Is this correct regarding worker comp law?

[linux4guru]

What is the name of your state? California

Past: I got injuried back in 1997 and have close my case in 1998 with future medical benifit.

Present: I recentl went thru a microscopic surgery on L4 and L5 back in March of this year 2004. Shortly after my surgery, an adjuster from the insurance company wants to settle my case without waiting for the report from the doctor and I was also told that after the surgery and decided not to settle which they say I can. My benifit will be limited and if my lower back L4 and L5 ever get injure again, they won't be responsible for it.

As far as I know from my case manager, I am told that my doctor have already placed me in the P&S. I won't know until I see the report

Question 1: Will my closed case be reopen as a new one?


Question 2: Is that correct that if I get re-injure my back (same area), they won't be responsible for it?

Question 3: If I am to be on P&S, will I be eligible for re-training and future medical benefits.

Thanks,

linux4guru

 

[Beth3]

You really need to be talking to a worker's comp attorney. The answers to your questions are far too specific to your situation for you to obtain relevant information on a bulletin board.

I can tell you that you shouldn't settle your current medical claim until you reach MMI (maximum medical improvement) and/or consult with an attorney. I'm rather surprised the WC carrier is attempting to do so - although perhaps this has to do with the terms of the compromise agreement reached in 1998.

 

[linux4guru]

I see. I just to see what I can get out of this in the forums. Maybe others like have gone thru this that might help me.

I have gone thru rehab and was already release by the rehab in Campbell, Ca. to continue exercise outside of a professional care.

Every now and then, I get a flare up on my back, but it usually subside after taking a pain medication.

 

[linux4guru]

I know have a report indicating that I am now P&S after surgery.

My case was close back in 1998, I guess after the surgery. It is open again and will I be eligible for re-training which I did not know about when my case was close in 1998. I was not given training then, but will I be able to now???

Thanks,

/linux4guru

 

[v102377]

What is the name of your state? California

Past: I got injuried back in 1997 and have close my case in 1998 with future medical benifit.



Question 1: Will my closed case be reopen as a new one?

**No, if it is the same injury, your old case will be re-opened- they will not open a new claim.

Question 2: Is that correct that if I get re-injure my back (same area), they won't be responsible for it?

**Have you already previously settled your case? There are two forms of settlement options: 1) Compromise and Release-where all you are paid a lump sum for any permanent disability and future medical needs. 2) Stipulation: You are paid bi-weekly for any permanent disability until a pre-determined amount has been paid. Future Medical care will remain open. For your peace of mind, all settlements with Insurance companies must be approved by a Worker's Compensation Judge. Since you don't have an Attorney, they will pay extra attention to your case.

Question 3: If I am to be on P&S, will I be eligible for re-training and future medical benefits.

**Being P&S (permanent and stationary) and being eligible for re-training (QIW) and entitlement to future medical benefits are 3 separate issues. It will all depend on what your doctor states in his final (P&S) report.

 

[linux4guru]

In regards to questions...

1. It is the same case.

2. I have signed stipulative agreement back in 1998.

3. Will this be the doctor that do the operation on me or will it be my primary doctor asgined by worker comp???

Can I ask my doctor for training?

 

[Beth3]

Can you ask your doctor for training? Your doctor has absolutely nothing to do with this. Whether you are eligible for vocational rehabilitation is dependent upon your State's WC regulations and the particulars of your situation.

 

[v102377]

2. I have signed stipulative agreement back in 1998.

A: If you have signed stipulative agreements back in 1998, that means you were previously declared P&S with future medcial. At that time, your doctor should have made a QIW determination to see if you were eligible for vocational rehabilitation. If you were QIW (Qualified Injured Worker-meaning you were not able to go back to your usual & customary occupation), the Insurance company should have made you an offer for VR. if you declined, then you have 5 years from your date of injury to request VR training.
What have you been doing since 1998? Did you go back to work for the same employer?

 

[v102377]

Can you ask your doctor for training? Your doctor has absolutely nothing to do with this. Whether you are eligible for vocational rehabilitation is dependent upon your State's WC regulations and the particulars of your situation.

The doctor has absolutely EVERYTHING to do with this in California!! The doctor, in his permanent and stationary report, must comment on the issue of vocational rehabilitation (AKA:training). He/She is the one who must determine if the claimant is a Qualified Injured Worker (cannot return to their usual and customary occupation).

 

[linux4guru]

The first time around, I was told that I do not need training and was not provided one. I have re-train myself in another career. Maybe this time, I can check with my doctor to see if I can get those vocational training.

 

[v102377]

The first time around, I was told that I do not need training and was not provided one. I have re-train myself in another career. Maybe this time, I can check with my doctor to see if I can get those vocational training.

For clarification, we are talking about the same date of injury, right? Although you have required medical care recently, it is still due to the same injury?

If you have been working in another career, then you may not be entitled to Vocational Rehabilitation. Also, it appears to me you have already past your 5 year statute to request a QIW evaluation. If you settled your case back in 1998- then I assume your injury is prior to '98. The 5 year statute has already passed.

 

[linux4guru]

This is the same injury I received back in 1997.

If it is past the 5 years statute, I am not quailify for the re-vocational training?

But I thought that after surgery, the case is consider open again and there for I can get another QIW?

 

[linux4guru]

I am back...

Are there options that I can consider when I have worker comp called me yesterday wanting to settle my case?





Thanks,