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California Workers' Compensation Questions & Answers
1 Answer | Asked in Workers' Compensation for California on
Q: Is “date of last incident” the last day I worked or is it the last date of misconduct?

I was terminated for misconduct after I returned with doctors note for modified duty. The reason they gave me was that i did not follow procedure from a month prior to my injury.

I received my report today and I found the seperation papers. On the file it says I was terminated misconduct.... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 14, 2018

If you have a valid workers compensation claim, and you were on modified duty when you were terminated, AND the employer was unable to provide modified work that fit your limitations, then yes you have a 132a discrimination claim before the Workers Comp Appeals Board. Within the 132a you can argue... View More

2 Answers | Asked in Workers' Compensation for California on
Q: Can the insurance carrier deny your benefits for something that they’ve known for almost two years

I have been appealing my claim for over a year and a half and I just received a denial letter saying they accepted the doctors report of ttd and dates but are denying benefits because I was terminated for cause. Why did they wait this long to send me this letter? They have known of this and has... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 12, 2018

Yes, the insurance carrier can deny your case at any time. However, there may be consequences if the denial is improper. Technically, if your claim is not denied within 90 days of notice, then it is presumed to be a work injury by statute. This appears to be the case with you.

At this...
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1 Answer | Asked in Workers' Compensation for California on
Q: What is the strategy of the defense for scheduling an msc less than thirty days after qme appointment.

I have an msc next month but the qme report will not be available before the msc hearing. I have a qme and ptp report from last year but I’m not sure if the defense wants to use those at msc. The qme report just gives mmi date and not much more. The ptp report has two separate rating. If the... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 12, 2018

It's impossible to know what defendants are thinking without more information. However, if your medical providers have found you MMI and the defendants have requested an MSC, my guess is the defendants want to close out the case before you can get additional discovery or amend your case.

2 Answers | Asked in Workers' Compensation for California on
Q: Will I need an attorney if I don’t want to settle?

I have rejected every offer From the defense attorney. They could not explain how they decided on that offer. They wanted to close out future medical at $4,000. The last one I refused was with open medical. These were all offered with a two week span and they never explain why or how they decided... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 10, 2018

When you get to the MSC the WCJ will look over the medical file, then determine if the evidence is substantial. If the medical reports support your disability, the case is essentially done unless someone disagrees with the rating. Defendants will tell the court the basis of their close out offer... View More

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1 Answer | Asked in Workers' Compensation for California on
Q: Why would the Insurance carrrier change attorneys?

My workers comp has finally been accepted and the insurance carrier decides to change their attorney. I thought it was just a delay tactic but it doesn’t seem cost friendly to hire counsel when I’m not represented. I’m a bit worried that this will delay things further. Why would they changed... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 9, 2018

It is very common for new attorneys to take over cases. If the same defense law firm is handling your case, not much should change because you will still have the same insurance adjuster on your case. I have cases where I am on my fifth or sixth defense attorney. Turnover is a challenge to most WC... View More

3 Answers | Asked in Workers' Compensation for California on
Q: Can I sue over wrongful termination

Hi I got injured at work and they had to rush me to the E.R I received workers comp for two weeks and they terminated me after the pee tested positive for marijuana I had a medical card at that time but they didn’t drug test me before hiring me and that is there policy

Ronald Mahurin
Ronald Mahurin
answered on Nov 9, 2018

You can always sue, but that does not mean you will win. In California you cannot bring a wrongful termination suit before the workers compensation appeals board WCAB, so you want to find a civil attorney practicing employment law, not a workers compensation attorney.

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2 Answers | Asked in Workers' Compensation for California on
Q: In a CA workers comp case can the Ins Co deduct child support from award that I already paid from my TD checks?

I had owed back child support and in 2017 I fulfilled my obligation to child support. All the payments were paid out of my TTD checks how can they say I need to pay the money back to them when it was taken out of my own checks?In a CA workers comp case I was paid my TD payments and out of those... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 7, 2018

The insurance company will get credit for any payments made for child support. However, since the payments were made from your temporary disability, as you say a percentage was paid, there should be no further deductions from your award. The insurance carrier is only responsible for paying 104... View More

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2 Answers | Asked in Employment Law and Workers' Compensation for California on
Q: Does "sick pay" medical benefit payments qualify as a salary continuation plan as justification to avoid a WC penalty ?

Employer continued to pay wages out of accrued sick pay benefits after the injury was determined to be compensable.

Nancy J. Wallace
Nancy J. Wallace
answered on Nov 1, 2018

IF what you are trying to say is that the INSURER did not pay Temporary Disability indemnity AT ALL, then no, a penalty is due. But if you are trying to say the Insurer paid 2/3 of your average earnings PLUS the employer used accrued benefits to add to that to make a full paycheck with... View More

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1 Answer | Asked in Workers' Compensation for California on
Q: I am on wc through my job still working was just told company wide my job is being eliminated I am on lite duty

There will be two full time positions but my GM told me the only way I can apply is if I get workers comp doctors to release me. I went through physical therapy, and doing acupuncture know and its not working ortho doctor ordered for me to have a MRI waiting for them to call me they told me I will... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 1, 2018

The GM is correct, you cannot return to work without a physician's release, or a report giving you permanent restrictions which the employer can meet. The answer to your question is that you should be receiving workers compensation benefits because you have not been released by your doctor.... View More

1 Answer | Asked in Workers' Compensation for California on
Q: what steps do I need to take to have insurance carrier to pay benefits if my claim is now accepted.

My claim was denied but it is now accepted. It was accepted a year ago but they told me it’s denied. They have come up with numerous reasons as why I’m not being paid benefits for loss wages. They can never provide any reasons. They have all the doctor report but refuse to pay. They always back... View More

Ronald Mahurin
Ronald Mahurin
answered on Nov 1, 2018

The only recourse is to go to court and have the WCJ order them to pay. No matter what the status of the acceptance/denial, if the insurance company is not paying benefits and the medical records supports those benefits, you must seek court help. If you believe the lack of payment is in bad... View More

1 Answer | Asked in Workers' Compensation for California on
Q: Are independent contractor home care workers covered under Workmans comp in California?

M y insurance agent says the worker is covered underworkmans comp in her homeowners policy.

Ronald Mahurin
Ronald Mahurin
answered on Oct 31, 2018

It is a difficult question because there are very specific requirements for someone to be considered an "Independent" contractor. You must be very cautious because the workers compensation laws favor injured workers and if the "Independent" contractor is found to be an... View More

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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1 Answer | Asked in Workers' Compensation for California on
Q: Can you file a workers comp claim for migraines/closed angle glaucoma from migraine medication?

I was having migraines almost everyday due to stress from work. My dr. prescribed me Topimarate for the migraines. I started the medication in June. When the pharmacy changed the manufacturer of the medication I began having vision problems. After the vision problems not getting better I went to an... View More

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 22, 2018

Can you file a claim? Yes. Will it be accepted? Most likely, no. Stress claims are regularly denied. Labor Code 4660.1 says the employer has no responsibility for psychiatric injuries generally, with these exceptions:

(A) Being a victim of a violent act or direct exposure to a...
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1 Answer | Asked in Workers' Compensation for California on
Q: I’ve been on workers comp for 3 yrs my PTP (I’ve had 4) & the QME all agree on my permanent disability.

I am now at MMI & I’ve been rated by the DEU. I can no longer do my job & I was approved for SSDI. My attorney has sent a “demand” to the claims adjuster to settle my case. Will I have to go to a deposition or is that only for cases which are denied? I have a MSC coming up in less... View More

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 24, 2018

Your attorney will take THOU$ANDS so if you cannot talk to her, you need a different attorney!!! Injured workers are deposed more in accepted cases than denied, so it is possible there could be deposition still. If you really meant to ask if there would be a TRIAL, yes, if the defense fails to... View More

1 Answer | Asked in Workers' Compensation for California on
Q: What to expect at expedited hearing for temporary disability benefits.

What can the adjuster used at the hearing to defend their reason for not paying ttd?

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 19, 2018

An adjuster need not pay TTD when (1) they never received the Work Status report showing TTD status by an MPN Physician; (2) the physician reporting is no longer on the MPN so they can ignore his findings; (3) The claim is now denied in its entirety; (4) there are videos of the applicant... View More

1 Answer | Asked in Workers' Compensation for California on
Q: I reported a WC injury and was directed to call a company that takes care of our workers Comp claims. It is over the

Phone and on the computer live so you talk to a doctor on the computer screen. I went through all questions with the doctor. He told me to go home so I called my store manager and he did not return my call, I called the Asst. He told me to go home. I had 1 1/2 hours left on my shift. I was told by... View More

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 16, 2018

Sadly, the injured worker IS NOT PAID for the first 3 days of temporary disability following a work injury! IF this injury causes you to lose more than 14 days of work as being found Temporarily Totally Disabled, only then does the adjuster owe you for the three days you lost following this... View More

1 Answer | Asked in Workers' Compensation for California on
Q: Can I file a petition for penalties?

My claim was denied. I have seen several doctors that has stated my injury is industrial related. They have modified my work duties with restrictions and have me as ttd. I have not been paid any benefits in over a year. I have schedule an expedited hearing for ttd. Can I file for penalties in this... View More

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 15, 2018

You COULD try that, but most judges will refuse to award any penalty to an insurer exercising it's right to prove the claim is non-industrial at trial. You CAN take those reports, request a Trial, offer them to the judge at trial as evidence that the injury IS work=related, then you would... View More

2 Answers | Asked in Employment Law and Workers' Compensation for California on
Q: I need anattorney that knows tribal law. I broke my foot at work. Workman comp denied my case. Morongo had me go out.

9-18-18 was when FMLA exhausted. I am terminated & have no insurance to take care of my broken foot.

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 15, 2018

I know of NO ONE who practices Workers Comp for injured workers on in Tribal jobs because it's hours and hours and hours of work for no money. You only get to see Tribal doctors, and those doctors write that the Tribe is not responsible or otherwise owes you no treatment and no money.... View More

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1 Answer | Asked in Workers' Compensation for California on
Q: Workman's Comp Deposition

I am being required to attend a second deposition on my WC claim. The accident was in Feb 2016 and I do not understand why the second meeting. There is a new attorney on the side of my company. I was fired in April this year, stating that they no longer need

a receptionist, with... View More

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 9, 2018

if you must ask questions here instead of the firm you will be paying thousands, you need new counsel. There are wonderful firms in the bay area. You need a lawyer that answers your questions. YOU MAY 'dismiss' this attorney who won't speak with you and hire a new attorney. You... View More

1 Answer | Asked in Workers' Compensation for California on
Q: Qme and ptp both reported industrial and gave work restrictions.

Why have I not received any ttd benefits. My claim was denied but every doctor that has evaluated me has listed as industrial and the restrictions varies from 10-20lb no lifting.

Nancy J. Wallace
Nancy J. Wallace
answered on Oct 9, 2018

You have not gone to Trial. IF you went to trial with those reports, the WCAB Judge would issue a finding that you WERE injured on the job. Until the court issues a Finding and Award, the insurer has no obligation to pay when it has denied all responsibilities for the injury.

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