Posted 11/2/2012 4:24 PM (GMT 0)
Hi Leek, sorry your BF is having so many problems, if he doesn't have a good work comp attorney yet (sounds like you might since you've already been to court) you need one fast, you can find one in your area at www.aaa.org. I would make sure the attorney is barred as a work comp specialist.
First, if the PQME that court sent you to said TTD is in order, than he should be getting a check. If not, he should file for a penalty against the IC. Second, if his PTP said he needs back surgery, he can get a second opinion, but that has to be approved be the IC, if not, the IC will not listen to the second doctor's opinion, and if he refuses the surgery, he will automatically be declared MMI, and no longer be eligible for TTD.
If your BF says he can work, but the doctor says no, your BF's opinion is irrelevant, but the claims adjusters still like to use those kind of statements as a way to minimize TTD pay out. Also, if you live in CA he can file for SDI, and they will pay him temp benefits, and put a lien against the IC. I'm not sure what state you live in, but work comp laws are pretty state specific, one of the biggest reasons you need a good barred work comp specialist. If you do have an attorney, it sounds like they're not doing their job, but DO NOT FIRE YOUR ATTORNEY UNTIL YOU HAVE ANOTHER WHO AGREES TO TAKE YOUR CASE!!!! There is only one attorney fee for work comp claims, that's it, if you go through multiple attorneys through the life of the claim, they have to split that fee, so once hmyou have signed an attorney, it can be difficult to have another take the case over.
I could write a book on what I've learned about work comp, and I still won't represent myself for my claim, there's just too much to handle, and trying to deal with being injured at the same time. The main thing is, don't go with tv attorneys, they just want to push you through with as little work amd treatment as possible, and push you into a settlement, you need a good attorney who cares about their clients. My attorney's first question to me was "is your pain being treated, we need to get you to a pain management specialist immediately if not". That was before I even signed him up, and he offered to do that with no compensation.
I'm right in the middle of the work comp game myself, I know how stressful it is, and I know just how inhuman the insurance companies can be. Don't give up, and don't let them push your BF around. Good luck, and keep fighting, it can take a long time, but keep pushing for the treatment he needs.