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Worker`s Compensation/My CA Workmans Comp Claim


I worked for a large Hospital in the La Area from 2001 to 2012. I injured my back and a claim was filed in 2006. The claim was settled in 2009 with stips and FM. The effected body parts are Lumbar and circulatory due to getting high blood pressure from back pain. In the years past the insurance company denied everything but the kitchen sink as far as medical care and in 2011 my case was re-opened by my original attorney and the QME put in the report that I was entitled to surgery but the insurance company denied it of course and my chiropractor didnt want to do anything else cause he felt that invasive treatment besides the surgery would injure me more and he was right. In early 2012 I fired my attorney because I felt he didnt have my best intrest at heart. In Sept of 2012 I hired another attorney to either carry out the re open or close the case by cashing out the future medical. In Nov of 2012 I was laid off my job as soon as they found out I had a new attorney and I then had to move to Idaho because I couldnt support myself down there with no job. Shortly after I moved the new attorney fired me saying I couldnt attend my Dr's appts. Of course I couldnt cause I had to move. Since all of this has occured and for quite a while prior to all this the CA refuses to talk to me at all. I've sent letters and e-mails and no response from her. I can't afford to pay and see Dr's and wait to be reimbursed since the CA hasn't even reimbursed me for my monthly meds. I'm at my witts end as to what to do about this and still need medical care.

I do not see any specific question here...

If your phrase "CA" means Claims Adjustor, I suspect the lack of response is because there is likely a new Adjustor assigned.

Normally I would suggest hiring a Certified Specialist Attorney.   

With two attorneys already hired, the third attorney would have to split her fee with the first two, so most well-qualified counsel will say 'no, thank you.'

Also, the dollar value of your future medical rights plummeted to zero when you moved.  

The Adjuster knows you cannot find physicians in Idaho who know how to issue reports admissible under the California Labor Code.  

You took all the 'bullets' out of your proverbial 'gun' when you decided to leave California.

If you cannot see California doctor(s) who can issue admissible medical reports demanding that treatment be authorized, no judge would ever award any treatment or any penalties.

An Award on Stipulations With Request for Award is just a license to fight over future medical care for life,...  it is NOT a guarantee you will get any future treatment.

If you cannot get to court with a California physician's report in hand to fight for treatment, the adjuster has no reason to call you or respond.   You will cost them nothing sitting in Idaho.

What about trying to return to Attorney #1?

I'll bet Attorney #1 can locate a new treating physician at the south shore of Lake Tahoe in the Insurance Company's MEDICAL PROVIDER NETWORK.   California Law requires the report requesting treatment come from the MEDICAL PROVIDER NETWORK (yes, even if you find the most wonderful doctor in the world in Idaho).

South Lake Tahoe is about an 8-hr drive from Boise, and has some excellent Orthopedic Surgeons... most Medical Provider Networks have a couple on the list.

I realize driving this time of year from The Rockies to The Sierra is life-threatening... I'd make a written "4600 Election of New MPN Physician" now, and begin the process to get the new MPN Physician to schedule you for early May (when the storms are less life-threatening).

It may take you two months of letters and even filing for a hearing just to get the new Adjustor to 'authorize' a new treating physician in Lake Tahoe to schedule you.

The new physician can write you need the medications and why, so you can get your medication bills reimbursed.   I'm surmising you have zero current "MPN" medical opinions in indicating the current reason for the prescription medication is the old 2006 injury (and nothing new).   

The New MPN Treating PHysician can look over studies and records from Idaho doctors and write that the treatments and prescriptions you received there WERE necessary "to relieve the effects of" the 2006 industrial injury.

Without current medical reporting, and no hearing on calendar, the adjuster has no reason to answer you.   You will cost the insurance company zero without current medical evidence from an MPN Physician and no hearing on calendar.

Finally, you might think of either
(1) finding an Attorney next to the SACRAMENTO Workers Compensation Appeals Board OR
(2) filing your own Petition to Transfer Venue to the Sacramento WCAB noting it is the nearest to you in Idaho.   Sacramento is about 9.5 hours from most of southern Idaho, a one-day drive.  Eureka appears closer...but it is not.  The Redding WCAB office would involve hours  of treacherous mountain switchback driving.   

Plus I find the judges at the Sacramento WCAB most helpful and logical...they will understand you cannot tolerate a 'continuance'.

Here are helpful links (you might have to copy them and paste them in your brower to make them work):
Treating Doctor's REquest for authorization:

Treating Doctor's REport Form:

How to file EAMS Documents at the WCAB:

How to reach the Information & Assistance Officer:  

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Nancy Wallace


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).


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

California State Bar Board of Legal Specialization

Editor, Western State University College of Law newspaper

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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