AME report filed still no $$

[520747]

What is the name of your state (only U.S. law)? CA

Hello all! I'm 11 months into my WC claim for cumulative stress/repetitive motion injury; I have only received 6 weeks of TTD $$; PTP signed off on me after 5 visits with literally nothing done & returned me to work @ 100%. Haven't worked or had any benefits since Dec 13th '10.

Went to my AME 4/7/11 - he said surgery needed and put me back at TPD status; ordered an EMG and a surgeons consult. EMG was inconclusive (not an issue); surgeon said I need surgery on both elbows and both hands.

Here's the problem: The AME report got sent out by the 6th week, it is now 10 weeks after my AME and I have not gotten any TTD $$. The paralegal keeps giving me one excuse after another. Isn't the law in CA that TTD benefits have to be paid/reinstated within 14 days of the AME report? So, what valid reason could there be for the delay?

One more thing, after I left the AME exam I called the Attorney and spoke with the paralegal; I told him the AME said surgery and I was TPD, he (para) said good, we can get your retro benefits from Dec 14th brought current. Could the fact that they are looking at getting me retro $$ be the reason my atty is not holding the DA/IC to the 14 day rule?

Thanks!

 

[520747]

Never mind....

My attorney finally admitted the DA/IC is contesting everything...so, they will probably settle to pay the atty for the last 11 months...I and my family get screwed of course -I am unable to pass any pre-hire lifting/physical testing and so, I have to look for work in a minimum wage job...great. Looks like foreclosure on the horizon.

 

[Willlyjo]

My attorney finally admitted the DA/IC is contesting everything...so, they will probably settle to pay the atty for the last 11 months...I and my family get screwed of course -I am unable to pass any pre-hire lifting/physical testing and so, I have to look for work in a minimum wage job...great. Looks like foreclosure on the horizon.

If the IC is contesting the AME report, your attorney files a DOR (Declaration of Readiness to Proceed) citing failure to pay TTD benefits. Although the judge can't order such payments until trial, penalties and interest can be awarded on top of such benefits if it does go to trial.

Also, you have a right to future medical benefits for any permanent disability resulting from your work-related injury. So unless there is an agreed settlement stipulating FMC, you may not want to hastily sign any agreements.

 

[520747]

I'm aware of that...

Thanks, I'm aware of that - it's being done. Doesn't help me take care of my mortgage due in 9 days. The WC court/hearing calendars are pretty full, lucky to get a docket date this year, per my attorney.