Need some input please

[hurting in ca]

I have an accumulated injury due to my work and have been out on disability since August 2008. First time I filed for workman's comp was in 2007 for my neck and shoulder, however since the company was deducting money for the hours I missed going to the doctor, I dropped the case and worked/lived with the pain. A year later in 2008 the pain got worse and spread down to my elbow, arm, wrist, hands and I no longer could bear the pain. so I filed for workman's comp again.

Between 2007 and 2008 my employer had changed wkmns comp ins co. I finally had my MRI and nerve conduction test done, I will find out the results Dec. 8th.

In the mean time, I've already had one deposition with one of the insurance co, and another one with the current ins company is due to take place Dec 11th. ( I do have an attorney, but I can never get a hold of him unless I make a phone apt and it's so hard to be prepared when he calls) so I figured maybe I can get some answers here? Here they are:

1-Will the employee and company contribution amounts for my health insurance benefits be covered since I can't work to pay my part of the contribution?

2-It's been over 90 days from the beginning of my claim that was filed in 2008 and I'm still in limbo, (delay status) Isn't it the law that if they don't either deny or reject my claim that it's an assumption of liability? (I've been in delay status this whole time!)

3-I know these two insurance companies are trying to get the other one to take the case, but my benefits are being delayed and I'm at the verge of getting evicted from my apt. Is there a moratorium as to how long you can be placed on "delay status" ?

4-Will the amount of my workman's comp checks be higher than my state disability?

I'm barely able to survive on what I'm receiving. Any insight or/and ideas would be greatly appreciated.

Thank you

[1171]

1 no. workers comp benefits are specified by law and do not include payment of other insurance premiums.
2. yes. they have 90 days from the filing of the claim form to reject the claim or its considered accepted. there is also a rule that until the claim is rejected they are required to provide up to $10K in medical treatment.
3. no moratorium. it's lasts as long as it takes fto go to a comp court hearing. you can file for an expedited hearing at any time.
4. no. generally sdi and worker comp rates are similiar.

ideas: learn as much as you can about your rights and the benefits available: start with the fact sheets here
http://www.dir.ca.gov/dwc/iwguides.html
the guidebook also has valuable information
http://www.dir.ca.gov/CHSWC/Reports/Work...-3rdEd.pdf
It sounds like your atty has been less then helpful in directing your claim.

[hurting in ca]

1171 Wrote:1 no. workers comp benefits are specified by law and do not include payment of other insurance premiums.
2. yes. they have 90 days from the filing of the claim form to reject the claim or its considered accepted. there is also a rule that until the claim is rejected they are required to provide up to $10K in medical treatment.
3. no moratorium. it's lasts as long as it takes fto go to a comp court hearing. you can file for an expedited hearing at any time.
4. no. generally sdi and worker comp rates are similiar.

ideas: learn as much as you can about your rights and the benefits available: start with the fact sheets here
http://www.dir.ca.gov/dwc/iwguides.html
the guidebook also has valuable information
http://www.dir.ca.gov/CHSWC/Reports/Work...-3rdEd.pdf
It sounds like your atty has been less then helpful in directing your claim.

[Manley2]

My monthly income on disabilty is what my weekly gross was before my injury so it's very hard to make it. But I think that is normal for most of us that have been injuried at work. WC doesn't make life easy for those injuried and that is sad. I understand there are those that fake things but once it is proven that your injuries are real being able to pay your bills and put food in your mouth should not be a problem, but it is. Sorry to hear of your troubles but I just wanted to let you know that this is life once you have been injuried. Some companies go the extra mile to help employees hurt at work but most don't. Hope thinks will work out for you but don't expect anything to work fast.

[hurting in ca]

First thanks for your reply.
On
Question 3 - If there is no moratorium for acceptance or rejection of my claim then what's the 90 day rule about?
Question 4 - I understand the rate is 2/3 of your regular salary. Is this from net or gross salary? (btw I'm not getting that now!)
Will the pay rate be re-calculated by the insurance company or DWC?

[Manley2]

My work still pays their part of my health insurance but I have to pay my part. In my case that is 10% of my monthly check goes to cover my health insurance.

[Manley2]

My monthly diablity is based on a lower income right now. My injury was in 2005, beside losing money for going to doctor appt, therapy, tests, and treatment they cut my pay in April 2007. Last week I had my first hearing to get my pay back covered under WC. It will be a month before I get the answer from the IC, and even if it goes my way the company can appeal. Which could mean a year or more before resolved.

[1171]

there is no time limit for the carriers to dispute the liability among themselves.
gross.
any dispute is handled by the comp court. you can request a finding on your comp rate if you believe it has been calculated incorrectly.
you can always supply additional earnings information to the carrier and ask for a recalculation.

[hurting in ca]

Manley2 Wrote:My work still pays their part of my health insurance but I have to pay my part. In my case that is 10% of my monthly check goes to cover my health insurance.

Who issues your check? your company?

[Manley2]

If you are asking about my disabilty checks I get once a month it is the insurance company separate from WC. This because they said my injury was not work related after my doctor wanted to try a spinal cord stimulator.