Workers' Comp and ADR, esp. in California

[Michelle]

Have you asked your attorney about asking for an emergency hearing on this? In my experience, even hearing the word 'hearing' got WC to jump. My attorney threatened them with this 3 times-I've never once seen the inside of a courtroom. It seems with the spinal cord compression the 'emergency' isn't unreasonable. I'd hate to see you get a surgery you don't prefer just because they're dragging their feet. The only other thing you can do in the meantime is try to get your WC primary to refer you to that Calif ADR doc. At least you can get the proccess started while working on surgery approval. Wish I could be of more help! I feel for anyone struggling with this!! I actually used my short-term disabilty (sick leave) through my work to pay my time off this last surgery since it was easier than getting my case (which is maxed out) to pay it. Is that an option if you do wind up going overseas??? Good luck!!

[KL Aguilar]

Thanks for the good ideas. I will pursue some of them. I didn't mean to imply my attorney wasn't on my side. We discussed all of my options and he would say something like, "The advantage of this option is ___ while the potential disadvantages are ___."

The cervical ADRs aren't even FDA approved yet, so it will be a hard battle to convince WC.

[racergaldar]

Probably a bit too late for this, but for future viewers in California. When I calculated what my WC benefits would be while recovering, it was about $200 less per week than SDI (State Disability Insurance). Since we CA pay state tax, we also pay SDI (deducted from your payroll check). Therefore, if you're not on WC, you are eligible for SDI (see: Employment Development Department).

I'm in HR and handle our leave of absence even for those not on WC, and they receive disability benefits.

If you (if self-employed) or your employer did not pay into the account, then you're up a creek. If you're employer didn't pay it and deduct it from your check, I would report that employer to the authorities (The U.S. Department of Labor Home Page, Secretary of Labor Elaine L. Chao). This is a legal mandate for all CA employers.

[Maria]

Have Future Medical with California WC insurance co. Have only been advised that if I go outside the country to have surgery with a non US non WC authorized surgeon I will lose my future medical benefits completely.

That isn't applicable to your situation but it's my California WC scenario with future med.

[nopain]

Here is a question with probably no good answer.

I've done a ton of computer work in the past 5 years. I am an employer, I pay into the State Workers Compensation Fund.

I understand a "slip and fall" type injury, but how many cases are actually presented as a result of a Desk Job destroying ones spine?

How in the world would one go about proving it?

How would you even start the process?

[Maria]

That's a good question to which I have no answer although I'm wondering if there was a point in time where you started to see a doctor regarding your spinal problems so there was documentation of the beginning of your spine problems and some diagnostic testing ordered and performed ?

It sounds like it might be viewed as "aggravation of existing injury" and difficult (though not impossible) to prove.

If you pay into the State Workers Compensation Fund it seems like you yourself should be eligible for work related benefits just like anyone else.

Then again.. I know nothing when it comes to this, just throwing some ideas out there that you've likely already thought of.

I'd suggest contacting your State Worker's Compensation Board however I've tried that and it was grueling with fairly poor results in terms of information access. Might be different for you though and can't hurt to try if you've not already.