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06-07-2019, 09:35 PM
Happy Friday All! CA IW
I've been declared P&S w/future treatments by AME as of 2/4/19, receiving PPD benefits.
I continue to see my PTP and as of 6/3/19, new restrictions, due to reinjury.
I submitted my new restrictions to Employer, who will not accept as they do not apply to my current case since I was declared P&S. Please confirm.
* I apologize if duplicate question * I thought everything was ok w/Employer *
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Contact edd for sdi benefits for your new injury.
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(06-07-2019, 09:35 PM)Proud2bme Wrote: Happy Friday All! CA IW
I've been declared P&S w/future treatments by AME as of 2/4/19, receiving PPD benefits.
I continue to see my PTP and as of 6/3/19, new restrictions, due to reinjury.
I submitted my new restrictions to Employer, who will not accept as they do not apply to my current case since I was declared P&S. Please confirm.
* I apologize if duplicate question * I thought everything was ok w/Employer *
Posts: 16
Threads: 3
Joined: May 2019
No SDI - not an option.
Am I not able to submit new restrictions on current claim? If not, please explain.
Posts: 16
Threads: 3
Joined: May 2019
No SDI - not an option.
Am I not able to submit new restrictions on current claim? If not, please explain.
Posts: 10,690
Threads: 90
Joined: Apr 2007
The new restrictions are relevant to the new injury and would not apply to the prior work injury unless or until the court determined they were related.
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CA IW - Still confused. Simple and easy to understand for others, but not me.
Let me rephrase the question - I think this belongs in a different forum.
P&S per AME Report with recommendations of further treatment. Able to RTW w/restrictions. Employer denied. Case has not settled.
My PTP recommends surgery due to pain getting worse, Surgery has been approved by IC.
Will I continue to receive PPD or do benefits revert back to TTD benefits while recovering?
From what I gather:
Anytime restrictions change, they have to be determined if case related to existing, by the court? Why? Because declared P&S prior to change?
Thank you for your patience.
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You will no longer be at MMI or P&S once there is surgery; TTD will restart if you haven’t exceeded the 104 week limit.
You stated there was a reinjury; i assume this is not a work injury.
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P.S. i’m a bit confused by carrier allowing surgery so soon after Permanent & Stationary determination.
Looks like they disagree with the AME.
I hope you are keeping n contact with your atty.
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(06-09-2019, 12:17 AM)1171 Wrote: P.S. i’m a bit confused by carrier allowing surgery so soon after Permanent & Stationary determination.
Looks like they disagree with the AME.
I hope you are keeping n contact with your atty.
Me too. How can they use P&S as a means to stop TTD when surgery is approved? Was AME not aware PTP was requesting surgery or did not comment on need for surgery? Also, still confused if they allowed IW to RTW with restrictions from AME and IW refused due to new restriction from PTP?
Was surgery approved by insurance carrier in writing? Asking just in case it is being done on a lien without IW knowledge (have seen it in the past but not so much now).
It looks like the re-injury may not have been accepted by IC (unknown). Did it happen at work? 1171 if re-injury happened at home is this generally covered or disputed by carriers? I am curious myself.
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.
