. Even after falsifying dates and writing an advocacy letter to the qme they are not happy. I’m sure they already contacted him to get answers regarding the return to work restrictions. The reason I believe this is because cell phones these days have very loud speakers.

The odds are definitely stacked against me. I’m up against an IC that has billions in assets and now they have a judge that will approve the non-medical records whether I object or not. Even with all of this, I’m still confident and don’t mind trial. The problem they face with trial is that they involved too many people in order to manipulate the system.

I can’t guarantee that this qme report will be in my favor because the last qme also said similar things and he somehow changed his mind after he requested mri. I just need a doctor who isn’t afraid of the IC’s threat then I’ll be able to get the necessary treatments.

I think this is the only forum that truly gives honest feedbacks. I know I personally gain strength from the information this site provides. Whereas others just try and paint me as a fraud. I only wish the search previous answers was easier. It’s hard to find previous posts or answers.

Thanks
 
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#6
If the form you received the form from the link you provided above above,it is the benefit from the first link I provided.

It is common for doctors to change their mind after a diagnostic test like an MRI. The insurance carrier has to copy you when they converse with the QME and they must converse with him in writing. Both the insurance company and you can send records and a cover letter to the QME, however there are rules what can be sent and when they can be sent. The insurance company can call the QME's office for setting an appointment or billing questions, but they are not allowed to call the QME and talk to him directly about his report.

While this site does contain a lot of helpful info, the link to the DWC site has current up to date info with more detailed explanation with codes etc and you should be able to search topics in the search engine. I would recommend that site for complex questions and not an injured worker forum, but that is up to you. Forums are good for support and basic guidance. There are no experts here.

Take care.
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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#7
Sorry I could not edit my last response. I consider user 1171 an expert. I am not though.
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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#8
(11-25-2018, 05:11 PM)California_Help Wrote: Sorry I could not edit my last response. I consider user 1171 an expert. I am not though.

I realize that there’s more than meets the eye with workers compensation. The more I think I know, the less I do. Sometimes it’s probably better to just walk away.

It’s been rough trying to fight this claim with zero income the last three months. Unless there is a miracle this week, I won’t even have access to research the internet for help.

Thanks
 
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#9
Well if the form you received is the one from the link you provided you can take it down to a district work comp board and apply for the second benefit, which is a check for 5 grand from RTWSP.

Best 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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#10
This is very important. Is this the form you received?

https://www.dir.ca.gov/dwc/DWCPropRegs/S...133.36.pdf

If it is I can try to walk you through the process on applying for the second benefit OR an I&A officer can help 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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