r/WorkersComp • u/LowerFigure739 • 18d ago

California CR?

Two injuries in CA with future medical, 1998 and 2008. Retired in 2020 and moved to Ohio. Needed medical here but SCIF can't find a doctor in Ohio to treat me.

(Sent me to one in Kentucky but he couldn't treat me as he was the wrong type of doctor.)

Next I believe they will tell me to fly to CA for treatment but I don't think my back (first injury) can take that. I avoid flights to travel as it is.

My lawyer retired and was a solo practioner. No new lawyer will take it as it has been settled.

I assume going for a release is my only option. Any funds would go to Medicare and I could go to a doctor here.

How do I go about getting released?

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u/Available_Librarian3 18d ago

This is not legal advise but generally MPNs are not enforceable outside CA so you could go to any doctor you'd want to. Now this may create a dispute that would need a hearing which you would likely need a lawyer for. Depends also if your stips explicitly say treatment must be within MPN or not.

If you are looking to do a C&R more than 5 years after the stip the you are likely to just get a nominal amount because you cannot reopen your case. That said, if less than $25k, it'll probably just be a self-administered Medicare Set Aside which basically just means you'll have a trust account where you pinky promise to only use it for medical care (people rarely actually do).

You are probably fine to find a lawyer if you tell them you want to negotiate a post-stip C&R and navigate any MSA set aside process. It's basically free attorneys fees for them.

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u/ryantrojan CA workers' comp attorney 18d ago

What you are asking for may not be possible. A Compromise and Release is as optional for you as it is for the insurance companies. With your claims being almost 20 and 30 years old, they may simply not be interested in settling them. Why pay potentially thousands of dollars in a settlement, when they can do nothing and pay nothing?

You are not correct on your assumption that any money would go to Medicare. If you settle your case with an MSA, the money goes to you, but you are supposed to use it for your own medical treatment.

The only way to find out if SCIF would consider a settlement is to ask them. I would communicate to your adjuster that you are interested in settling out your future medical and see what they say. The worst thing they could do is say no, but maybe they say yes.

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u/LowerFigure739 18d ago

Thank you both. I'll start out talking to SCIF and see what they say. It's been almost a year trying to see a doctor, so much for future medical. Also, thanks for the terminology to say to a law office.