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Questions Answered by Steven James Foster
2 Answers | Asked in Workers' Compensation for California on
Q: I had a mri last September. When the results came back, my wc doctor was on a month vacation, so I had to wait for his

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 »

Steven James Foster
Steven James Foster answered on Aug 24, 2019

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.

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2 Answers | Asked in Workers' Compensation for California on
Q: Can you utilize MSA money on non med. things if you never seek treatment from Medicare for workers comp injury

I've heard recently that if you never seek treatment for your work-related injury to Medicare you'd be okay in spending the money to live on. Any and all advice welcome.

Thank you

Steven James Foster
Steven James Foster answered on Jan 28, 2019

You may use the MSA account to pay for the following costs when they are directly related to the MSA account:

• Cost of copying documents

• Mailing fees/postage

• Any banking fees related to the account

• Income tax on interest income from the account...
Read more »

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2 Answers | Asked in Employment Law and Workers' Compensation for California on
Q: how does COLA apply to life pension at 75% disability rating ?

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?

Steven James Foster
Steven James Foster answered on Jan 16, 2019

Unfortunately, COLAs only apply to Injuries occurring on or after 01/01/2003. A 1999 injury would not have a COLA.

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2 Answers | Asked in Workers' Compensation for California on
Q: in California workers comp system can you get cost of living increase?

I have been in the workers comp system for 18 years and my pay is 2/3 of my weekly rate based on my earnings of 18 years ago shouldn't I receive cost of living increase ?

Steven James Foster
Steven James Foster answered on Oct 29, 2018

The Cost of Living Adjustments (COLA) apply to work injuries occurring on or after January 1, 2003.

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2 Answers | Asked in Workers' Compensation for California on
Q: Can you negotiate for a higher settlement amount?
Steven James Foster
Steven James Foster answered on Oct 3, 2018

Yes, all workers' compensation settlements are subject to negotiation.

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3 Answers | Asked in Workers' Compensation for California on
Q: I think my work aggravated a previous non-work injury - can I still make a claim?
Steven James Foster
Steven James Foster answered on Aug 23, 2018

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.

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1 Answer | Asked in Workers' Compensation for California on
Q: I lost my balance and fell down at work. Can I still claim workers' compensation for my sprained ankle?

I didn't trip over anything. I just stumbled and stepped awkwardly.

Steven James Foster
Steven James Foster answered on Jun 6, 2018

Yes, workers' compensation is a no fault system. If you are injured at work while working, you can claim your injury and seek medical care for the injury.

1 Answer | Asked in Workers' Compensation for California on
Q: Why would a workers comp carrier ask you to waive the requirements of Labor Code section 5313?
Steven James Foster
Steven James Foster answered on May 7, 2018

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 »

2 Answers | Asked in Workers' Compensation for California on
Q: What does the serving of work or school training vouchers and my workers comp Is still not settled.

Is the insurance company trying to get me just to accept the vouchers and not proceed to trail

Steven James Foster
Steven James Foster answered on Apr 30, 2018

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 »

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3 Answers | Asked in Workers' Compensation for California on
Q: I am rated at 32% by DEU, final doctor report states I will need a back fusion surgery. I elected a CNR, $38,000?

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 »

Steven James Foster
Steven James Foster answered on Apr 20, 2018

Yes, you should seek the help of an attorney.

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 »

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2 Answers | Asked in Workers' Compensation for California on
Q: Why is Workers Comp denying me back surgery?

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 »

Steven James Foster
Steven James Foster answered on Apr 18, 2018

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 »

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2 Answers | Asked in Workers' Compensation for California on
Q: I was only with the company 4 months when I got hurt, how do they compute my workers comp disability payment ?

Can they compute from the beginning of the year to when I got injured? Or from my start date?

Steven James Foster
Steven James Foster answered on Apr 11, 2018

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 »

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1 Answer | Asked in Workers' Compensation for California on
Q: I'm in ca. I feel at work and have tbi my cases has settled but they payed me two checks one was medicare msa can they

Do that no one will help me understand

Steven James Foster
Steven James Foster answered on Apr 10, 2018

You should look at this link:

https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Workers-Compensation-Medicare-Set-Aside-Arrangements/Downloads/Self-Administration-Toolkit-for-WCMSAs.pdf

It should answer your questions about your MSA.

1 Answer | Asked in Workers' Compensation for California on
Q: I'm in cal.and have an open case with workers comp for my knee ,now new claim with my back same employer

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 »

Steven James Foster
Steven James Foster answered on Apr 5, 2018

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 »

2 Answers | Asked in Workers' Compensation for California on
Q: Can WC ins pay only the difference of what they owe u by subtracting ur wage from a 2nd job to = your total lost wages?

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 »

Steven James Foster
Steven James Foster answered on Mar 9, 2018

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 »

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1 Answer | Asked in Workers' Compensation for California on
Q: if I'm on restricted duty, but i don't feel like my injury is well enough to return to work can i fight it?

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?

Steven James Foster
Steven James Foster answered on Mar 2, 2018

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 »

2 Answers | Asked in Workers' Compensation for California on
Q: In California 2018, After my WC case has reached a settlement, how long by law can it take before I receive my check?
Steven James Foster
Steven James Foster answered on Mar 1, 2018

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.

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1 Answer | Asked in Workers' Compensation for California on
Q: Should I have received a notice by my workers comp Ins as to why they didn’t add my shoulder to the DWC-CA form 10214?

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 »

Steven James Foster
Steven James Foster answered on Feb 15, 2018

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 »

1 Answer | Asked in Workers' Compensation and Environmental for California on
Q: Can you please show me where can I find out if workers compensation still owes me money from the state of California
Steven James Foster
Steven James Foster answered on Feb 15, 2018

You can look on the California State Controller's web site

https://ucpi.sco.ca.gov/UCP/Default.aspx

2 Answers | Asked in Workers' Compensation for California on
Q: 1/2016 injured my knee torn meniscus,received benifits until I returned to full duty.will I get benifits again ?

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 »

Steven James Foster
Steven James Foster answered on Feb 15, 2018

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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