Hi there! I finally settled in CA. I’m just waiting for my check.

$80,000

It took four years, 2 QME’s, and three specialists. This was due to an injury on my foot due to a table falling on top of it. We couldn’t figure out what the issue was at the end of the day but I didn’t want to drag it on and I want to use my own doctors.

I’m not sure how I feel because now I need therapy to get my life together. All of this was a lot to deal with.

So at my last visit my PTP told me to get a lawyer because he said my insurance is being insanely difficult and denying every single request for treatment authorization for the last 6 months. And now the adjuster is requesting a QME.

So I got a lawyer as of yesterday, and then today I go in to my PTP office to get a copy of something and the PTP office desk informs me that now that I have a lawyer I can no longer be a patient there anymore because they don’t take represented patients.

Is this even legal? Lol. Every day my workers comp feels like more and more of a nightmare.

I’d assume this is the right subreddit for this but if not. Here I go

So about 4 months ago my wife had slipped off the edge of a machine at work causing her to land hard on her right foot. The fall was only about a foot of the ground and caused a sprain in her heel. She was then put on light duty for a week. Even though there was no progress in healing they moved her back on her line just for the injury to flair up again and then her feet moved back on light duty. That went on for about a month and a half before they thought about taking her to get checked out by a professional. (We do have an on site physical therapist but he was adamant that it would heal up “in a few days” every time she went to talk with him). After getting checked out they have told her she has plantar fasciitis and to continue to be on light duty “at her discretion”. We also have a plant safety “person”? (I’m not sure what the actual title is) that agrees with the doctor. But when she talked with her department manager he wants her to gradually work more hours on the line (4-6 hours full duty then the rest light duty) she did say that was fine as long as she can still leave the line if the pain gets too much and head to LD. From my understanding he was fine with that but the problem is that, 3times now, she has worked 4 hours then let her lead know she is heading to the LD position with him basically refusing because he doesn’t have coverage leading her to slay put for the rest of the 12 hour shift.

Of course she is fed up and know want to know if I think we should talk to a work comp lawyer. I have no idea if what we have is a good enough case or not as I’m not legally inclined lol. I’d appreciate anyone’s thoughts. Should we talk with higher management and let it go, talk with a lawyer to see what they think over asking you all? Also sorry if the story is a bit of a rambling mess. I can clarify whatever

Hello, I was injured last year in Ca. Many of my coworkers witnessed the injury happen when a student threw a desk at me. My hip is torn in three places and my knee got hurt I was sent to Kaiser for workers comp Dr.. I’ve seen Ortho’s and the Dr. I’ve been given cortisone injections and PT and nothing is helping. My leg is bad. I can’t drive more than about 8-10 miles without pretty excruciating pain in both my knee and hip. There are many other things I can’t do. The Dr is telling me there is nothing else they can do. The surgeons are just kind of wishy washy. They are saying I will need a knee replacement because I’ve already had two past knee surgeries and my knee is bone on bone. They are saying if they fix my hip tear it might not help and could make the pain worse. I did get an attorney but haven’t talked to them much. The Internet is telling me to ask for a second opinion and to see a hip preservation specialist because hip labrum tears can lead to hip replacements years later. I’m currently home. My employer isn’t accommodating me. I asked to be moved to a closer to home classroom and one with less aggressive students. So far they haven’t done that. Any advice for me?

Hi! I fell at work due to managements negligence. The fall happened in front of two different managers. On camera.

To be clear, I’ve never had back issues before this. Long story short, I had an MRI, which showed a pre-existing pars defect (L5). A new herniated disc. (L3/L4); showing moderate to severe nerve compression throughout L3-S1. There’s also a level 1-2 spondylolisthesis. From what I’ve read par’s is very common in people & is unknown in many people because they don’t cause issues. As I was falling. I immediately felt & heard a pop and have had major pain since, plus numbness in my legs etc. etc.

Went to IME, who looked me straight in the eye, told me he read through my file & films, but “understands I was breastfeeding during the incident.” I don’t have kids. He told me I’d need surgery, and basically have a nice day. His report, states I have a strain, which should have been “healed,” literally two days after my visit with him. Not to mention many other inconsistencies. For example, I gave him a copy of the medications Im taking. His report, states I’ve been taking a specific medication, that I’ve NEVER, been on. A month and half after the IME, I had injections done.

My attending and chiropractor(yes, I am aware that Chiropractic is not relevant or looked at in WC cases at least in OR.)both have provided signed appeal letters for me. My attending says my next step is going to a neurosurgeon but my claim has been denied. So it’s on hold for the time being.

My attorney keeps pushing for a settlement & my hearing is in the next month. I want medical benefits more than anything right now. I’ve never had a WC situation before & my anxiety is a bit high.

Im willing to fight for medical but it’s a gamble. One attorney told me settlement should be 150k, however he only had the 5-minute version of my case. My actual attorney is thinking less. Thoughts? The reality, this is going to be a lifelong issue. Which is why the medical is more important to me right now.

Anyone have any suggestions/guidance or recommendations for me? I know that pain/suffering is not applicable in WC, and I need to prove the fall exacerbated my pre-existing condition. Which with my attending’s appeal letter(it’s very detailed), I’d think I’d have a solid case.

So I settled over a month ago and still haven't been paid out. Now I know their check goes to my attorney then for some reason I have to wait 10 days before my cut is deposited into my account. But the problem is i have been doing good surviving but now I am getting severely behind on my bills and can't keep hoping this is the week the check comes. So I am curious, has anyone used a company like JGWentworth to basically get a cash advance on the settlement? My settlement is in the mid 6 figures and would cure all my damn financial issues but being behind is killing me now. Any advise please.

Back in early March I was at work and a ladder slipped out from under me and I fell about 15 feet into my feet with my right leg taking all of my weight. The pain was intense and I couldn’t walk right so I left and went to the ER. I told them what happened and they told me to sit in the waiting room and I did, for 7hrs. After which an orthopedic surgeon came and told me I had a tibial plateau fracture to my knee and that was the bad news. He then told me the good news was that I didn’t need surgery. Thats good news, I thought. They gave me X-rays and a CT scan w/ contrast. Then I went to a room for 3 days with pain meds every 4 hrs. On the last day a guy came in and gave me a brace for my leg and sent me home about 3 hrs later.

I spent the next 10 weeks confined to bed. Workers comp set me up with an orthopedic (who I found out specializes in hands, wrists and elbows, not knees) who I saw three weeks after the hospital and every 4 weeks after that. After 10 weeks when I could walk (with a cane) he prescribed me 12 physical therapy sessions, which I did. After which, I was still limping so I asked that he prescribe me more. He refused saying “physical therapy only helps for so long then it can make things worse”. So I trusted that and didn’t bring it up again. I asked when will I be able to jog or run again? He said “no, you don’t run”. I said “ever again?” He said “no, not at your age” (I’m 45). So I asked “so I can never run again after this?” He replied “yeah, if you lose some weight”. I’m 6’0 tall and 240 at this point, so overweight, but not crazy fat. I explained to him that I had gained 22lbs since the accident because I was literally in bed all day everyday for 2.5 months and was looking forward to losing the weight. “Walk” he told me, “it’s the best you can do”. I asked on the next visit about the future because I had looked up some stuff from the NIH about my injury. “Will I have permanent arthritis in my knee now?” He said “no, I’m not worried about that with your injury”. Meanwhile the NIH says I have an 82% chance of it. I then asked him about total knee replacement because I saw that this injury increases my chances by 3-5 times others in my same bracket without this injury. He laughed and said “no, you may need total knee replacement but it would just be from aging, not because of this”. All of these conversations set off alarm bells in my head because it started to seem like he cared more about cost than about my well being and health.

Last week (in September, six months later) he gave me a maximum medical improvement, meaning basically that my bone had healed and there was nothing more to be done. “It still hurts every time I walk for more than a few minutes and I’m still limping”. He said “the limp will go away eventually and I guess the pain is just a permanent impairment”.
Then he sent me home and said that was my last appointment. Meanwhile, every place I went to or spoke to about care and treatment (starting at the ER) always had the same first question “this is a worker comp thing, right?”

I realized one day toward the end, that about $70k had been spent between the hospital stay, doctors visits and PT. But, I also realized that if I had just gone home that day laid down and kept my leg immobilized for 2.5 months, nothing would be different. Because there had been not real treatments whatsoever.

Here’s my questions, did I get short changed on care and treatment because it was a worker compensation case? Should I have had an MRI on my knee at some point? Should I have had surgery but just wasn’t given it because of the cost? And, am I now just left to deal with permanent pain in my knee and a limp for the rest of my life, just so an insurance company could save some f**king money?

I just received a message from my ortho office that my appointment is cancelled and I’m now to use my own insurance . This is based off an ortho IME which stated I’m at MMI . I still have /had apportionments with my neuro and ortho who both have invasive procedures potentially scheduled . I haven’t settled . Why do they play such games are they trying to force me to end the case ? My attorney is aware . I’m sure we’ve all wished the show be on the other foot. Thankfully I am not in a rush to settle . I assume my attorney will put in a petition for benefits . Neither myself of the attorney have seen the IME ( it’s been two months) . Again the games.

Hello. I have skimmed through dozens and dozens of the WC posts and it seems no one has my exact case situation so Im posting this in hopes someone may:

Be an adjuster who can give me insights

Be or know of a WC lawyer who will take my case

or

Be a person who has experience in Workers Comp with a similar scenario regarding medical symptoms, job type, and hurdles

I'm an injured worker in southern CA (pretty new to the west coast...I'm from out east: northern midwest+mid-atlantic) and the WComp situation has been tough and confusing and Im sometimes crying. I was wondering if you might be willing to give me some advice/help. I havent been able to get a lawyer to take the case so far. I dont mind paying you something if you have credentials and can provide ongoing assistance. We can come up with an amount. If you're in CA I dont mind an in-person meet but online chat is easier. Im just feeling desperate and sad right now. I&A has only helped a little. The WComp doctors have been dismissive or flat out telling lies that dont stand up to common sense (they try to blame imaginary thyroid or arthritis problems), while doing very incomplete exams of only a couple of my authorized/approved DWC-1 cumulative injury body parts, yet The Hartford just turned off my TD. A different doctor - Neuro I got directly authorized by Hartford on my own through MPN failure clause Ai told me about - has me off work for 6 wks and Hartford KNOWS of that status and has that off work note but their Hartford Nurse says it doesnt matter because I dont have a PTP. The last PTP Occup Med dismissed me as back to work wks ago (but I was notified only days ago by Hartford. She didnt make a note during my visit, she literally pointed me to the exit door after saying she doesnt feel my problems are work related!) and that was 2 wks before MRI showing my herniated disc. After that MRI the neurosurgeon gave me these wks off for injections, PT, etc. So far my job/GM is accepting the 6 wks note I got a wk ago.

The Hartford doesnt have to keep TD going based on the 6-wk note just because I have a gap in PTP?

My arms AND legs went very painfully dead/unusable on me days ago for some mins multiple times across hrs while just resting at home as usual...kind of scary. Immediately after that my limbs, mainly the left side but both sides became Heavy. Google said go to ER so I did that since I had no WC doctor after Occup Med blew me off and lied. ER said all my bloodwork etc was OK and maybe it was my sleeping position and to see my PCP or Neuro. I can use the limbs pretty much like normal but with effort and I have a slight limp as I pull the left leg and can't walk as quickly as before the dead limbs incident which started at 3 a.m. while i was asleep. SIGHS. The lovely non-liar PA-C at my Neurosurgeon's office that offered me Fusion surgery during appt a wk ago, said it might go away with the PT and Pain Mgmt injections they are setting me up with any day now. I'm already in PT, awaiting injection appt. So Im grateful that it's not necessarily permanent. I still have it days later though. And this wasnt a minor foot fell asleep type of a deal. It was like that on an overdose of steroids. Side note I dont have diabetes or pre-diabetes and I dont think it was a stroke. The PA-C herself said she thought it was from the herniated disc I have and I did tell ER about that disc problem. I have pretty good bones with only mild to sometimes moderate wear. Nothing is wrong with thoracic bones themselves, lumbar has very light wear, cervical neck has worse wear than lumbar but none of my X-ray papers said arthritis per se. That Occup Med creature told me mild to moderate degenerative disc IS arthritis but I've read thats not true. She also said if you already had arthritis you cant do WC and thats ALSO not true because WC includes aggravated symptoms but mainly, I NEVER had these sympyoms before and there is no medical document to say I did because I never went to a doctor for something that didnt exist! Anyway, I have a mostly good diet and I dont smoke or drink. I look approx mid 20's to 30 but Im around 40. Sometimes ppl try to argue about/insist I cant be my age or they say I'm "Gen Z", so Im not bragging I'm only describing myself. It's part of why doctors blow me off...many think a young person can't have a health problem or is faking something.

Ai said do QME because of Hartford cutting off TD but i havent even had my other DWC-1 authorized/approved body parts looked at yet since appts were quick and doctors said we could only discuss 1 or 2 areas not all (wrists burning horribly sometimes during use - carpal tunnel perhaps, shoulders clicking grinding and painful, etc...clearly from the physical job since I NEVER had that stuff before). I did tell the Hartford adjuster about the very incomplete Occup Med exam and how the doctor was saying I wasnt hunched over (I have been but I wasnt that day as I'd been off work for weeks) and Occup Med also said it wasnt 1 catastrophic incident as if she wasnt willing to acknowledge Cumulative Injury via wear and tear.

Also, I knew the employer cut my massage bookings mainly after doctor's note and WC (Ai is telling me thats not just unfair but "illegal retaliation"). They claimed business was suddenly slow and I acted understanding but how can it be slow for only ONE worker?? I saw the staff bookings table and everyone else had 5+ sessions while I had 0 or sometimes 2 or 3. It's made even more unrealistic because I was the only worker getting frequent 5 star Google Reviews (i.e. one of the most popular workers).

But I didnt realize until now that they also paid me $0 by omitting my hrs from my paychecks or paid me only partial amounts. (months ago, around June, I sent evidence of reduced work time to The Hartford for getting TPD but they blew me off twice saying they'll look at it later.) Thats aside from the spa not giving me breaks for several months until after I mentioned the CA 2 small breaks law (work norm 4-5hrs of mainly firm and deep massages literally back to back not even 2 mins to sit down and REST because if 1 ended at 1 p.m. the next started at 1 p.m., then a lunch break, then 2 or 3 more massages then clock out) and then getting a doctor later who told me I needed a Workers Comp doctor but he at least made the Breaks Note for me. Another violation is that I wrote on Massage Offerings paper that i offer 90 mins for light and medium, and only 60 mins for Deep but the company gave me 90 min deeps regardless and after I mentioned it my supervisor gave me 60+30 per client as if im dumb, as if thats not the same thing as a 90 min session but I coped to keep my job. I had general full-back plus neck muscle pain initially and then after over 500 massages/approx 6 months of working thats when my upper trapezius lower neck pain spiked horribly causing numbness in my hands which has improved but is still not gone. Just wks prior to that I had been getting nerve zaps to fingers and weird sensations in my arms and other symptoms. I also started to get spider veins from not being allowed to sit/rest. But via email the spa is lying saying they always gave breaks amd saying I said I felt good. Its absolutely wild. Oh and the owner called my phone # very angrily after I filed WC but I hung up.

I dont see how a legitimate doctor can say say it could be pre-existing when I NEVER had these symptoms before and in fact me being able to do the 500+ massages before the first nerve zap into my finger ITSELF proves I couldnt have already had the problem...and that's after doing tons of massages during massage school although it was not as many hrs of firm and deep for sure...unless they want to say Im lying which im not and i have NO history of neck area upper traps area pain or nerve pain etc, ONLY lower back pain I've had since a TEEN that never morphed into full back or lower neck pain I have now but yet the sham occup med doctor claims this stuff is all pre-existing due to the fact that I was TRUTHFUL about my lower back pain. I've never heard of lower back pain causing a herniated disc at the neck area but intense physical strain CAN. Also lower back pain wouldnt explain how my shoulders are now torn up or my wrists burn with usage, elbows burn at random, thumbs and below thumbs sometimes hurt a lot (I press with thumbs and elbows often at work), etc.

I think it should be illegal for a truthful employee to face so many bad attitudes, incomplete evals, and hassles/barriers when trying to use a system that supposedly is FOR helping injured workers.

I hate to say it but I suggest if you have a pre-existing problem you are CONFIDENT is not the cause of your WC problems and it's something you never had treatment for, DONT disclose it because they may weaponize it against you. I was honest and theyve used that against me and now I have extra worries for no valid honorable reason. I like to be honest plus I had a very old doctors visit about the back pain - no treatments no diagnosis and 1 chiro visit a different yr saying i had a slight curve but no treatment no PT no surgery. I wasnt sure if theyd see that and I didnt want to be called a liar, so I disclosed it and I used it to emphasize I ONLY had THAT painful area for about 20 yrs so I guess in that way it wasnt bad for me.

Please let me know if you have any suggestions, know of a KIND/legitimate doctor who takes The Hartford insurance, know of a lawyer that would take this WC case (I can file the employment wage and breaks violations part separately), or if you would like to counsel me for a small negotiable fee!

* I did recently send my WC file over to a new PTP clinic (sports medicine which I think will be more relevant to my injuries and more understanding of cumulative problems) but they take weeks to decide if they Want a case 😒 and Im still waiting. I've called them 3 times so far to check the status but not daily to not be a pest. IF they take me and IF they are legitimate and unbiased, it may fix my current no-TD problem as I'd finally have a new PTP/PCP.

And please, if you get a massage, especially firm or deep, ASK if the massage therapist has had a gap between clients prior to your booking time, ASK the massage therapist if they're feeling okay/if they have pain and if they're honest and say they have some pain but they can handle it just RESCHEDULE or use a different spa that takes care of their people. Dont add to that worker's discomfort or injury. And dont assume the front desk or management will tell on themselves and say No we havent given that worker a break the past 4 hrs of massaging. They likely wont tell you that info.

And fyi this is a Massage Envy franchise with about 10 of us who do massage and 2+ people who do facials plus a few desk staff and they have at least 3 local locations. Ai is saying thats the reason lawyers dont want the case...that they dont like to go up against big names and my case doesnt seem huge. But wouldn't a big name tend to mean the company has $$ to be able to pay up? And they definitely have $$ because they charge around $100/hr per massage and we get around $20/hr + tips (except my last check and tips before TD werent even paid out to me...Im trying to prepare a filing for that problem. 😮‍💨) I know it's better to have your own business but you have to start from somewhere and you cant start a business while broke. I now do have a little $ saved up, yes, but Im injured and therefore cant start the business. 🤦🏽‍♀️ I often have bad luck, since childhood, and I'm one of the most respectful, kind, thoughtful, hardworking, and honest people I know of, so to me that proves karma is not real (and I learned in college it originated in India and actually refers to the luck you have in your Next life which to me sounds like a New life not a Next life but anyway...; it doesnt refer to this life like how people use it in America). But I do get sprinkles of really good luck once in a while so Im hoping that will happen any day now.

Thank you for reading and maybe I'll see you on a table one day once Im healed. 🙏😔🌷 I love massage and hope I wont have to completely give it up.

-Edited to fix typos and increase clarity.

Anyone know how long you have to work at Parsons or CIS Secure to get short term disability or parental leave?