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Question by Dr. K: CA Workman’s’ Comp; Disaster help!?
Complicated Work Comp Case Basic Overview:

A friend of mine has found himself in a horrible situation after 1 year of Work Comp case proceedings. The following facts are pertinent to his specific situation:

IN BRIEF

Employment History:
1. Employed with employer 20+ years
2. Almost no Disciplinary or problems with employer until Company recently merged with another company and has since become “Self Insured”.
3. Company began making constant demands for employee to sign “At Will” and “Acknowledgment” there of documents.
4. Employee got first write up in 20 years and asked to sign “at will” at the time of write up. Upon refusal to do so due to the contract stating that he was to carefully consider what he was signing, he was forced to a new machine for “training purposes” that of which he initially believed a prior injury may had been exacerbated due to repetitive motion of his wrist.

Industrial Injury History:
1. Old injury to wrist about ten years back; new injury appears to be separate injury but may be contributing to aggravation of the newly diagnosed mild carpal tunnel syndrome in both wrists.
2. Both past and present Injuries were sustained while with same employer

New Injury:
1. Employee informed supervisor of swollen wrist while on new machine, he gave him wrapping gauze and sent him back to work.
2. 2 weeks later Employee went to emergency after a failed attempt to talk to the General Manager for swollen wrist and stress due to industrial injury as a result of being denied treatment.
3.Employer started immediate “fraud investigation”.
4. Employer informed employee of UPN doctor he had to go to; employee complied not knowing rights at the time.
5. Employee sent to drug test; Doctor suitable to treat injuries was not in on the date of referral, also employer did not list the “wrist” injury, only listed “stress” on referral slip.
6. Employee returned to employer for correct referral slip and returned to UPN doctor who did no referral for psychiatric treatment and sent employee to get old medical records in part with return to work slip.
7. Employer had employee fill out wc form 1 almost a month after injury; he complied
8. Employer informed employee of need to separate claims; and verbal statement of denial saying “stress” is self inflicted due to detachment from machine.
9. Employee placed on Short Term Disability; pressured by employer to fill out FMLA forms and refused as it is industrial injury not FMLA related.
10. Employee obtained an Attorney
11. Employee complied with all doctor referrals from attorney
12. Employee wanted to get surgery and go back to work.

ATTORNEY DISASTER/PRIORITY CONFERENCE
1. Employee sent formal request to attorney inclusive of questions as to why no expedite hearing had been requested in part with need for surgery, why he had been sent to a QME instead of a AME as informed in a letter, and why his deposition is scheduled after Priority Conference Date.
2. Attorney Request to Withdraw immediately
3. Attorney wont give original file
4. Attorney sent copy of file of 400+ papers mixed up that
5. Employee can’t access WC WCAB file even after getting authorization from Sacramento; they claim 14 days for file to documents to be sent.
6. Copies of WC form sent in file copy from attorney state new claim for injury was submitted due to “harassment” without employees knowledge. No trace of original claim form (he does have a copy of the first one he actually filled out)
7. Attorney is still on record despite his claim to be relieved due to his request to Withdraw.
8. Employee just found out no medical records were entered on his behalf and priority conference is this next week.

**Employee can’t seem to be able to confirm insurance carrier of Employer. Nothing makes sense and Employee is breaking down. Is there any hope?

Thank you kindly, any helpful suggestions are appreciated. Please consider the over whelming impact of such circumstance. How does he find an Attorney he can trust at this point?

Aside from Cal State Bar…what can I help him do that is immediate?
His lawyer quit after asked him why it was taking so long to get an authorization for surgery… he wants to go back to work. Must work for an insurance company lol. I guess you didn’t read the part where I said they might not have insurance. Now confirmed. Thanks for your advice though, nice try.

Best answer:

Answer by mbrcatz
Let me totally rewrite my answer.

1. The vast majority of the information you posted is irrelevant to a workers comp claim.

2. The question – is there hope? The answer – not much.

3. Mental issues of any kind are not covered under workers comp. As soon as you start trying to claim them, it red flags your claim. As far as I can tell, your wrist swelled up at work one day, and you waited two weeks to go to the ER to have it looked at. Wrist swelling cause was never diagnosed, and you don’t mention if it ever went down, but you don’t get disabled over a swollen wrist – you get light duty.

4. Your lawyer doesn’t think you have much of a case, so he quit. Want a third opinion? Go to the local yellow pages, and look for an ad for a local workers comp attorney.

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