Stress Claim - Freakin Out

[chrischris]

My CA has forewarned me that because of my stress claim, he will be investigating and will have to dwelve into my past. He has also indicated that I need to decide one or the other, if my stress claim is due to work injury, or if my claim is due to work situation. I think it's both and cannot be separated. Also, CA has informed me that he has assigned a new NCM and he/she will be contacting me to assist me. I'm freaking out!

1) What is included in dwelving into one's past. Please be specific.
2) What exactly would be the purpose of determining the stress factor; i.e.: work injury or work situation?
3) I had NCM removed before for MPN non-compliance. Gawd, I don't want another NCM.
4) I am having trouble finding a lawyer to help me. No one has returned my call as of yet. What happens if an IW cannot find a lawyer?

I really would like 1171 to reply, as well as anyone else who can offer advice, opinions; or has been thru a stress claim an would tell me your experience. You can PM me if you would prefer. Thanks!

[1171]

Easy, easy.  just a standard requirement. the adjuster should not have made it out to be a big deal. they need to tead a bit more lightly when dealing with those who have stress claims. I suspect they came on a bit too strong with you.
They have to establish a causal connection between your claim and the job-- just like with physical injuries. Stress claims in california also have a higher standard then physical injuries in order to be accepted. There was a lot of abuse of these claims in the past so the legislature made special rules to keep some claims out of the system.

here are the special stress claim rules for california:

1.  You have to been employed for over 6 months to be eligible (some exceptions)
2.  The employee must “demonstrate by a preponderance of the evidence that actual events of employment would be predominant as to all causes combined of the psychiatric injury.”
3. There are futher restrictions if the claim was filed after notice of termination or layoff
4.  It also cannot be substantially caused by a lawful, nondiscriminatory, good faith personnel action.

If those factors are not involved in your case then that leaves the standard test that the condition has to arise and occur in the course and scope of the employment.
The examining doctor will want to go over all your medical records and will take a detailed history from you. You wouldn't expect anything less from any competent psychiatrist.

I think you must have got the question about which decision you have to make wrong or misworded your post because the statements are identical.
Here's a tip: when talking to the doctor or adjuster or nurse case manager on the phone keep a note pad handy to write down reminders and exact words.
Adjusters always have your file open when they discuss a case and are taught to take copious notes. It helps them and could help you.
When we are under stress our memories don't function well. you can also keep a list of questions to ask so you don't forget important information.  

Most important: be calm. this happens thousands of times and you are not going to make a mistake or do anything wrong. You know things go very slowly in comp so there is no need to rush anything. take your time and a deep breath.

If you want more information on these issues there are some links and legal references in the law i can give you. But not if it'll worry you more.

I'll be glad to help you all i can.

[chrischris]

1171, Calmed a tad, so I want to continue this. CA also said that if I wanted immediate phyche/counseling help I need to go thru my private insurance, as he would have to delay claim for investigation process. I asked him about ACOEM Chap. 6 regarding Chronic Pain and if it would not be allowable for psyche help as I have been in pain 24/7 for 15 months. He said he could not comment on ACOEM as it relates to my treatment. Geeze, should I send him a copy. What's the Big Deal?

Please send me from your archives anything you have in relation to stress claims. I have nothing else to do and might as well study up.

Complete medical history doesn't worry me, nor does an investigation. However, since these claims are not considered "No-fault" the proof of injury has to be proven to employee's favor and I feel like it's an uphill battle, especially here in California. When I think of all the what if's it makes me ill. My supervisor is a liar and as past experience has shown, she will take someone down with no thought about it. I have no doubt that supervisor's depo will weigh more, it's just the way it is and most likely what the IC wants to hear.

I have one thing going for me and that is I have a reputation of being fair and honest, and my employment record here, and elsewhere is spot clean.

I appreciate your help 1171, and will probably need advice from time to time to get thru this. What a mess! Thanks!!!!!

[1171]

It sounds like you believe the carrier, adjuster, doctor, comp board etc. are all in cahoots with the bad supervisor and will reject your benefits no matter what the evidence is.

more attys can be found here
http://www.caaa.org/

i'll post some reference links in the next couple days.
P.s. whether the injury was brought about by the work or the claim or both doesn't change the compensibility tests; they are all covered.

[Wink]

chrischris Wrote:My CA has forewarned me that because of my stress claim, he will be investigating and will have to dwelve into my past.    He has also indicated that I need to decide one or the other, if my stress claim is due to work injury, or if my claim is due to work situation.   I think it's both and cannot be separated.  Also, CA has informed me that he has assigned a new NCM and he/she will be contacting me to assist me.

Chris~
There is a distinct reason why your adjuster needs for you to decide whether your stress claim is due to work injury, or if your claim is due to work situation.  Why, I do not know, because I haven't been there.  Certainly, both should be intermeshed.  Whether you realize it or not, you're now - not by your own choice - playing chess, so to speak, with the adjuster, and truly need to look ahead at what moves you need to make--and more, what moves the adjuster may take.  I know that you don't have a lawyer, but if I were in this situation, I'd just walk in off the street to a lawyer's office that represents injured workers and simply ask for advice on the stress claim question alone.  What lawyer won't at least help you on such an important question?  It'll only take a minute.  And who knows, he may take on your case.

[chrischris]

1171, I have to get that out of my head and think positively about this. I know what I am doing is right. I'll be looking for your reference links. Thanks again!

Wink, I am hoping I can find the answer. I can't separate the work injury from the work situation on my claim because this situtation didn't exist prior to injury. Does that make any sense? And, I can't do this on my own. I have to have a lawyer. There's no question anymore. I just didn't think it would be so hard to find one. Thanks!

[Sithie]

Hey Chris, I know aabsolutly nada about Cali WC, but I know that you will be fine. Also, just a tip, I found my PI lawyer, by asking a friend of my dad's in tx who is a lawyer, who was good here and would take good care of me, he asked around, he did'nt know anyone here either, until he found someone with a good reputation in his circles. Maybe you could do something the same, if you have ever used a lawyer in the past or know one, or even someone who knows one. I can also ask around here, as Colorado is quickly filling up with Califorinians.

You will be fine, and I will be pullin for you! (((((Chris)))))

[chrischris]

Thanks Sithie, I appreciate the support.   I'm not giving up.   I have absolutely no experience with lawyers and really don't know any IW's either.   New and uncomfortable experience.        I might have to go knocking on doors.   Ugh!!!!!!!!!     Take care of yourself.

[Pooh]

Chris

Sorry your having to decide this at this time.

First off on choicing an attorney - one tip that I can give you is go to a larger city to choose an attorney.

I don't know if California has thier decisions posted on line or not - but that is also a good source for WC attorneys and you can research how they do on cases as well at the same time .... tricky little thing there but well worth it. If they do - they will at least have the attorney name and address on the decision on line - then you can look up the phone number.

If your company has a union - sometimes the union can give you leads to attorneys as well for attorneys for IW.

Just trying to help with different suggestions here although not much really in that line.

As far as the stress claim - yes I understand what you are saying - it's hard to seperate the 2 - the injury from the work situation. But sounds like you also suffer from severe anxiety and I am sure prior to the injury you were probably a type A personality and that has really changed for you now.

All I can offer you other than some advice at this time is some ((((((((((gentle hugs)))))))

[capricorn]

Morning CC and hope you are a little calmer. I can't add to the legal issues as I have opted not to file a stress claim. In my case the verbal and mental abuse for years combined with the extent of injuries caused me to have a breakdown months ago. My reason for not pursuing this is that I was dx with PTSD about 5 years ago hence it not being work related. My attorney told me he would do whatever I wanted BUT also assured me that all mental health records would be brought into light and I really wasn't putting myself through having my personal life made into a movie. CC, I also agree with Pooh in the type A personality. I don't know if it's true in your case but it was in mine. I know longer am. Did the badgering and harrassment on the job add to the mix? Absolutely!!! Did my injuries add to the mix? Absolutely!!! It was just my preference not to have them brought out into the open. BUT i have to say in someone else's case I would probably tell them to go for it. I am wishing you the best. Please do what's right for you.

Prayers,
CAP