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Worker`s Compensation/After Permanent Disability

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Question
I was injured on the job over 4 years ago.  Last year they awarded me permanent Disability.  I never had  a lawyer.  There Dr. told me that I would have pain the rest of my life.  Do I just live with the pain or can I go to my regular Dr. to get help?  I don't want to do anything illegal, but if  there is a way to finally resolve my pain, I would be willing to stretch the truth.

Answer
"THEY" awarded you permanent disability would require a Trial at the Workers Compensation Appeals Board.

I see from this question phrasing there was no Findings & Award from trial.

What I suspect you are trying to report is AN INSURANCE ADJUSTER sent you a letter indicating one doctor wrote one report with one opinion you had reached Maximum Medical Improvement... and based on that one opinion, that insurance adjuster issued some permanent disability advance payments.

That's dramatically different from getting an 'award' of permanent disability, just so you're clear.

If you go to your "regular" doctor, either you must pay cash for the doctor's office time and the pills -- adding up to tens of thousands over time -- of have written permission from the insurance carrier it will pay for the visits to that 'regular' doctor.

Private Health Insurance specifically excludes treatment for on-the-job injuries...so if you use your private health insurance and lie to the doctor, you are committing fraud.

If the private health insurer learns of the fraud -- and it could happen years later -- they can bill you for all the treatment for the industrial injuries.

You are entitled to a Panel Qualified Medical Evaluation, a QME -- if you didn't have one already.

If you already had one QME, you can request a repeat evaluation with that QME to see if there is any 'New & Further Disability" -- all of which needs to be demanded in writing with proof that writing made it to the insurance company and the QME.

If you had a Primary Treating Physician, you WRITE your adjuster for permission to get back to that PTP for further treatment.   You'll likely be sent a list of docs the adjuster would prefer you see... if you see the wrong doctor, you'll get nothing.

Which is why having a CERTIFIED SPECIALIST ATTORNEY now is so important.    

You've got to get a LOCAL attorney who knows the local doctors you can see... hiring an attorney in Long Beach for a claim in Palm Desert is a total waste, you'll be sent to a doc 'in bed' with the insurer who will write you can just live on over-the-counter ibuprofen and don't need anything more.

Check your local Bar Association for specialists in workers comp to find a specialist, pointing out you've got 'new & further disability' and you are up against the 5-year limit to prove new & further disability.

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Nancy Wallace

Expertise

California injured workers employed by state and private agencies (NOT federal employees) regarding On-The-Job injuries, disability payments, and terminations from being injured on the job (work-related wrongful terminations).

Experience

20+ years in California Workers Compensation law practice in California. Certified Specialist, Workers' Compensation, Board of Legal Specialization, State Bar of California

Organizations
California State Bar Board of Legal Specialization

Publications
Editor, Western State University College of Law newspaper www.Avvo.com www.imhurt.info

Education/Credentials
J.D., Western State University College of Law B.S., cum laude, Cal Poly Pomona

Past/Present Clients
Senior adjuster for one county sent me her husband when they needed caring representation. The injured Employment Development Dept. hearing representative -- who see all applicant's attorneys in the region -- hired me when she got hurt on the job. A Fire Department Chief in Orange County came all the way to San Bernardino for my representation.

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