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Questions Answered by Nancy J. Wallace
1 Answer | Asked in Workers' Compensation for California on
Q: Work comp doc put me on full duty trial, employer won't let me return. Am still in pain, doc says can't help anymore?

Sorry about my question was trying to fit it all in these boxes. I suffered a neck sprain at work over a month ago. I have been out of work since, my employer would not accommodate my restrictions which I understand they have a right to. Now my employer says I can not return bcuz I am still... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Aug 24, 2021

You're in PHOENIX? I can only answer for CALIFORNIA workers comp claims. The SMART solution is to change Primary Treating PHysicians to one who is only your side instead of 'in bed' with the insurance company. IF the doctor you are with now already wrote "MMI" then... Read more »

2 Answers | Asked in Employment Law and Workers' Compensation for California on
Q: Is there a law stating the max attorney fees for workers comp cases in CA? I've read 15% one lawyer is asking 18%
Nancy J. Wallace
Nancy J. Wallace answered on Jul 19, 2021

The Labor Code just says 'reasonable' which is as clear as mud. The FEE DISCLOSURE FORM you signed at the outset says 9-12%. The WCAB Judges regularly award 15%. The judges in MARINA DEL REY award 18% because the rent is so much higher around that region. But it's just... Read more »

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1 Answer | Asked in Workers' Compensation for California on
Q: Can we claim the price/usage increase compared to our average electric bill?

My husband broke his right ankle at work. He is now home 24/7. Our electric bill has gone up because he is home.

Nancy J. Wallace
Nancy J. Wallace answered on Jun 21, 2021

Sadly, no! There is nothing in the Labor Code that requires the Employer or INsurer to pay for the increase in residential electricity during periods of Temporary Disability. The Labor Code only requires payment for 'reasonable' treatment (which includes mileage reimbursement to the... Read more »

1 Answer | Asked in Workers' Compensation for California on
Q: When do I start getting PPD?

My last appointment where my MD told me I was at MMI was 13 days ago. I have heard nothing from him or my WC company. I looked online and it says that my return to work day was 12 days ago. When are they required to pay me my PPD in California (I thought it was 14 days)? I called the MD office... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Jun 9, 2021

if you went to a doctor 'in bed' with the insurance adjuster, he may be writing you have ZERO rateable Whole Person Impairment from this injury. I set a trial for one just like that today...the treating physician said the worker had permanent restrictions from her injury but no... Read more »

2 Answers | Asked in Insurance Bad Faith, Personal Injury and Workers' Compensation for California on
Q: a corrupt doctor had my supportive care ended, the lawyer and insurance co were complicit ! I have documentation please

Please help, the attorney made false pleadings to the judges, the doctor did not even see me for 10 minutes and never examined me.

the recent laws changed helped them to squash my pleadings. I've gone as far as I can . they made so many lies that can be proven with electronic files.... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Jun 9, 2021

The trouble with this scenario is the damage was done when this doctor was selected. There is no mechanism for a lawyer to get paid anything in this fact pattern. I read there already were hearings. This means a judge has made a ruling. A ruling has to be appealed within a few days. PLUS there... Read more »

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1 Answer | Asked in Workers' Compensation for California on
Q: I was working for a person they were late on my pay so they put in their credit information on my Phone to pay it

He didn't pay me in full when I was working with himand also didn't pay me my last check. the card was charged I didn't get to pay with cash but his card was charged 67 dollars when I called for an extension I guess they just charged me to the info he left logged in I tried canceling... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on May 31, 2021

This is NOT a true 'workers compensation' matter, workers comp is for folks who fall of the ladder at work and need a back surgery. YOU have a Labor Law question, a WAGE CLAIM. Wage Claims go to the California Labor Board : https://www.dir.ca.gov/dlse/HowToFileWageClaim.htm That is... Read more »

2 Answers | Asked in Employment Law and Workers' Compensation for California on
Q: regarding FMLA.. my employer is saying I'm on the FMLA abuse list one day. because i went over the certified hours

I went over the hours the doctor certified me with... but all the times my supervisor had approved my time off but one day my manager tells me that I'm on the FMLA abuse list cause i went over my hours. they didn't even ask me if i can provide doctors notes for the days I left early which... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on May 31, 2021

There is no such animal in the Labor Code as an FMLA Abuse List.

That is an internal bookkeeping tool that employer just made up.

Workers us FMLA up to a certain amount, and when all those hours are used up, the employer may reprimand then terminate the worker for absenteeism....
Read more »

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2 Answers | Asked in Employment Law, Workers' Compensation and Employment Discrimination for California on
Q: How do I go about getting my restrictions changed by an AME now that I have completed my the

How do I go about getting my restrictions changed by an AME now that I have completed my therapy and him requesting me to return after the therapy and medical test were completed.

Nancy J. Wallace
Nancy J. Wallace answered on Mar 2, 2021

AMEs are ONLY for people with a lawyer, so if this doctor is truly an Agreed Medical Evaluator, YOU have a lawyer! So tell your lawyer to schedule the final re-evaluation with the AME ASAP. THAT's why you are paying your lawyer 15% of your recovery!

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1 Answer | Asked in Workers' Compensation for California on
Q: Can 2 QME reports Along with Supplemental Reports last One Done July 2020 Be Stricken Because Dr died ?

I have an Attorney , I question his statements Seriously injured in 2017 . First QME report would give me lifetime disability benefits , insurance company sits on report for a year. I go back to same QME one year later , my condition worsening . 2nd report in July 2020 now gives me a rating of... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Mar 1, 2021

MAYBE. If there is any NEW evidence the evaluating physician would need to see to render an accurate opinion, then you have to pick a new QME. IF a Party said they planned to depose the QME when they had the records collected and they proceeded reasonably (they didn't wait 3 years before... Read more »

1 Answer | Asked in Workers' Compensation for California on
Q: Injured at work 09/09 2019. Had a surgery 01/22/2020. Treating doctor (also the surgeon) issues 2% WPI in Aug 2020.

QME doctor issues 17% in Jan 2021. Claims admin objects to the medical determination, report, conclusions regarding causation, apportionment, disability, impairment, work restrictions and treatment. They want a supplemental report, PQME Cross-examination and to obtain additional records, etc.... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Feb 20, 2021

Your options are to file / serve DOR for a trial immediately. Defense has had the QME report for more than a month, it should have obtained these records BEFORE the QME saw you, and the QMEs deposition should have beend scheduled already. YOu are ready for trial for a decision on the jan. 2021... Read more »

1 Answer | Asked in Workers' Compensation and Construction Law for California on
Q: I was trying to service an ac unit on the 2nd roof of a townhouse a roof tile broke under my ladder, broke my ankle

I am trying to see how to move forward with this. I got up on the first roof then my co worker handed me the ladder to get to the second roof I secured it got up about 3 steps then the roof tile broke my ladder slid and my weight the the weight of my ladder came down on my right ankle and broke it... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Feb 20, 2021

This is a classic Workers Compensation claim. to 'move forward', you get a REAL ortho surgeon from the comp insurer's approved list, do NOT let the comp insurance adjuster or the boss pick your treating physicians or you won't be happy. But you need the list of approved... Read more »

1 Answer | Asked in Workers' Compensation for California on
Q: What information do I have a right to request during a workers comp investigation and how long do they have to comply?

My supervisor was written up for my injury and I would like a copy of the disciplinary action. How do I request this document? Can I request a copy of the workers comp insurance carriers investigation? How long does my employer or insurance carrier have to comply with my request for records? I... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Feb 1, 2021

You are NOT entitled to another person's personnel file, if that is what you are asking. You would be very upset if a co-worker got YOUR personnel file. Those are transactions between the employer and the worker ONLY. An 'investigation report' is prepared in anticipation of... Read more »

1 Answer | Asked in Workers' Compensation for California on
Q: Maximum percentage of attorney fee that could be taken out of settlement with two liens on the case.

Hi,

1) What is the maximum percentage from the settlement amount that a a judge could award to each attorney, if there were TWO liens for attorney fees on the case?

2) Is any law or code in this regard in workers comp system and if yes what is that code?

3) If an attorney... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Jan 5, 2021

The Labor Code just says 'Reasonable', it doesn't limit the judge to a maximum percentage. THAT said, some WCAB judge award 18% in the 'high rent' regions, most limit it to 15%. The fee withheld is split between all the attorneys who worked on the file. If the... Read more »

2 Answers | Asked in Workers' Compensation for California on
Q: Trial scheduled for disputed attorney fees.

Hi,

I am an Applicant In pro per. I settled my WC case before trial thru a signed C&R. I dismissed my attorney a year before the settlement reached for "cause''. He now wants 15% of the settlement amount and has filed a DOR for it which I have objected and the case is set... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Jan 4, 2021

JUST ANSWERED YOUR QUESTION ON AVVO: Be Careful!!!

Yes, if the matter goes on the record, the Judge has to call a Court Reporter. Yes, if you find a serious error of fact or law, you have the right to file a Petition For Recon.

NO, YOU CANNOT judge serve a Petition for...
Read more »

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1 Answer | Asked in Workers' Compensation for California on
Q: Hello, I went to a deposition and did not receive a copy. What happens after 30 days?

I was informed that I must go over it and sign it in order for it to be valid and used in court. What happens after 30 days? Does it expire? Do I have to do another deposition?

Nancy J. Wallace
Nancy J. Wallace answered on Dec 16, 2020

You really need to remind your attorney to send you the transcript ASAP. At the end of the proceeding, the attorneys agreed to a certain number of days AFTER RECEIPT of the transcript for you to review the transcript and submit any changes. Did your attorney get your transcript? They should have... Read more »

3 Answers | Asked in Workers' Compensation for California on
Q: Hello, Is there a deadline for submitting mileage paperwork for California Workers Comp case?
Nancy J. Wallace
Nancy J. Wallace answered on Dec 10, 2020

The only deadline is BEFORE the Judge issues an order approving a final settlement. Remember: mileage rates change each year. If you are adding up trips from 2017, you have to go get the 2017 form : https://www.dir.ca.gov/dwc/forms-Mileage.html (if that link doesn't take you to Workers... Read more »

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3 Answers | Asked in Workers' Compensation for California on
Q: QME form

After filling 2 QME forms I sent one to my adjuster and the second to the state compensation places, and this is because my adjuster closed my case because Concentra gave me a zero impairment rating, now I called my adjuster today to confirm he got the mail but could not answer his phone, but the... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Oct 21, 2020

The Labor Code FORCES the adjuster to authorize the QME to see you. So this phoning around is 110% waste. You don't need to involve any adjuster anyway. You just mail the completed QME REQUEST FORM to the Medical Unit in Oakland, the po box is posted right on page 2 of the form. If you... Read more »

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3 Answers | Asked in Workers' Compensation for California on
Q: workers comp- Cant get hold of my adjuster and his supervisor but apparently the case has been closed

My lower back got injured at work on august as a result of my companies negligence, I was sent to concentra did all dr's visits and therapies, hot and cold packs, medication and 8 weeks later I was released on full duty. A month later I had not heard from the adjuster so I called him to check... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Oct 16, 2020

First, your case is plenty 'ripe', scrap that lawyer and get a real lawyer, who needs to rush you far, FAR AWAY from concentra hacks. Next, adjusters blow off people on the phone. Concentra doctors routinely write that patient fully recovered with zero permanent disability and zero need... Read more »

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2 Answers | Asked in Workers' Compensation for California on
Q: Do I HAVE to release my medical records for my worker's comp claim?

I strained my lumbar region at work just short of a month ago and I have gone the course of alerting my employer of the strain, going to treatment, and was pending response about lost wages until this week. I received a check for lost time so far, but also received a packet containing paperwork for... Read more »

Nancy J. Wallace
Nancy J. Wallace answered on Sep 28, 2020

You do not have to release the records, BUT the insurer can decide to deny the claim for failure to participate fully in discovery. It shouldn't be permitted but it is. When you ask Workers Comp insurance to pay benefits for treatment and disability, the insurer is entitled to see if you... Read more »

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3 Answers | Asked in Workers' Compensation for California on
Q: my workers comp attorney is not doing there job and is letting the other party stall and/or put things off

its been going on for sometime and i was promised x amount of money and so far i cant even get my out of pocket expenses paid back

Nancy J. Wallace
Nancy J. Wallace answered on Sep 17, 2020

Sadly, the regulations and the California Labor Code let a party delay to obtain all medical and employment records, and get a replacement list of doctors (the QME panel), and the pandemic rules let doctors set appointments out as long as 90 days from the date you call. Your elected officials give... Read more »

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