worker's compensation issues

[jayson]

things that i have learned and would like to share. your not protected from losing your job. i was unable to return to work on the specific date (6month) because of the traumatic event that occurred and recovering from my surgeries. my employer voluntarily resigned me however, once my i'm able to return back to work, my employer can hire me back if a position is open. my w/c attorney reviewed my employer's policy and even reviewed my policy being a union employee. i have been frustrated not knowing when my temporary disability check to arrive. there are times i get paid weekly and some occasion i get paid biweekly and there is no set day when to expect check versus there is a set day when i expect to receive my by social security disability check which is always the 2nd Wednesday of the month. my w/c check can arrive any day of the week and it's very difficult to manage your finance. i even call the insurance company to verify whether a check has been mailed. there is no statue when w/c check is to me mailed because it's bases on your follow-up with your physician and updating your file. the only time you or your attorney can complain is when you haven't received your w/c after a month has gone by. i was told by my case manager that, i'm suppose to receive a check on a weekly basis. i have complained and there is nothing anyone can do to change when you are to receive your check. i'm glad that the person processing my check is getting paid on a regular basis because, i hate for them to receive there check late. unfortunately, they don't realize that the injured individual has suffered mentally, emotionally and has to bear more problems by not knowing when to expect the check to pay for bills. i have also been told that the insurance company use the term "MMI" Maximum Medical Improvement..there is no such wording. the only individual that can release you is your physician. your physician determines when you have reached "MMI" and not your case manager. the case manager does not represent you.....they represent the insurance company and there goal is to discharge you so as quickly so, that the insurance company can stop paying you. also your limited on who you can see (physician/surgeon). you have to stay within network or you will be responsible for paying a physician that is out of network. also, it is your choice to whether to agree for your case manager to present during your follow-up. in my case my attorney advise me that any further follow-up my case manager is not permitted in the room. i had had a situation that my case manager attempted to persuade my surgeon to "MMI" me and even mention that if i'm "MMI" my case can precede. my case is the last thing on my mind. what's important is my recovery and my surgeon stated that my because of my surgery, the expected "MMI" is approx. 1 year from the surgery date. my surgeon is the expert and has more knowledge when it comes to the client's recovery and not my case manager. i don't know what to expect from here. i'm also frustrated of the statue that any third party lawsuit w/c can place a lien in any award settlement. 2/3 is approx. 66% and not including attorney fee, approx 33% therefore leaving the client practically with nothing. in my opinion my former employer should be responsible in paying the insurance and not the client. and there's also an offset if your receiving social security disability and the offset also includes your children's benefit. the offset is remove once your w/c stops. i have also encourage that the client them self applies for social security disability before seeking an attorney. your disability will be your witness once your evaluated by a physiatrist. the paperwork can be very lengthly therefore, i suggest that you ask a family member to help you fill out the form. social security will ask for your consent to obtain all medical records from all your doctors and once all this is receive you will be contacted to be evaluated by the physiatrist. the physiatrist will determine whether you qualify or not and your award is already precalculated base on your earnings therefore, why should you give any money to pay an attorney when you can use the cost to pay your bills, etc. however, if you have been denied than i suggest that you seek an attorney. this is base on my personal experience and sharing my experience with other who are injured and going thru the process. i have even called my senator but unfortunately, i did not get the opportunity to speak to her instead i spoke with her cheif of staff. i was told that if this goes to court, i will be notified to tell express my concerns. the bottom line is that no one really cares nor this issue is in the top of any legislation. until them self becomes a victim. i have alot of questions and hope to ask for your response who is also going thru is ordeal.

[Sithie]

I am sorry, i do not understand what is the question exactly?

[sparkey]

I did not see really a question either. But did see that you were not being paid weekly. When i was out of work, i could expect a check every Sat. from the Ins. If it was not there on a Sat. it would show up on the following Monday. So it should be showing up there every week. I do not have SS so I do not know anything about how that effects your payments.

If i were you, i would call the labor board and report them. I had to call the labor board this week because i had over 2 months i was waiting on mileage reimbursement of 500 miles. As soon as i called them, i went out to get the mail and it was there . I got to the point i got sick of waiting. I told them to let me just see if it came this week and if not they were going to be following up with the IC.

I also finally got my date for my IME for April 3rd. I had been waiting to hear when that would take place,and i asked the labor board and they told me that the ic has 30 days in which to set one up. So now both things are taken care of and now i am just waiting for April to roll around.

[jayson]

jayson Wrote:things that i have learned and would like to share. your not protected from losing your job. i was unable to return to work on the specific date (6month) because of the traumatic event that occurred and recovering from my surgeries. my employer voluntarily resigned me however, once my i'm able to return back to work, my employer can hire me back if a position is open. my w/c attorney reviewed my employer's policy and even reviewed my policy being a union employee. i have been frustrated not knowing when my temporary disability check to arrive. there are times i get paid weekly and some occasion i get paid biweekly and there is no set day when to expect check versus there is a set day when i expect to receive my by social security disability check which is always the 2nd Wednesday of the month. my w/c check can arrive any day of the week and it's very difficult to manage your finance. i even call the insurance company to verify whether a check has been mailed. there is no statue when w/c check is to me mailed because it's bases on your follow-up with your physician and updating your file. the only time you or your attorney can complain is when you haven't received your w/c after a month has gone by. i was told by my case manager that, i'm suppose to receive a check on a weekly basis. i have complained and there is nothing anyone can do to change when you are to receive your check. i'm glad that the person processing my check is getting paid on a regular basis because, i hate for them to receive there check late. unfortunately, they don't realize that the injured individual has suffered mentally, emotionally and has to bear more problems by not knowing when to expect the check to pay for bills. i have also been told that the insurance company use the term "MMI" Maximum Medical Improvement..there is no such wording. the only individual that can release you is your physician. your physician determines when you have reached "MMI" and not your case manager. the case manager does not represent you.....they represent the insurance company and there goal is to discharge you so as quickly so, that the insurance company can stop paying you. also your limited on who you can see (physician/surgeon). you have to stay within network or you will be responsible for paying a physician that is out of network. also, it is your choice to whether to agree for your case manager to present during your follow-up. in my case my attorney advise me that any further follow-up my case manager is not permitted in the room. i had had a situation that my case manager attempted to persuade my surgeon to "MMI" me and even mention that if i'm "MMI" my case can precede. my case is the last thing on my mind. what's important is my recovery and my surgeon stated that my because of my surgery, the expected "MMI" is approx. 1 year from the surgery date. my surgeon is the expert and has more knowledge when it comes to the client's recovery and not my case manager. i don't know what to expect from here. i'm also frustrated of the statue that any third party lawsuit w/c can place a lien in any award settlement. 2/3 is approx. 66% and not including attorney fee, approx 33% therefore leaving the client practically with nothing. in my opinion my former employer should be responsible in paying the insurance and not the client. and there's also an offset if your receiving social security disability and the offset also includes your children's benefit. the offset is remove once your w/c stops. i have also encourage that the client them self applies for social security disability before seeking an attorney. your disability will be your witness once your evaluated by a physiatrist. the paperwork can be very lengthly therefore, i suggest that you ask a family member to help you fill out the form. social security will ask for your consent to obtain all medical records from all your doctors and once all this is receive you will be contacted to be evaluated by the physiatrist. the physiatrist will determine whether you qualify or not and your award is already precalculated base on your earnings therefore, why should you give any money to pay an attorney when you can use the cost to pay your bills, etc. however, if you have been denied than i suggest that you seek an attorney. this is base on my personal experience and sharing my experience with other who are injured and going thru the process. i have even called my senator but unfortunately, i did not get the opportunity to speak to her instead i spoke with her cheif of staff. i was told that if this goes to court, i will be notified to tell express my concerns. the bottom line is that no one really cares nor this issue is in the top of any legislation. until them self becomes a victim. i have alot of questions and hope to ask for your response who is also going thru is ordeal.

[jayson]

thank for replying ....sorry if i had misinformed people regarding my experience. first i wanted to tell my experience regarding my ordeal. i forgot to mentioned that my case manager had told my surgeon that i had to follow-up with him on a monthly basis to continue my temporary benefit. initially my surgeon had request for me to schedule my next follow-up in 3 month but that was unaccepted by my case manager. she expressed that i can not sit in my home for three month and collect my temporary disability check from w/c and not be seen by a physician within those 3 month therefore, my appointment was changed to a monthly scheduled. i informed my w/c attorney and was informed that it is not the case manager who decides and it is the decision of my surgeon when he/or she feels to schedule my next follow-up. it's really upsetting that we all don't work together to advocate for the client and represent what's best for the client and not the insurance company. i had an experience with a pain management physician stating that my complaint was not the cause of the injury therefore my case manager was very quickly to note that. i had rebutted his statement and had to correct him by asking him that he/she can not be 100% accurate in his/her statement and that physician agreed therefore why should he/she should have made that statement in the beginning? I strongly feel that most of the physician that i have seen doesn't represent me nor treat me therefore violating there code of ethics, to treat the patient and do no harm. my physicians treat the insurance company. the goal of the physician is again to discharge you so that you are clear to return back to some type of work and payment will stop from w/c. the faster there rate of discharge, w/c will recommend clients to there practice. i had made a complaint to the medical review board and finally someone had stated that this physician are not my doctors but doctors who are assigned by your w/c. but please don't get this message the wrong impression of physicians because not all physicians have forgotten the client. there are good physicians out there that will advocate for you. initially i didn't have a question to ask, instead just telling my experience to others who are injured and going thru this and hopefully to help them learn from my experience so that they don't have to face ordeal. regarding my disability check from social security. an offset has been place because i can not receive than approx. 80% of my earning for example my offset was $400 minus therefore receiving approx. $1000.00 a month and my children's offset is more than 90%. for example there receiving only 5 dollars each initially and and increase in 2008 because of the increase from the standard of living to $9 dollars. originally they were entitle to receive approx. $400 each and once my w/c stop all the offsets will be remove and i will receive full benefit from social security. i'm glad to hear that other injured individuals are receiving there check on a timely manner. please bear with me...i joined this site to voice my experience and share my ordeal and read other experience and learn from them and hopefully i can do the same with me sharing my experience to who reads my issues. i was even told that once that i am cleared from my physician and my benefits will stop. i can asks my case manager to receive some money from the future settlement to accommodate until my case settles and that amount will be reduce from the settlement but i haven't discuss that with my w/c attorney because that has not happen yet. thanks for your reply.

[tweety00]

Hi jayson welcome to the boards or forums

Please ask an questions and I understand the frustations that you are having

It took Me a long time to remember This Isnt my insurance its the employers .. so they will try all conservative measures if at all possible ... and There isnt a magic pill to make it all better ...

I was use to going to doctor for a pill to make me feel better big wake up call ... after getting hurt .... Maybe its because Im a small town girl and nieve .. lol

[tweety00]

Do you have a lawyer ??? Im really surprised that they are allowing the case manager to go into the appointments ..... Remember that pointed black hat ... lol you dont want her in there at all ..

thats my opinion ...

[jayson]

RE: worker's compensation issues

thank for replying ....sorry if i had misinformed people regarding my experience. first i wanted to tell my experience regarding my ordeal. i forgot to mentioned that my case manager had told my surgeon that i had to follow-up with him on a monthly basis to continue my temporary benefit. initially my surgeon had request for me to schedule my next follow-up in 3 month but that was unaccepted by my case manager. she expressed that i can not sit in my home for three month and collect my temporary disability check from w/c and not be seen by a physician within those 3 month therefore, my appointment was changed to a monthly scheduled. i informed my w/c attorney and was informed that it is not the case manager who decides and it is the decision of my surgeon when he/or she feels to schedule my next follow-up. it's really upsetting that we all don't work together to advocate for the client and represent what's best for the client and not the insurance company. i had an experience with a pain management physician stating that my complaint was not the cause of the injury therefore my case manager was very quickly to note that. i had rebutted his statement and had to correct him by asking him that he/she can not be 100% accurate in his/her statement and that physician agreed therefore why should he/she should have made that statement in the beginning? I strongly feel that most of the physician that i have seen doesn't represent me nor treat me therefore violating there code of ethics, to treat the patient and do no harm. my physicians treat the insurance company. the goal of the physician is again to discharge you so that you are clear to return back to some type of work and payment will stop from w/c. the faster there rate of discharge, w/c will recommend clients to there practice. i had made a complaint to the medical review board and finally someone had stated that this physician are not my doctors but doctors who are assigned by your w/c. but please don't get this message the wrong impression of physicians because not all physicians have forgotten the client. there are good physicians out there that will advocate for you. initially i didn't have a question to ask, instead just telling my experience to others who are injured and going thru this and hopefully to help them learn from my experience so that they don't have to face ordeal. regarding my disability check from social security. an offset has been place because i can not receive than approx. 80% of my earning for example my offset was $400 minus therefore receiving approx. $1000.00 a month and my children's offset is more than 90%. for example there receiving only 5 dollars each initially and and increase in 2008 because of the increase from the standard of living to $9 dollars. originally they were entitle to receive approx. $400 each and once my w/c stop all the offsets will be remove and i will receive full benefit from social security. i'm glad to hear that other injured individuals are receiving there check on a timely manner. please bear with me...i joined this site to voice my experience and share my ordeal and read other experience and learn from them and hopefully i can do the same with me sharing my experience to who reads my issues. i was even told that once that i am cleared from my physician and my benefits will stop. i can asks my case manager to receive some money from the future settlement to accommodate until my case settles and that amount will be reduce from the settlement but i haven't discuss that with my w/c attorney because that has not happen yet. thanks for your reply.

[tweety00]

click at the bottom after where you typed in the quick reply and then its a fresh message

or if you want to use a Quote at the end of where you typed hit the reply button

I know just got to get use to it lol
Tweety

[ksgirl]

Hi Jayson and welcome to this wonderful community! Thank you for sharing your wc experience with us. I agree that the drs are working for the insurance company and not the injured worker. I have read my drs reports and none of them are quite accurate. What really makes me mad is when the dr says he has examined me and the only exam he has done since I had surgery was to look at my incision once. He doesn't even watch me walk in or out of the room. I also had problems with getting my check in a timely manner. I have had two adjusters and three nurse case managers. Thankfully I found a lawyer that deals with them now.

Again, I just wanted to welcome you and tell you that if you need to ask a question, go ahead, and if you have an answer, jump right in!