Q: 5 years after back injury, delays by Co. WC atty, nerve damage from lack of definitive care, can we sue Co. ?
patient worked in E.R. lots of back strain, developed nerve impingement, entered WC system, hospital's WC atty instigated a series of delay tactics spanning several years, hoping claimant would give up. After four years a small settlement is expected. Patient incurred additional nerve damage due to delayed access to definitive treatment as approval for any treatment had to be approved by hospital WC atty physician. Can patient sue hospital's WC atty for damages incurred due to their tactics? Can patient sue the State of California for creating this system which prevents patient from obtaining definitive treatment ASAP ?
A:
What you are going through is very common in WC and unfair in the opinion of many. The current condition of the WC system is due to changes done in 2013 when the IMR was implemented and power taken from attorneys and judges and solely given to medical unit and IMR (Independent Medical Review).
As to your questions. You can sue. Will you prevail? Most likely not. Why? They cover themselves by the medical opinion of a doctor that has never seen you (Utilization Review from Ins.) then it is reviewed by Maximum (another doctor that has never treated and/or seen you) and most likely than not, they will agree with UR.
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