WC Claim case closed or not?

[misskirby]

Hello,

I have a CA WC claim for a repetitive injury on my shoulder. Of course, the claim was initially denied. (I guess they only accept cases without a fight where your limb is severed on the job site with witnesses.) I waited months for the QME doctor's exam. It took another six weeks to get his report.

Upon his exam, instead of just validating the claim for treatment, he assigned me a PD rating BEFORE I even received treatment. He also recommended that my medical treatment be covered.

Based on that evaluation, I did finally get my treatment. However, it seems that my WC adjuster may have informed my job that my claim was closed based on the assigned PD rating. Now my job is saying that my continued absence while I have been receiving treatment has been a "personal" leave, not WC related.

Can a claim be "closed" when you have not yet been released by your doctor? Or before the claim PD rating been signed off by a WC judge?

My doctor released me to return to work with restrictions and my employer is telling me not to report, and complaining that I have exhausted my leave, and that a job does not have to be reserved for me. Can anyone advise me? I think all of this is legally wrong on their part.

Thank you for any input.

[1171]

if your employment is covered by the Family & Medical Leave Act you get 12 weeks of job protection
more here
http://www.dol.gov/whd/fmla/
as long as they are paying benefits your claim is not closed.
whether you have an open file with the comp court or the work comp board depends on how your state runs it's work comp program.
without knowing your state I can't tell you more.

[misskirby]

(06-06-2011 07:34 PM)1171 Wrote:  if your employment is covered by the Family & Medical Leave Act you get 12 weeks of job protection
more here
http://www.dol.gov/whd/fmla/
as long as they are paying benefits your claim is not closed.
whether you have an open file with the comp court or the work comp board depends on how your state runs it's work comp program.
without knowing your state I can't tell you more.

Thank you. I'm in CA. Benefits still being paid, no judge has signed off on PD rating as req'd, doctor still hasn't released me, so I was convinced it could not possibly be closed.

Why did I think they had to keep a position for you if you went out on WC claim?

Thank you again for your response.

[1171]

many have misconceptions about comp.
that a worker is given immunity from termination by filing a claim is a common one.

[lizdawiz82]

(06-06-2011 03:49 PM)misskirby Wrote:  Hello,

I have a CA WC claim for a repetitive injury on my shoulder. Of course, the claim was initially denied. (I guess they only accept cases without a fight where your limb is severed on the job site with witnesses.) I waited months for the QME doctor's exam. It took another six weeks to get his report.

Upon his exam, instead of just validating the claim for treatment, he assigned me a PD rating BEFORE I even received treatment. He also recommended that my medical treatment be covered.

Based on that evaluation, I did finally get my treatment. However, it seems that my WC adjuster may have informed my job that my claim was closed based on the assigned PD rating. Now my job is saying that my continued absence while I have been receiving treatment has been a "personal" leave, not WC related.

Can a claim be "closed" when you have not yet been released by your doctor? Or before the claim PD rating been signed off by a WC judge?

My doctor released me to return to work with restrictions and my employer is telling me not to report, and complaining that I have exhausted my leave, and that a job does not have to be reserved for me. Can anyone advise me? I think all of this is legally wrong on their part.

Thank you for any input.

How funny im going through the same exact problem.

[Woodlawn]

(06-06-2011 03:49 PM)misskirby Wrote:  Hello,

I have a CA WC claim for a repetitive injury on my shoulder. Of course, the claim was initially denied. (I guess they only accept cases without a fight where your limb is severed on the job site with witnesses.) I waited months for the QME doctor's exam. It took another six weeks to get his report.

Upon his exam, instead of just validating the claim for treatment, he assigned me a PD rating BEFORE I even received treatment. He also recommended that my medical treatment be covered.

Based on that evaluation, I did finally get my treatment. However, it seems that my WC adjuster may have informed my job that my claim was closed based on the assigned PD rating. Now my job is saying that my continued absence while I have been receiving treatment has been a "personal" leave, not WC related.

Can a claim be "closed" when you have not yet been released by your doctor? Or before the claim PD rating been signed off by a WC judge?

My doctor released me to return to work with restrictions and my employer is telling me not to report, and complaining that I have exhausted my leave, and that a job does not have to be reserved for me. Can anyone advise me? I think all of this is legally wrong on their part.

Thank you for any input.

The PD rating could have been a provisional rating. Some QMEs do this, and generally, it does cause some confusion.

Anyway, i'm not entirely clear on some details. if the QME's report noted you were permanent and stationary, then your claim would be "closed" but not in the sense that it would commonly be understood. if the rating was provisional and you are not P&S, then that's another matter and your claim would not be closed in any sense of the word. The QME's report may or may not trump your doctor's opinion.

Having a WC claim does not shield you from losing your job, however you can claim benefits as a 132a claim.

Have you spoken to the adjuster about the whole "closed" thing?

[gba2011]

They can't stop payments until you have been properly notified, at least that is how it is in MA. Here they have to give you ten days written notice. According to my attorney, your case is never closed until you settle. What is your attorney doing for you? If you don't have one, now is the time to act.

Your employer doesn't need to save your job unless you are protected by a contract or a collective bargaining agreement that states such.

**website link removed by moderator**

[gba2011]

They can't stop payments until you have been properly notified, at least that is how it is in MA. Here they have to give you ten days written notice. According to my attorney, your case is never closed until you settle. What is your attorney doing for you? If you don't have one, now is the time to act.

Your employer doesn't need to save your job unless you are protected by a contract or a collective bargaining agreement that states such.

**website link removed by moderator**