As someone who has gone through this process my best advice: LAWYER UP EARLY! You will be forced to resign (like I was) because they will be watching you like a hawk and documenting EVERYTHING all the while making your life miserable!. Once you resign, you have three years (at least in my state) until they close your claim. In my case, I wasn't interested in a lump settlement. My attorney was very good. She successfully won me a lifetime L and I pension for life with backpay! My monthly benefit is around $5K a month (with COLA increases).
Thank you. I have a lawyer that wants to settle, but I have had a change in ability to help move my self from where I live and he is looking at his 30 percent where he sees less the 100k. That is not worth it to me as I will have to pay a lot more for the rest of my life to make up the funds it will take me to move to my forever home. Dirt. Thank you again
I just settled my workers comp case this week and thank God I didn't have to resign. Or I didn't have to give up my civil suit. I made sure the language in my settlement said exclusively settling for working comp claim only. And not waiving my right to file a civil case or any other economic or no economic damages.
@@myworkerscompguide Great video this really hit all aspects of my situation right now. At this point I can move forward with my civil case. Also can you elaborate on AB749. And on another note I have an open case with the DFEH, and an arbitration with my union next month. It's a great feeling to finally start getting justice for the years of harrasment and discrimination that I delt with from this company.
@@Hubcitybg If by AB749 you're referring to the prohibition recently against no rehire clauses in settlements, I haven't reviewed it lately. I will say that when my clients are presented with a voluntary resignation that includes a clause against any future rehire, that I do two things. One, I tell my clients that I'm only a workers' comp attorney, and employment law is a closely related area of the law, but very specialized. They are always best served by talking to an employment law attorney as I only have passing knowledge of that area of law. Two, if they don't meet with an employment law attorney, I always strike any no rehire provision and simply tell the defense attorney we won't agree to it. Been doing that for years, and have never had a defense attorney put up a fight over it. Lastly, these videos are aimed a typical workers' comp issues for unrepresented injured workers, and an in-depth video with analysis on AB749 would (I suspect) be dry, boring, and likely not of wide interest. Or so says my gut instinct.
@@dennismosley9163 Workers' comp is an administrative law system through the Department of Industrial Relations and the Workers' Compensation Appeals Board. Workers' comp is generally the exclusive remedy for injured workers. However, in certain fact patterns you can also pursue a civil suit, which would be either in the California Superior Court system, or in the Federal Court system. In those civil cases you may be suing the employer or perhaps another third party. In a comment above another person mentions DFEH, which is the California office of Department of Fair Employment and Housing, which is where you would generally go to pursue a civil case pertaining to discrimination.
Question for you. If you were recently injured (days) and are going to file for W/C, is it a good idea to find an attorney right away? I have a friend that was injured over a year ago and recently got an attorney after all sorts of delays and wishy washy treatment. 4 days ago I was injured and do not want to go thru all the bs that she did.
Every case is unique, and I can't say what you should, or should not, do. But in general, most injured workers are better off with an attorney to help with the QME process, to help with treatment denials, and to help ensure all appropriate benefits are paid. If it's a minor injury, is accepted, and there is no time lost from work, then there is less need for an attorney. If time is lost from work, or the claim is denied, or the injury is more significant, then an attorney becomes more important.
I'm currently dealing with a workers comp claim involving both knees. I've been going to therapy, and just had a MRI done, but have yet to find out the results of it. My attorney has already scheduled a mediation with both the companies attorney, and with the judge. I'm assuming my attorney wants to go for a possible settlement, however I don't wish to resign, as I like the company and my job. Time will tell how things work out I suppose.
Just let your attorney know your desires. Sometimes my clients want to quit, and sometimes my clients have been at the job for decades and love it. Each case is unique.
Thank you for your videos. They have been very helpful and educational. After insurance denied my work compensation case, I called several workers comp lawyers. None were willing to take up my case due to it not being financially beneficial for them. They advised me to file a claim with the industrial commission (IC) which Idid. IC reached out to my employer and a court date was set. At present the lawyers representing my employer reached out to have a pre-trial settlement at 60% of my wages, and pay my medical bills up until the time of the settlement, with the condition that I sign a CNR and to not bring any further claims against them. There are other claims due my employer not giving me accommodation to work with the limitations according to the doctor's recommendations. What is your take on this seeing that I do not have a lawyer and they want me to sign the CNR?
Based on your references to the IC and a settlement at 60% of your wages, it sounds like you're not in California. I'm only familiar with California's system. I'd recommend asking if they have anyone to answer questions at the IC. For example, in California there are Information and Assistance Officers at the WCAB offices, and they can answer questions for injured workers without an attorney.
@My Workers' Comp Guide , thank you for your response. I had requested assistance and the response was that they have to remain fair so they don't get involved or provide resources.
@@jalamvula2510 The same is generally true in California. The I&A Officers cannot provide advice, but they can answer questions - a lot like what I do on here. The only way to really get advice is to meet with an attorney and go over the specifics of your case, your goals, etc. You may want to reach out to additional attorneys. It's not uncommon that several attorneys will say 'no' and then suddenly one will agree to represent the injured worker.
If you deal with a government agency, get a lawyer. Workmans comp, unemployment, ssi, ssdi, basic traffic court, ect ect. Lawyers want you to win because they generally keep 20%, and theyre probably smarter than you when it comes tobour ever changing laws
Great videos. My question is on a work related 2019 vehicle accident that gave me 4 cervical disc damage. 3 dis replace. The 4th disc C2 was a “ The risk out weighed the benefits”. My QME rating was 28% permanent stationary. My attorney forward all the required medical documents to the QME. In my Exam I did not notice the QME refer to any notes or documentation other than the books on hand. I realize it’s possible that he reviewed his notes prior to my exam. My question is how does the C2 “ The risk outweighs the benefits” play into that 28% permanent stationary rating. My attorney has setup 2 phone meetings with me post exam but has canceled both appointments. I understand that I’m not his only client and he is likely closing or settling other cases. Which is why I am reaching out to you because of your informative TH-cam videos. Thank you for any insight you may have.
I'd have to defer to your attorney, as he or she will know your case best. I'm not entirely sure what the "risk outweighs the benefits" means other than maybe the surgeon didn't recommend surgery at that level. Nonetheless, generally the QME addresses the level of WPI or disability based on your condition at that time. So depending on your condition at the point you are declared P&S, will determine your level of whole person impairment, and would take into account your diagnosis, any surgeries, any range of motion issues, weakness issues, etc. The QME doesn't generally offer any rating on a hypothetical of "you could have had surgery but didn't, so here's what the rating would be if you had surgery." The QME just addresses how you are at that time. But again, you'd have to ask your attorney for specifics on your case.
@@myworkerscompguide Thank you! This was kinda the answer I was expecting. It’s just another piece of my puzzle to think about. I realize I’m not going to get rich but I am looking for my best outcome. Again thank you.
Going back to the unemployment compensation, if you haven't worked for over a year, and collect a Time loss benefits you won't have any wages built up to even collect unemployment.
It is possible, depending on what has been paid in to EDD and what has been withdrawn. I recommend people contact EDD directly to find out what benefits may be available.
I have been on WC for roughly 3 years. Out of those I have work with restrictions on and off. Recently, I found out that my employer cancelled my long term disability insurance and any other insurance I had. When I asked why, they told me that it was because I had another job. But I’m still supposed to employed by them. 8:45 And they never notified me. Now I’m am applying for total disability through social security. My is still going, I do have an attorney for SSI but not for the rest. What can I do?
I'd recommend reaching out to a local attorney for a consultation, and it may be that you need to speak to an employment law attorney and a workers' comp attorney. Your situation sounds complicated, and not like something that I could really address over this forum. I would also recommend reaching out to other attorneys soon, as there can be deadlines that might apply depending on when insurance was canceled and other issues in your case. Best of luck to you.
You have the final choice as to whether to keep your medical open or not, but there are many factors that go in to how and when to settle. You would have to discuss with your attorney as he or she knows your case best.
@@PHOENIQUES_ Thanks. You can ask questions here. I can't give any advice. I can only answer questions about how the California workers' comp system operates. If your questions are too involved, I'd likely refer you to the I&A Officer at your local WCAB office, or recommend you reach out to a local attorney.
Well i been waiting see what happens still treatment is been on hold with fighting for authorization with no progress with system woserning and being fired during my time off under workers comp 😤😤
@@myworkerscompguide so true seen it all that nothing surprises me now of days from getting fired from job after worker comp treatment slowed down and delayed oh well killing me for now
I've been on comp for over 5 1/2 yrs with a broken ankle, lower back and rght knee issues been offered 3 settlement amounts the last being 90k I am unable to return to work, Currently im at 85 % according to both sides I have also reached mmi my attorney says the ins company is not willing to settle now what happens next ?
I couldn't say what will happen in your case. If both sides agree to the level of permanent disability, then usually it is a matter of negotiating a C&R or just waiting on the defense attorney to draft the Stipulations. If either side disagrees with the rating, then further discovery may be needed. I will say that in California, for an injury occurring in the last nine years or so and at the maximum PD rate, the PD alone is worth $195,000. However, since you have an attorney, you really need to reach out to him or her as that person knows your case best, what the strategy is, what the case value is, etc. Best of luck to you.
I had a slip and fall work injury on April-2020, I hit very badly my whole back, neck and head, I heard that all my back bones cracked and my head bounced, and the neutral doctor reported on Dec-2020 that I slipped and fall from my head, neck and didn’t mentioned about my back, favoring to the insurer employer with his report, not giving any rating for my lower and upper back
It is not uncommon for a QME to fail to address certain body parts or issues. When that occurs a supplemental report can be requested, or a re-exam may be needed. However there are strict rules for how to request a supplemental report. You may want to reach out to your I&A Officer at your local WCAB office to discuss your options.
@@myworkerscompguide the representing attorney didn’t request a supplemental report to the doctor, instead send me to other specialists doctors, not related to my lower back, and now my case is close to settle and most attorneys said, they can’t do anything to change that report, since it was not requested the supplemental report on time, is this for real?? And the judge also is relaying only on this doctor report and blaming to my past injury
@@quinnoaechase7432 I cannot speak to your case. I can only answer questions as to how the workers' comp system works. It sounds like you need legal advice, and I cannot offer that. You mentioned the "representing attorney." If you have any attorney, you need to ask him or her. If you do not have an attorney, I would again recommend asking the I&A Officer at your local WCAB office for your options.
I was injured in March of 21 had to have surgery after a year with therapy didn’t heal right and had to have a second two years out my company took away my seniority and vacation and sick time telling me they are starting me over like a new employee is that legal?
At first blush it doesn't sound right. However, every case is unique and different employers/employees have different rights. I'd recommend reaching out to a local attorney near you to discuss your specific case/facts.
Is in writing the agreement of resignation after a c and r settlement? In which part of the form is . Can I ask to my employer for accomodations after the settlement or is over?
It really sounds like you should talk to an attorney for advice. I can only answer general questions as to how the system works. In general, if an employee is still with an employer, then the insurance company will not do a C&R unless the employee resigns first or at the same time. A resignation is generally in writing, but that's not necessarily required. There is no workers' comp form for a resignation. A resignation is an employment issue, and workers' comp deals with the injury. If a worker is injured and has permanent work restrictions, the worker certainly can ask for accommodations, and that all falls under employment law issues such as the interactive process.
No, I do not. It seems most attorneys who handle California workers' comp cases do not handle cases for the USPS as it is the Federal system and completely different. Best of luck to you.
If injury is dated July 2021 and return to work date is September 2021 and there is a stip & award offer, is there any chance the award would be alotted as a lump sum rather than biweekly payments due to so much time has passed now?
Stipulations are basically never paid out as a lump sum. However, the date of injury is not important for when benefits would start. The permanent disability payments will generally start either when temporary disability ends, or at the permanent and stationary date. So in some cases if an injured worker returns to work, is not getting permanent disability advances, and later a judge approves an award of permanent disability, there can be a lump sum payment at that time for retroactive benefits.
I have a question? I keep seeing that 99% of cases settle. I’m on 9 months of bring off work. Claim excepted, they have payed all PT, all chiropractic and recently an injection. I get paid every 2 weeks, but didn’t in the beginning for 3 months. Why cases do they not even offer a settlement, ? My attorney has barely talked about hypotheticals with me and got irritated that I ask him questions? Almost like he was taking it personally and was not compassionate at all. He took on my case 7 months ago. Do you see most cases settling or do I just see that in every TH-cam video? Something seems odd and is it normal for your job to never once reach out to you and ask you anything after 9 months?! Yet I’m still an employee? Thanks, hope that made sense. I’m not in California.
@@TMH792 I can really only speak to California, as that is the only system with which I am familiar. As to your case, you would have to ask your attorney as he or she knows your case best. In California, and in general, I suspect the number of settled cases is around 99%. However, cases until both parties agree to terms, and that often occurs after active treatment slows down, and after a QME writes a ratable report, and after the parties agree on all the terms - and that may take six months, or two years, or five years. There is no standard time for when a case settles. I'd guess the average litigated claim in California settles at around the two year mark. Keep in mind that a "case" doesn't really go to trial, but rather a "dispute" goes to trial. So there has to be a dispute over the PD rating, or the authorization of medical treatment, or the denial of a body part. That dispute may go to trial, but even then it will only do so after both sides have completed discovery on that dispute.
@@myworkerscompguide Thank you!! I have never heard any of this from my attorney. I did ask when will they offer a settlement and he said “we are way far from that right now.” He got frustrated when I asked him, too. Appreciate you writing this out! Thanks for all the info. Oregon may be different. I’m also wondering if he’s not on top of it. I call and get things sent to him all the time and he misses my emails and have to go over it all again on the phone with me. I know he’s busy, but he’s slowly becoming less engaged. He was really on top of things in the beginning. Thanks again! Really appreciate you writing this out.
If the insurance company has been paying and sending tou to doctor and also sports medicine doctor does this mean there takeing responsibility??? Ive been receivi1ng care but no payments yet do i have t?hat right to say hello whats going on with my temp payments?
Question? If you don't take the C&R settlement with resignation attached. And you choose your job over settelment. And you go back to work . And at a later date you reinjure same body part. Does the insurance company still have to cover that same injury again? Thanks in advance for your help.
If you resolve your injury with Stipulations with Request for Award, and keep on working for the same employer, and then down the road have a new injury, that is generally a new injury. So you'll file a Claim form for a new injury, and start the process anew. Then it will be up to the doctors to figure out if you had a new injury, whether treatment is needed for the new injury or old, etc. What really can complicate it is when the employer changes workers' comp insurance companies. I've had cases where my client had multiple injuries with the same employer over the years, and each case is handled by a different insurance company. All those companies can then fight it out amongst themselves as to who has to pay for treatment.
@@myworkerscompguide Thanks again. Maybe I'm not understanding. So I'm going to re ask. So if the insurance company comes to my lawyer and says. Ok we have a settlement for your client. But it's a compromise and release. Your client has to resign. And I say nope screw their CR. And I take nothing in order to save my job. I go back to work. A year later that same injury occurs. At that point does workers comp and the companies workers comp insurance company have to cover that same injury all over again. And this is assuming it's the same insurance company. My job has had them forever they're not switching insurance companies.
@@williamlevi5051 First, since you have an attorney your question would best be directed to him or her, as your attorney knows your case best. Second, in general, you can't have the same injury occur again. You could have a new injury to the same body part. In that case you'd file a new Claim Form. Or you could have an aggravation of your original injury, or an increase in pain due to your original injury. If you settle with future medical care open through Stipulations, then workers' comp is liable for all future medical treatment to cure or relieve the effects of the injury. So, if in the future you have increased pain due to this injury, then workers' comp would be liable. If in the future you had a new injury to the same body part, then that would be a new workers' comp injury and the insurance company would need to determine if they administered treatment through the original claim or the new claim.
@@myworkerscompguide Got it. So my next ? Then would be if you aggravated that same injury. And you originally just left your case open without settling on a monetary pay out because me as the injured worker didn't want to sign the CR with resignation attached. Fast forward to the future I reagravate that same injury. They treat it. At that point can I still settle for a monetary settlement amount ?
@@williamlevi5051 Two parts to that hypothetical. If you aggravate it within five years of your original date of injury, you could file a Petition to Reopen your case so you could potentially settle with Stipulations at a higher PD amount. Second, the option of a C&R is always available at any time in the future. So if you and insurance came to an agreement years down the road, you could always settle with a C&R and close out medical. So the bottom line is that you can get more money in the future if the aggravation is within five years and you have increased WPI, and you can get more money in the future by potentially closing out future medical.
Im still on wcb,my shoulder hurts everytime i used it,I'm done yesterday with 2nd comprehensive functuality assestment. I'm worried what will be their decision. Injured sept 2019, while on light duty employer laid me off march 16 2020.stating no work available for me.what will im going to do?
I always tell my clients that we need to wait to see what the report says before we decide what to do about it. As to your situation, often the functional capacity evaluation is used by the treating physician and the QME to determine ability to return to work and any necessary work restrictions. In your specific case, I am uncertain as to why you have had two functional evaluations, unless you might be referring to qualified medical evaluations. If that's the case, then the QME report (once it is issued) will be a key factor as to what happens next, how much your case is worth, etc. As to what you should do, I can't offer advice other than to say that you would probably be best served by reaching out to an attorney for a free consultation.
Thanks for the reply..1st functional test done last yr,then they send me to mri and cortisone with diagnose subcromial pain syndrome.give me limitation like limit to 6 lbs and send me to physio for 4mos.february they assign me to another case manager for the 3rd time and send me to wcb physician then to comprehensive functional capacity yesterday for 2 hrs and today another 2hrs.my new case manager stop my physiotherapy also.she told me she need to wait for the result and made decision because therphy seem doesn't work to me.
@@vhigomezvlogs4114 Keep in mind that if you are unhappy with your primary treating physician, you do have the right to change physicians. I did a video on that topic here - th-cam.com/video/1Xk4dsPt6Fs/w-d-xo.html You also have the right to get a second opinion if you see a specialist and disagree with the recommendation, or are unsure. Talk to your PTP about a referral to another specialist for the second opinion.
Thank you for this video and all your videos. I have a question on a QME appointment/report. I went to my scheduled QME appointment on January 7, 2022. The Dr. mentioned he did not have my medical records and we continued on with the appointment. My attorney finally gets the report which was dated January 24, 2022 and he does give some conclusions on some things but pretty much says he cannot really finish the report without having the medical records. Who was responsible to getting him the medical records? I also feel like he missed a couple of key issues but without the medical records that may be the reason why. So my attorney is reaching out to the insurance administrator and now asking for my records to be sent. What is the protocol from here. How long? I’m frustrated he never got my records!!
Sadly your situation is too common these days. The legislature changed the way med/legal examiners are paid a couple years ago, and they now bill by the page (at least in part). Because of that the parties try to avoid sending duplicate records/reports. For my clients I put the defense attorney or adjuster on notice at least a month before the exam that I expect them to send everything, and I am not. But still they fail to do so at times. It is just one of many frustrations of this system. In general, once the records are sent, examiners have 75 days to issue a supplemental report, so that gives you some idea. For any specifics on your case, reach out to your attorney as he or she will know the plan and strategy
@@myworkerscompguide thank you for your response. Bus this doesn’t seem right at all. So they pick/choose/ select which medical records to send because that are afraid to pay too much for the doctor to go over them? Well then choose the records that they rather you see to make your decisions! That sound like craziness to me. If they want an actuate and good report then give them all to him how can they truly make an informed decision without them??? Seems very sky and in favor of the insurance company making decisions on what reports will be submitted.
@@Krystaldoll282 No matter who sends the records, generally all of the records do need to go to the examiner to ensure that the report is substantial medical evidence. On most of my cases what I do is have the defense attorney send all of the records to avoid duplication of records. But both parties know ahead of time what records are going and, if appropriate, which records are not. You should discuss this with your attorney. Your attorney will know which records are going to the examiner and any records that are not. But the general rule is that all of the records do need to go to the examiner. The focus of my point is to avoid duplication of records, as on some of my cases I have had tens of thousands of pages of records, and you wouldn’t then want to send double sets.
If the adjuster sent a C&R to you, and you signed it and sent it back to the adjuster, and now the adjuster isn't responding, you may have to file a DOR. I did a video on that topic here - th-cam.com/video/P_qPyY9Vs5w/w-d-xo.html and I'm actually having the same situation on one of my files now. The adjuster sent Stipulations to me, my client and I signed them, I sent them back to the adjuster, and now nothing. She won't return messages, won't respond to emails, nothing. I'll likely be filing a DOR soon. If your situation is that you and the adjuster signed a C&R and it was sent it to the WCAB for approval and you haven't heard anything, it's a bit different. The judge has 15 days to act on a settlement. If not approved or disallowed within that time, the case should be set for a Status Conference and an Order Suspending Action will likely issue. Here's a video on how long the judge gets - th-cam.com/video/Rwpy_yEXKUQ/w-d-xo.html
Check out this video th-cam.com/video/KWBTM7Q3YQA/w-d-xo.html and see if it answers your question. If not, drop a comment on that video and I'll see what I can do.
To “reopen“ a case is generally done within five years of the date of injury and refers to filing a petition to re-open for new and further disability. You can compromise and release a case at any time, assuming both parties come to an agreement and the judge approves it. There is no need to re-open a case or anything along those lines for a C&R
Wow this is a lot to take in I have a quick question is it true that it worker comp settlement is worth more if you off work for long time due to the injury
The final settlement isn't really tied to how long someone was off work. However, in general if someone was off work longer that generally means it was a more significant injury which means the final settlement may be larger. But the final settlement is primarily based on the level of permanent impairment and the anticipated future medical care.
@@myworkerscompguide to be honest I've been out of work for almost two years I got surgery last year they did a lumbar laminectomy I already had about three different QMEs now they're talking about spinal injections my work restrictions are 20 lb I know that I do have a good case but I just want this to be all over with
I often have clients who want to quit their job, whether it be to go to another job with better pay, to another job with different coworkers, another job with better hours or work environment, or to a job in another city. There are many reasons to quit a job. It just has to be the best option for the injured worker, and not the best option for the insurance company.
@@myworkerscompguide I misworded the question. I get though but for an insurance company to suggest I resign to benefit them easily gets a middle finger.
@@creepincarl I hear you on that. Every case is unique. I've had many a case in which insurance offers an extra couple thousand dollars for the employee to quit a long time and well paying job, and my only response is, "Are you crazy?"
If you choose not to resign, then most of the time the insurance company will not offer a C&R. If you choose to remain employed, the case will generally resolve with Stipulations with Request for Award.
@@nicolebeltran7028 The short answer is that there is no "right" to a C&R. Neither side can be forced to agree to a C&R. Not even a judge can order the parties to enter into a C&R. The judge's only option is to either approve a C&R, or refuse to approve it. So the only way to get to a C&R is if both sides agree to all the terms, and for an employer to agree to a C&R they usually want a resignation. It's not an absolute rule. Some employers will agree to a C&R without a resignation, and your employer may agree to a C&R for a lower dollar amount. I can't imagine any judge would approve a C&R which waived your future rights to any injury to a body part, though.
As someone who has gone through this process my best advice: LAWYER UP EARLY! You will be forced to resign (like I was) because they will be watching you like a hawk and documenting EVERYTHING all the while making your life miserable!. Once you resign, you have three years (at least in my state) until they close your claim. In my case, I wasn't interested in a lump settlement. My attorney was very good. She successfully won me a lifetime L and I pension for life with backpay! My monthly benefit is around $5K a month (with COLA increases).
How did u get hurt? I'm glad that someone fought fairly for you. Stay blessed.
Would you help referring you attorney? Are in California
What is your pd rating
What was your injury? Was the $5k what you were making before injury.
That’s amazing. I wish I can get that offer. I’m still awaiting for settlement. Your lawyer is awesome indeed.
Thank you. I have a lawyer that wants to settle, but I have had a change in ability to help move my self from where I live and he is looking at his 30 percent where he sees less the 100k. That is not worth it to me as I will have to pay a lot more for the rest of my life to make up the funds it will take me to move to my forever home. Dirt. Thank you again
In California the attorneys generally only get a 15% fee, so it sounds like you are in another state. Best of luck to you.
I just settled my workers comp case this week and thank God I didn't have to resign. Or I didn't have to give up my civil suit. I made sure the language in my settlement said exclusively settling for working comp claim only. And not waiving my right to file a civil case or any other economic or no economic damages.
Excellent!
@@myworkerscompguide Great video this really hit all aspects of my situation right now. At this point I can move forward with my civil case. Also can you elaborate on AB749. And on another note I have an open case with the DFEH, and an arbitration with my union next month. It's a great feeling to finally start getting justice for the years of harrasment and discrimination that I delt with from this company.
@@Hubcitybg If by AB749 you're referring to the prohibition recently against no rehire clauses in settlements, I haven't reviewed it lately. I will say that when my clients are presented with a voluntary resignation that includes a clause against any future rehire, that I do two things. One, I tell my clients that I'm only a workers' comp attorney, and employment law is a closely related area of the law, but very specialized. They are always best served by talking to an employment law attorney as I only have passing knowledge of that area of law. Two, if they don't meet with an employment law attorney, I always strike any no rehire provision and simply tell the defense attorney we won't agree to it. Been doing that for years, and have never had a defense attorney put up a fight over it. Lastly, these videos are aimed a typical workers' comp issues for unrepresented injured workers, and an in-depth video with analysis on AB749 would (I suspect) be dry, boring, and likely not of wide interest. Or so says my gut instinct.
What's a civil suit
@@dennismosley9163 Workers' comp is an administrative law system through the Department of Industrial Relations and the Workers' Compensation Appeals Board. Workers' comp is generally the exclusive remedy for injured workers. However, in certain fact patterns you can also pursue a civil suit, which would be either in the California Superior Court system, or in the Federal Court system. In those civil cases you may be suing the employer or perhaps another third party. In a comment above another person mentions DFEH, which is the California office of Department of Fair Employment and Housing, which is where you would generally go to pursue a civil case pertaining to discrimination.
Question for you. If you were recently injured (days) and are going to file for W/C, is it a good idea to find an attorney right away? I have a friend that was injured over a year ago and recently got an attorney after all sorts of delays and wishy washy treatment. 4 days ago I was injured and do not want to go thru all the bs that she did.
Every case is unique, and I can't say what you should, or should not, do. But in general, most injured workers are better off with an attorney to help with the QME process, to help with treatment denials, and to help ensure all appropriate benefits are paid. If it's a minor injury, is accepted, and there is no time lost from work, then there is less need for an attorney. If time is lost from work, or the claim is denied, or the injury is more significant, then an attorney becomes more important.
I'm currently dealing with a workers comp claim involving both knees. I've been going to therapy, and just had a MRI done, but have yet to find out the results of it. My attorney has already scheduled a mediation with both the companies attorney, and with the judge. I'm assuming my attorney wants to go for a possible settlement, however I don't wish to resign, as I like the company and my job. Time will tell how things work out I suppose.
Just let your attorney know your desires. Sometimes my clients want to quit, and sometimes my clients have been at the job for decades and love it. Each case is unique.
Excellent explanation, thank you for your knowledge.
Glad you enjoyed it!
Thank you for your videos. They have been very helpful and educational. After insurance denied my work compensation case, I called several workers comp lawyers. None were willing to take up my case due to it not being financially beneficial for them. They advised me to file a claim with the industrial commission (IC) which Idid. IC reached out to my employer and a court date was set. At present the lawyers representing my employer reached out to have a pre-trial settlement at 60% of my wages, and pay my medical bills up until the time of the settlement, with the condition that I sign a CNR and to not bring any further claims against them. There are other claims due my employer not giving me accommodation to work with the limitations according to the doctor's recommendations. What is your take on this seeing that I do not have a lawyer and they want me to sign the CNR?
Based on your references to the IC and a settlement at 60% of your wages, it sounds like you're not in California. I'm only familiar with California's system. I'd recommend asking if they have anyone to answer questions at the IC. For example, in California there are Information and Assistance Officers at the WCAB offices, and they can answer questions for injured workers without an attorney.
@My Workers' Comp Guide , thank you for your response. I had requested assistance and the response was that they have to remain fair so they don't get involved or provide resources.
@@jalamvula2510 The same is generally true in California. The I&A Officers cannot provide advice, but they can answer questions - a lot like what I do on here. The only way to really get advice is to meet with an attorney and go over the specifics of your case, your goals, etc. You may want to reach out to additional attorneys. It's not uncommon that several attorneys will say 'no' and then suddenly one will agree to represent the injured worker.
@@myworkerscompguide Thanks
Thank you ☺️ for this video! Very informative and I appreciate this.
Happy to help inform.
If you deal with a government agency, get a lawyer. Workmans comp, unemployment, ssi, ssdi, basic traffic court, ect ect. Lawyers want you to win because they generally keep 20%, and theyre probably smarter than you when it comes tobour ever changing laws
Great videos. My question is on a work related 2019 vehicle accident that gave me 4 cervical disc damage. 3 dis replace. The 4th disc C2 was a “ The risk out weighed the benefits”. My QME rating was 28% permanent stationary. My attorney forward all the required medical documents to the QME. In my Exam I did not notice the QME refer to any notes or documentation other than the books on hand. I realize it’s possible that he reviewed his notes prior to my exam. My question is how does the C2 “ The risk outweighs the benefits” play into that 28% permanent stationary rating.
My attorney has setup 2 phone meetings with me post exam but has canceled both appointments. I understand that I’m not his only client and he is likely closing or settling other cases. Which is why I am reaching out to you because of your informative TH-cam videos.
Thank you for any insight you may have.
I'd have to defer to your attorney, as he or she will know your case best. I'm not entirely sure what the "risk outweighs the benefits" means other than maybe the surgeon didn't recommend surgery at that level. Nonetheless, generally the QME addresses the level of WPI or disability based on your condition at that time. So depending on your condition at the point you are declared P&S, will determine your level of whole person impairment, and would take into account your diagnosis, any surgeries, any range of motion issues, weakness issues, etc. The QME doesn't generally offer any rating on a hypothetical of "you could have had surgery but didn't, so here's what the rating would be if you had surgery." The QME just addresses how you are at that time. But again, you'd have to ask your attorney for specifics on your case.
@@myworkerscompguide Thank you! This was kinda the answer I was expecting. It’s just another piece of my puzzle to think about. I realize I’m not going to get rich but I am looking for my best outcome. Again thank you.
@@learn2listen705 Best of luck to you.
Going back to the unemployment compensation, if you haven't worked for over a year, and collect a Time loss benefits you won't have any wages built up to even collect unemployment.
It is possible, depending on what has been paid in to EDD and what has been withdrawn. I recommend people contact EDD directly to find out what benefits may be available.
I have been on WC for roughly 3 years. Out of those I have work with restrictions on and off. Recently, I found out that my employer cancelled my long term disability insurance and any other insurance I had. When I asked why, they told me that it was because I had another job. But I’m still supposed to employed by them. 8:45 And they never notified me. Now I’m am applying for total disability through social security. My is still going, I do have an attorney for SSI but not for the rest. What can I do?
I'd recommend reaching out to a local attorney for a consultation, and it may be that you need to speak to an employment law attorney and a workers' comp attorney. Your situation sounds complicated, and not like something that I could really address over this forum. I would also recommend reaching out to other attorneys soon, as there can be deadlines that might apply depending on when insurance was canceled and other issues in your case. Best of luck to you.
Love the video ❤! I wish if I have someone like you representing me
Thank you for the kind words. Just trying to help people understand this system
I'm so confused with my case. My lawyer wants me to settle, but I'm worried about my future medical care.
You have the final choice as to whether to keep your medical open or not, but there are many factors that go in to how and when to settle. You would have to discuss with your attorney as he or she knows your case best.
Hey, how you doing how can I ask you some questions you are very helpful
@@PHOENIQUES_ Thanks. You can ask questions here. I can't give any advice. I can only answer questions about how the California workers' comp system operates. If your questions are too involved, I'd likely refer you to the I&A Officer at your local WCAB office, or recommend you reach out to a local attorney.
They don’t ask you to resign if you’re unionized. For example they would never ask a UPS driver to resign for doing a C&R.
this is a question I’ve wanted to ask if we were in a union and wanted to settle via C&R
I got injured at work and now the doctor wants to close my case but im still in pain and if i get injured again same spot lower back
Well i been waiting see what happens still treatment is been on hold with fighting for authorization with no progress with system woserning and being fired during my time off under workers comp 😤😤
Unfortunately this system is slow and frustrating, and that's when it's working normally.
@@myworkerscompguide so true seen it all that nothing surprises me now of days from getting fired from job after worker comp treatment slowed down and delayed oh well killing me for now
What State does this apply to. It doesn't sound like this is Georgia where there is essentially no Work Comp to speak of.
This is only for California cases. Each state has its own unique system, and they are each different from one another.
I've been on comp for over 5 1/2 yrs with a broken ankle, lower back and rght knee issues been offered 3 settlement amounts the last being 90k I am unable to return to work, Currently im at 85 % according to both sides I have also reached mmi my attorney says the ins company is not willing to settle now what happens next ?
I couldn't say what will happen in your case. If both sides agree to the level of permanent disability, then usually it is a matter of negotiating a C&R or just waiting on the defense attorney to draft the Stipulations. If either side disagrees with the rating, then further discovery may be needed. I will say that in California, for an injury occurring in the last nine years or so and at the maximum PD rate, the PD alone is worth $195,000. However, since you have an attorney, you really need to reach out to him or her as that person knows your case best, what the strategy is, what the case value is, etc. Best of luck to you.
I had a slip and fall work injury on April-2020, I hit very badly my whole back, neck and head, I heard that all my back bones cracked and my head bounced, and the neutral doctor reported on Dec-2020 that I slipped and fall from my head, neck and didn’t mentioned about my back, favoring to the insurer employer with his report, not giving any rating for my lower and upper back
It is not uncommon for a QME to fail to address certain body parts or issues. When that occurs a supplemental report can be requested, or a re-exam may be needed. However there are strict rules for how to request a supplemental report. You may want to reach out to your I&A Officer at your local WCAB office to discuss your options.
@@myworkerscompguide the representing attorney didn’t request a supplemental report to the doctor, instead send me to other specialists doctors, not related to my lower back, and now my case is close to settle and most attorneys said, they can’t do anything to change that report, since it was not requested the supplemental report on time, is this for real?? And the judge also is relaying only on this doctor report and blaming to my past injury
@@quinnoaechase7432 I cannot speak to your case. I can only answer questions as to how the workers' comp system works. It sounds like you need legal advice, and I cannot offer that. You mentioned the "representing attorney." If you have any attorney, you need to ask him or her. If you do not have an attorney, I would again recommend asking the I&A Officer at your local WCAB office for your options.
This happend at walmart I slipped and did a body slam out front door entrance fell on my back. Ended up with fractured vertabra.
I was injured in March of 21 had to have surgery after a year with therapy didn’t heal right and had to have a second two years out my company took away my seniority and vacation and sick time telling me they are starting me over like a new employee is that legal?
At first blush it doesn't sound right. However, every case is unique and different employers/employees have different rights. I'd recommend reaching out to a local attorney near you to discuss your specific case/facts.
Is in writing the agreement of resignation after a c and r settlement? In which part of the form is . Can I ask to my employer for accomodations after the settlement or is over?
It really sounds like you should talk to an attorney for advice. I can only answer general questions as to how the system works. In general, if an employee is still with an employer, then the insurance company will not do a C&R unless the employee resigns first or at the same time. A resignation is generally in writing, but that's not necessarily required. There is no workers' comp form for a resignation. A resignation is an employment issue, and workers' comp deals with the injury. If a worker is injured and has permanent work restrictions, the worker certainly can ask for accommodations, and that all falls under employment law issues such as the interactive process.
Question I don’t want to resign but I been off for a year and still not able to work my job do to my injury
If an injured worker doesn't want to resign, and the insurance company wants a resignation for a C&R, then Stipulations are always an option instead.
Do u try workers comp claims for the usps ? Rural mail carrier fulltime..23 years.
No, I do not. It seems most attorneys who handle California workers' comp cases do not handle cases for the USPS as it is the Federal system and completely different. Best of luck to you.
If injury is dated July 2021 and return to work date is September 2021 and there is a stip & award offer, is there any chance the award would be alotted as a lump sum rather than biweekly payments due to so much time has passed now?
Stipulations are basically never paid out as a lump sum. However, the date of injury is not important for when benefits would start. The permanent disability payments will generally start either when temporary disability ends, or at the permanent and stationary date. So in some cases if an injured worker returns to work, is not getting permanent disability advances, and later a judge approves an award of permanent disability, there can be a lump sum payment at that time for retroactive benefits.
I have a question? I keep seeing that 99% of cases settle. I’m on 9 months of bring off work. Claim excepted, they have payed all PT, all chiropractic and recently an injection. I get paid every 2 weeks, but didn’t in the beginning for 3 months. Why cases do they not even offer a settlement, ? My attorney has barely talked about hypotheticals with me and got irritated that I ask him questions? Almost like he was taking it personally and was not compassionate at all. He took on my case 7 months ago. Do you see most cases settling or do I just see that in every TH-cam video? Something seems odd and is it normal for your job to never once reach out to you and ask you anything after 9 months?! Yet I’m still an employee? Thanks, hope that made sense. I’m not in California.
What cases**
@@TMH792 I can really only speak to California, as that is the only system with which I am familiar. As to your case, you would have to ask your attorney as he or she knows your case best. In California, and in general, I suspect the number of settled cases is around 99%. However, cases until both parties agree to terms, and that often occurs after active treatment slows down, and after a QME writes a ratable report, and after the parties agree on all the terms - and that may take six months, or two years, or five years. There is no standard time for when a case settles. I'd guess the average litigated claim in California settles at around the two year mark. Keep in mind that a "case" doesn't really go to trial, but rather a "dispute" goes to trial. So there has to be a dispute over the PD rating, or the authorization of medical treatment, or the denial of a body part. That dispute may go to trial, but even then it will only do so after both sides have completed discovery on that dispute.
@@myworkerscompguide Thank you!! I have never heard any of this from my attorney. I did ask when will they offer a settlement and he said “we are way far from that right now.” He got frustrated when I asked him, too. Appreciate you writing this out! Thanks for all the info. Oregon may be different. I’m also wondering if he’s not on top of it. I call and get things sent to him all the time and he misses my emails and have to go over it all again on the phone with me. I know he’s busy, but he’s slowly becoming less engaged. He was really on top of things in the beginning. Thanks again! Really appreciate you writing this out.
Usps back injury, eeo targeting and disxrimination.
The federal workers' comp system is completely different from California's system. It's a strange animal.
@@myworkerscompguide hard to navigate
If the insurance company has been paying and sending tou to doctor and also sports medicine doctor does this mean there takeing responsibility??? Ive been receivi1ng care but no payments yet do i have t?hat right to say hello whats going on with my temp payments?
You certainly have the right to ask. Call the adjuster and ask why TD is not being paid.
Question? If you don't take the C&R settlement with resignation attached. And you choose your job over settelment. And you go back to work . And at a later date you reinjure same body part. Does the insurance company still have to cover that same injury again? Thanks in advance for your help.
If you resolve your injury with Stipulations with Request for Award, and keep on working for the same employer, and then down the road have a new injury, that is generally a new injury. So you'll file a Claim form for a new injury, and start the process anew. Then it will be up to the doctors to figure out if you had a new injury, whether treatment is needed for the new injury or old, etc. What really can complicate it is when the employer changes workers' comp insurance companies. I've had cases where my client had multiple injuries with the same employer over the years, and each case is handled by a different insurance company. All those companies can then fight it out amongst themselves as to who has to pay for treatment.
@@myworkerscompguide Thanks again. Maybe I'm not understanding. So I'm going to re ask. So if the insurance company comes to my lawyer and says. Ok we have a settlement for your client. But it's a compromise and release. Your client has to resign. And I say nope screw their CR. And I take nothing in order to save my job. I go back to work. A year later that same injury occurs. At that point does workers comp and the companies workers comp insurance company have to cover that same injury all over again. And this is assuming it's the same insurance company. My job has had them forever they're not switching insurance companies.
@@williamlevi5051 First, since you have an attorney your question would best be directed to him or her, as your attorney knows your case best. Second, in general, you can't have the same injury occur again. You could have a new injury to the same body part. In that case you'd file a new Claim Form. Or you could have an aggravation of your original injury, or an increase in pain due to your original injury. If you settle with future medical care open through Stipulations, then workers' comp is liable for all future medical treatment to cure or relieve the effects of the injury. So, if in the future you have increased pain due to this injury, then workers' comp would be liable. If in the future you had a new injury to the same body part, then that would be a new workers' comp injury and the insurance company would need to determine if they administered treatment through the original claim or the new claim.
@@myworkerscompguide Got it. So my next ? Then would be if you aggravated that same injury. And you originally just left your case open without settling on a monetary pay out because me as the injured worker didn't want to sign the CR with resignation attached. Fast forward to the future I reagravate that same injury. They treat it. At that point can I still settle for a monetary settlement amount ?
@@williamlevi5051 Two parts to that hypothetical. If you aggravate it within five years of your original date of injury, you could file a Petition to Reopen your case so you could potentially settle with Stipulations at a higher PD amount. Second, the option of a C&R is always available at any time in the future. So if you and insurance came to an agreement years down the road, you could always settle with a C&R and close out medical. So the bottom line is that you can get more money in the future if the aggravation is within five years and you have increased WPI, and you can get more money in the future by potentially closing out future medical.
Im still on wcb,my shoulder hurts everytime i used it,I'm done yesterday with 2nd comprehensive functuality assestment. I'm worried what will be their decision. Injured sept 2019, while on light duty employer laid me off march 16 2020.stating no work available for me.what will im going to do?
I always tell my clients that we need to wait to see what the report says before we decide what to do about it. As to your situation, often the functional capacity evaluation is used by the treating physician and the QME to determine ability to return to work and any necessary work restrictions. In your specific case, I am uncertain as to why you have had two functional evaluations, unless you might be referring to qualified medical evaluations. If that's the case, then the QME report (once it is issued) will be a key factor as to what happens next, how much your case is worth, etc. As to what you should do, I can't offer advice other than to say that you would probably be best served by reaching out to an attorney for a free consultation.
Thanks for the reply..1st functional test done last yr,then they send me to mri and cortisone with diagnose subcromial pain syndrome.give me limitation like limit to 6 lbs and send me to physio for 4mos.february they assign me to another case manager for the 3rd time and send me to wcb physician then to comprehensive functional capacity yesterday for 2 hrs and today another 2hrs.my new case manager stop my physiotherapy also.she told me she need to wait for the result and made decision because therphy seem doesn't work to me.
@@vhigomezvlogs4114 Keep in mind that if you are unhappy with your primary treating physician, you do have the right to change physicians. I did a video on that topic here - th-cam.com/video/1Xk4dsPt6Fs/w-d-xo.html You also have the right to get a second opinion if you see a specialist and disagree with the recommendation, or are unsure. Talk to your PTP about a referral to another specialist for the second opinion.
Ouff no settlement option
Thank you for this video and all your videos. I have a question on a QME appointment/report. I went to my scheduled QME appointment on January 7, 2022. The Dr. mentioned he did not have my medical records and we continued on with the appointment. My attorney finally gets the report which was dated January 24, 2022 and he does give some conclusions on some things but pretty much says he cannot really finish the report without having the medical records. Who was responsible to getting him the medical records? I also feel like he missed a couple of key issues but without the medical records that may be the reason why. So my attorney is reaching out to the insurance administrator and now asking for my records to be sent. What is the protocol from here. How long? I’m frustrated he never got my records!!
Sadly your situation is too common these days. The legislature changed the way med/legal examiners are paid a couple years ago, and they now bill by the page (at least in part). Because of that the parties try to avoid sending duplicate records/reports. For my clients I put the defense attorney or adjuster on notice at least a month before the exam that I expect them to send everything, and I am not. But still they fail to do so at times. It is just one of many frustrations of this system. In general, once the records are sent, examiners have 75 days to issue a supplemental report, so that gives you some idea. For any specifics on your case, reach out to your attorney as he or she will know the plan and strategy
@@myworkerscompguide thank you for your response. Bus this doesn’t seem right at all. So they pick/choose/ select which medical records to send because that are afraid to pay too much for the doctor to go over them? Well then choose the records that they rather you see to make your decisions! That sound like craziness to me. If they want an actuate and good report then give them all to him how can they truly make an informed decision without them??? Seems very sky and in favor of the insurance company making decisions on what reports will be submitted.
@@Krystaldoll282 No matter who sends the records, generally all of the records do need to go to the examiner to ensure that the report is substantial medical evidence. On most of my cases what I do is have the defense attorney send all of the records to avoid duplication of records. But both parties know ahead of time what records are going and, if appropriate, which records are not. You should discuss this with your attorney. Your attorney will know which records are going to the examiner and any records that are not. But the general rule is that all of the records do need to go to the examiner. The focus of my point is to avoid duplication of records, as on some of my cases I have had tens of thousands of pages of records, and you wouldn’t then want to send double sets.
@@myworkerscompguide thank you so much for your explanation.
@@Krystaldoll282 happy to help!
What happen if you send in a C&R and you have not received anything back.
If the adjuster sent a C&R to you, and you signed it and sent it back to the adjuster, and now the adjuster isn't responding, you may have to file a DOR. I did a video on that topic here - th-cam.com/video/P_qPyY9Vs5w/w-d-xo.html and I'm actually having the same situation on one of my files now. The adjuster sent Stipulations to me, my client and I signed them, I sent them back to the adjuster, and now nothing. She won't return messages, won't respond to emails, nothing. I'll likely be filing a DOR soon. If your situation is that you and the adjuster signed a C&R and it was sent it to the WCAB for approval and you haven't heard anything, it's a bit different. The judge has 15 days to act on a settlement. If not approved or disallowed within that time, the case should be set for a Status Conference and an Order Suspending Action will likely issue. Here's a video on how long the judge gets - th-cam.com/video/Rwpy_yEXKUQ/w-d-xo.html
What happened went I’m getting my disability i and my doctors put me on modified work that me check stop. Thanks
Check out this video th-cam.com/video/KWBTM7Q3YQA/w-d-xo.html and see if it answers your question. If not, drop a comment on that video and I'll see what I can do.
Hi… can someone reopen their case and get an c&r? Is that possible
To “reopen“ a case is generally done within five years of the date of injury and refers to filing a petition to re-open for new and further disability. You can compromise and release a case at any time, assuming both parties come to an agreement and the judge approves it. There is no need to re-open a case or anything along those lines for a C&R
Wow this is a lot to take in I have a quick question is it true that it worker comp settlement is worth more if you off work for long time due to the injury
The final settlement isn't really tied to how long someone was off work. However, in general if someone was off work longer that generally means it was a more significant injury which means the final settlement may be larger. But the final settlement is primarily based on the level of permanent impairment and the anticipated future medical care.
@@myworkerscompguide to be honest I've been out of work for almost two years I got surgery last year they did a lumbar laminectomy I already had about three different QMEs now they're talking about spinal injections my work restrictions are 20 lb I know that I do have a good case but I just want this to be all over with
Why would anyone in sound mind and body voluntarily quit their job? What am I missing here 🤔
I often have clients who want to quit their job, whether it be to go to another job with better pay, to another job with different coworkers, another job with better hours or work environment, or to a job in another city. There are many reasons to quit a job. It just has to be the best option for the injured worker, and not the best option for the insurance company.
@@myworkerscompguide I misworded the question. I get though but for an insurance company to suggest I resign to benefit them easily gets a middle finger.
@@creepincarl I hear you on that. Every case is unique. I've had many a case in which insurance offers an extra couple thousand dollars for the employee to quit a long time and well paying job, and my only response is, "Are you crazy?"
What if I refuse to resign?
If you choose not to resign, then most of the time the insurance company will not offer a C&R. If you choose to remain employed, the case will generally resolve with Stipulations with Request for Award.
@@nicolebeltran7028 The short answer is that there is no "right" to a C&R. Neither side can be forced to agree to a C&R. Not even a judge can order the parties to enter into a C&R. The judge's only option is to either approve a C&R, or refuse to approve it. So the only way to get to a C&R is if both sides agree to all the terms, and for an employer to agree to a C&R they usually want a resignation. It's not an absolute rule. Some employers will agree to a C&R without a resignation, and your employer may agree to a C&R for a lower dollar amount. I can't imagine any judge would approve a C&R which waived your future rights to any injury to a body part, though.
@@myworkerscompguide thank you very much for responding so quickly. I appreciate it
@@nicolebeltran7028 Happy to help inform. Best of luck!
What if I refuse to resign? But I I signed my settlement check on 4/20/22 but haven't seen the check as of today
very well