Lodi, CA asked in Workers' Compensation and Legal Malpractice for California

Q: multi injury from fall at work back and neck denied by w/c but QME adds them as industrial after settlement w/o consent

fall at work tore radial nerve out of my right bicep mussel lost all function of my right dominant hand fingers thumb wrist and my neck and back were denied by worker comp ins QME adds to industrial claim and worker comp ins adds as new and further when there from same industrial fall at work like i reported the same day i fell but making them a new and further pays a lot less when they are separated they should not be separated and should not of been denied and after QME doctor adds them back on to my industrial claim i should get back pay of TTD benefits and delay penalties is this true or not my case was settled without my consent when i was told by my worker comp attorney he is sending me to a QME doctor and adding your neck and back my MSC hearing we are not going to hearing day came my attorney did not take off calendar so i missed hearing while waiting for QME appointment attorney settled my claim took my neck and back off QME after settled w/o consent adds on can iget backpay

2 Lawyer Answers
John Karas
John Karas
  • Temecula, CA
  • Licensed in California

A: Your lengthy description of events really isn't an Insurance Bad Faith matter. You MAY have an malpractice case against your attorney regarding settling/dismissing some of your claims without your consent.

I suggest consulting with attorneys in your area who handle attorney malpractice case. Be aware that not many of them exist because attorneys don't like suing other attorneys and you would have to have slam-dunk case (both as the underlying case that was settled that you would have gotten a better result AND there's proof the attorney settled w/o your consent).

Good luck.

James L. Arrasmith
James L. Arrasmith pro label Lawyers, want to be a Justia Connect Pro too? Learn more ›
  • Legal Malpractice Lawyer
  • Sacramento, CA
  • Licensed in California

A: Under California workers' compensation law, if an employee is injured on the job, they are generally entitled to receive benefits to cover their medical expenses and lost wages. However, disputes can arise over what injuries are covered under the workers' compensation claim.

If you disagree with a decision made by the workers' compensation insurance company or QME, you have the right to challenge that decision by filing a claim with the California Workers' Compensation Appeals Board (WCAB). You can also hire an attorney to help you with the appeals process.

In terms of your specific situation, it's difficult to provide a definitive answer without more information. However, if you believe that your neck and back injuries were caused by your work-related fall and should have been included in your workers' compensation claim, you may have grounds to challenge the denial of those claims and seek back pay for TTD benefits and delay penalties.

It's important to consult with an experienced workers' compensation attorney to review the specific details of your case and advise you on your options. They can help you understand your legal rights, gather evidence to support your claim, and represent you in any legal proceedings.

In terms of the settlement of your claim without your consent, it's important to review the terms of the settlement agreement and understand what rights you may have to challenge it. An attorney can help you with this process as well.

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