return. He read the MRI results and then submitted it to the WC Insurance company to respond, if it was accepted or rejected. I got NO reply/response from the insurance company for SIX more months. It was declined for surgery. It stated on the report that they (insurance co) did NOT receive it... Read more »
Five (5) business days. Something else is going on. If you can prove the insurance company received the request from your doctor and did not respond within. Five business days you should be able to get the surgery authorization.
wages of $320 a wk 1999 injury how do you figure in COLA does it base it on AWW my AWW is based on a salary of 20 years ago and would have gotten raises during those years how does COLA apply to my figures?
Yes, if your work activities aggravated, exacerbated, or accelerated your previous non-work condition. The insurance company will likely deny the claim until a doctor finds your condition was made worse by your work activities.
Labor Code section 5313 provides "The appeals board or the workers compensation judge shall, within 30 days after the case is submitted, make and file findings upon all facts involved in the controversy and an award, order, or decision stating the determination as to the rights of the parties....Read more »
No, you can still provide to trial. If you have some level of permanent disability and your employer is not able or willing to provide modified work, the insurance company is required to send the Supplemental Job Displacement Voucher. The Voucher does not effect any of your other workers'...Read more »
I have C spine and L spine injuries. I am rated at 32% by DEU and final doctor report states I will need back surgery (fusion in C spine). I elected CNR as I hate the workers comp system. The City of Carlsbad has offered $38,000. This dollar amount seems extremely low and I doubt it would cover... Read more »
The dollar figure for your permanent disability rating comes from a chart. The permanent disability value is based on a number of factors including the year of injury. for example, a 32% permanent disability for an injury between 2005 to 2012...Read more »
I need to have Anterior Lumbar Interbody Fusion. Workers Comp denied it based on me not having a psychological evaluation clearing me for surgery. Every time we submit a request to see the psychologist they deny it stating they accept no responsibility for psychological injury. It seems to me they... Read more »
First, I would suggest you get an attorney to assist you with your case.
The denial of the psychological evaluation appears to be based on their denial of psyche injury as part of your claim. The surgery was denied based upon Utilization Review (UR). Is sounds like they did not UR the...Read more »
I assume you were working for a different employer prior to the the employer in which you sustained the injury. If that is the case, your earnings from the prior employer and current employer can be used to calculate your benefits. Labor Code section 4453(c)(4) provides " the average weekly...Read more »
I have an open claim for my knee at the time of knee injury i was earning$14.00 hr.i have now opened another claim for a back injury and I now earn $15.50 per HR. I'm scheduled for surgery on my knee while also being treated for back injury both require tpd ? Please I'm confused will my payments be... Read more »
If I understand your question correctly, you are off work for both injuries. Unless your employer can show you are off work for just the 1st injury, I would argue you are entitled to the higher rate. Usually, your employer will pay on ONE claim based on the medical reports they receive from your...Read more »
I've 2 jobs: 1 full-time where I was injured & 1: on-call. I've worked at both for 3 yrs. I've been receiving temp. dis. checks for the last 8 months from the full-time job & have been working at my on-call job within my claims dr.'s restrictions. I've informed the insurance company - that is hired... Read more »
Your benefits are calculated based upon your Average Weekly Wage. This can be calculated multiple ways, but is usually your total earning for the year prior to your injury divided by 52. It gets more complicated when you have multiple jobs. Unless they are paying at a rate that accounts for both...Read more »
i had tendinitis and carpal tunnel surgery in november and now im suppoesd to be limited to 25lbs pushing, pulling, and holding in my left hand. My employer is trying to send me to a food bank to work for $10 an hour M-F which is not my regular schedule or pay. What can I do?
As long as the modified duty is within your doctor's work restrictions your employer can have you work at the food bank. You should keep a copy of your doctor's work restrictions with you at all times so you can show anyone that asked you to do more than your doctor has approved. Also, the food...Read more »
That depends on how your case was resolved. Typically, after a settlement, the defendant has 20, 25, 30 or 35 days to issue payment. It depends on if the settlement was served in person or by mail and how much time was provided in the settlement document itself.
Had a neck and shoulder injury. My neck was listed on the Appeals Board Stipulations with Request for Award application but my shoulder wasn’t even though the QME stated that I needed future medical. Was I suppose to have received document/documents as to why I wasn’t getting future medical for... Read more »
If the settlement was approved by the Judge, you have 20 days from approval to ask that the mistake be corrected. If you are beyond 20 days, you can use Labor Code section 5803 to request the mistake be corrected, however, it's not automatic that a judge would make any changes to the settlement....Read more »
Fisrt surgery wasn't successful and now require another surgery . My question is will I receive workers comp. benifits again since I returned to full duty after my first surgery? now will be off work for who knows how long and it's on the same claim? Will benifits start automatically and if so... Read more »
If your doctor takes you off work again for a second surgery you will likely receive temporary disability benefits while you are off work recovering. Assuming it is all treated as the same injury, you will be paid at the pay rate at the time of your injury. Not your current pay rate.
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