WorkComp RTW Woes?! Just a “Circle Jerk”?! D’oh

*Return To Work! #RTW!  InjuredWorkers are just a profit center to the insurance industry.  No wonder the Defense tries so hard to prevent return to work, with creative failures to provide medical treatment in breach of fiduciary responsibilities and sheer bad faith and nasty evil doings.

 

work comp guidelines

Not only can it be a huge challenge for an Injured American Worker to get immediate, reasonable and appropriate medical treatment, it can be even more challenging to return to work.

Here’s more on the story that started January 9, 2012…. a witnessed slip and fall backwards on ice, in snowy Big Bear, California, at the WorldMark By Wyndham mountain resort sales office.

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One doctor, in October 2012, in response to a threat from the Defense counsel, alleging his reports had not been received (although they were sent multiple times, with and without proofs of service) changed his mind about work abilities, and requested accommodations.

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None of the treatments he had requested for nearly a year had been authorized, other than 4 sessions with a clinical psychologist to deal with the stress of having a brain injury, with strategies on how to fake-people-out that there is no brain injury, and if only the injured worker would spend $500 out of pocket for a day planner for TBI (Traumatic Brain Injury) survivors, and give 145% effort upon return to work…all would be well and they could close their case.

linda ayres says JOIN ME ON TWITTER

His reports insinuated that his requests resulted in treatments, but no reports on the progress of any such treatments, as they did not happen.  D’oh.  Anyway, his ‘requests for accommodations’ and medical impairments would have been enough to make an HR Manager Cringe, and a Timeshare Sales Manager curse and spit. Return to work denied in 2012.

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Throughout 2013 and to-date in 2014, attempts by the primary treating doctor designated by the WorkComp system, an Orthopedic Surgeon (FOR A BRAIN INJURY!!!) were ignored and denied at every turn of the calendar.  By mid-2014, said doctor’s office said, ‘you can see we cannot get you any brain injury care; you’ll have to find your own brain doctor’….. and through relentless dialing and crying and pleading…..a neuro-psychologist with a tremendous background in brain injuries was located, and agreed to treat this injured worker, because she took an Oath to help others, and do no harm.

By way of another miracle, the defense firm authorized this doctor to be the secondary treating doctor, who was successful in getting a little bit of medically necessary treatment authorized.   Six months at SCRIPPS Brain Rehabilitation Program was requested, 16 days were authorized.  At the end of the 16 days, another 2 months were requested; 8 more days were authorized.

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Part of what was paid for by the insurance company was a Work-Hardening, Return To Work Program, with participation in the FEHA required INTERACTIVE PROCESS with the Employer, at the job site, and with the expertise of their professionals to orchestrate the best possible return to work scenarious to set up the injured worker for success in RETURN TO WORK.  #WyndhamWorldwide HR refused to participate in the process, and it’s unclear if they just received bad legal counsel or what.

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Bottom line, THE INTERACTIVE PROCESS WAS THWARTED, AND RETURN TO WORK EFFORTS ABORTED, AND HOPE FOR RETURN TO WORK SHATTERED BY MORE FAILURE TO PROVIDE MEDICALLY NECESSARY TREATMENT FOR RETURN TO WORK.

Defense Attorney seemed thrilled to be (re)advised that the TTD (Temporary Total Disability) order was extended through October 18, 2014.  His response was as if he had never seen the report and continued TTD order.  He must be very busy with his partner/shareholder/office management duties, as he seems most unacquainted with this case, that was dropped on his desk a few months ago.

So, then the defense attorney goes on and on about there’s no medical release for return to work, the file (which he isn’t familiar with at all) ‘indicates your impairments are minor’ and there will be no medical treatment to aid and assist getting a medical release for return to work, there would be another Orthopedic Evaluation Order, and another request for another Neuro-Psychologist evaluation from “independent” insurance company owned/leased evaluators, in order to determine whether MMI – Maximum Medical Improvement has been attained.

QUESTION:  IS A MILD BRAIN INJURY LIKE BEING JUDGED ‘MILDLY QUADRAPALEGIC’ as asked by Super Lawyer, Chris Asvar in a famous work comp brain injury settlement case in California of 2012, that went differently that the Romano Trust vs. Sedgwick matter that cost the life of an injured worker with a rotator cuff tear.  D’oh.  In all cases, many doctors and lawyers make the big bucks, huh?

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(Without medical treatment, yep, f—–ked up is as good as it gets, Dude, thanks.  Life span cut by 7-10 years, which is about by half at this stage.  The line of defense brings to mind the question:  WHAT IS THE DEFINITION OF A ‘CIRCLE JERK’?)

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~~~~~~~~~~~~~~~~  WILL LA TIMES INVESTIGATIVE REPORTER, JACK DOLAN, DO A STORY?  WE CAN HOPE….  If YOU want corporate media to do a little research, maybe send Jack an email Jack.Dolan@LATimes.com and ask him to pretty please check this story out….it sounds too outrageous to be made up…. or find him on Twitter or LinkedIn…. 

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Hi Guys….This may be a step in the right direction since I heard from neither of you regarding the Coastline Cognitive Rehabilitation request for authorization and lodging requirements.
If I don’t start Coastline or return to work in a salaried job with minimal accommodations on October 20th…we will carry on by any and every means available and necessary.
Let’s get me medical treatment and return to work stat. You have already successfully shortened my life span by 7-10 years. …so let’s stop the insanity now.
Let’s pow wow Monday.
Cheers,
Linda Ayres, In Pro Per
 eagle outraged
Sent on a Sprint Samsung Galaxy Note® 3
(Best smart phone on the market for a TBI Survivor….find out why!)
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—–Original Message—–
From: CNA Help <cna.help@cna.com>
To: reolinda <reolinda@aol.com>
Sent: Sat, Oct 11, 2014 11:16 am
Subject: Re: Linda Ayres WWID415287 ACCOMMODATIONS AND RETURN TO WORK PROPOSAL FOR IMMEDIATE RESOLUTION CNA E3269102 Quality Assurance Representative [#1699004]
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Dear Linda Ayres
Thank you for your inquiry. It has been routed to the appropriate team and you will receive a response within the next two business days. If you require a quicker response please call us at 800-262-4357 for assistance.CNA Agency Help Desk
1-800-CNA-HELP (1-800-262-4357)
http://www.cna.com.
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[Sent to CNA Help since fraud@cna.com suggested unhappiness complaints be directed directly to the Department of Insurance, District Attorney and State Bar—-all of whom have been advised of the unhappiness complaints since late 2012, to no avail.  It was nice of Chicago to call and advise that the complaints had been mis-directed to their CNA Fraud Department.  Perhaps CNA Help will forward this to Mr. Motamed again…. last time, they were able to replace the adjuster; maybe now they can replace the law firm, in the best interests of Wyndham, Wyndham injured workers, and CNA itself.]
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—– Linda Ayres Wrote —–

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Dear Tina Jordan and Melisa Paramo and WVO Leave Support Department and CNA Central Help:
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I was so excited to see this position opening today.  It looks like a total trouble-shooter position, for which I am well armed.  If an additional responsibility could be added to include “Site Injured Worker Advocate/Liaison” all the better!    
 
Quality Assurance Representative
I would like to be considered for this position as part of the accommodations process, with an immediate start date.  Please let me know when we can meet to discuss this position.  I will ask my doctors to release me with minimal accommodations as soon as possible in order to attempt a 45-day trial return to work.  I think I could be a valuable asset in this position, and it will draw on all of my strengths, while providing a stable income and good medical benefits.
 
If you can provide me with an offer for this position, I can take it to Dr. Bergey on my appointment this coming Friday and I am sending a copy to Dr. Hilda herewith.  I think the attached will serve as a job description, but if you have one more doctor-oriented, please provide that as well.  I will, of course, need continued treatments, but I would imagine appointments can be scheduled on off days, since I would further imagine this position includes Saturday’s and Sundays.   I’m excited!!!    
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I have reached out to many global Wyndham employees telling my plight via Social Media; I will look forward to providing an update with some happier outcomes.  
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I didn’t hear back from Fred or Stewart regarding Coastline, and corporate housing in Newport Beach.  More neuro-psych testing was performed Thursday/Friday at the Coastline Cognitive Rehabilitation program, and results will be forthcoming, along with a hopeful approval to their program.  Without the return of the $27,000+ in reimbursements, and with the $20K that CNA sucked up in a bonus for refusing to pay TTD benefits in 2012/13, and being at risk of termination and a fight with LTD insurance provider while seeking reinstatement of benefits, I have no choice but to return to work.  I look forward to seeing you all.  In connecting on social media, it was a joy and delight to see that happy faces of so many uninjured Wyndham employees…..’having fun and making bundles of money, making a difference in people’s lives…’   
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An agreement to allow me to return to work to this position, on a 45-day trial, may give Dr. Bergey, Orthopedic Surgeon who was designated as the primary treating doctor for my brain injuries by the WorkComp people, and recently designated secondary treating doctor, Dr. Hilda Chalgujian, neuro-psychologist, something substantial to approve, eliminating all the unknown variables, particularly since malicious failures to treat and bullying continue.
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While Stewart Reubens, Grancell-NOvato Attorney/Partner/Shareholder is not a doctor, he alleges my injuries are minimal, in stark contrast to more than 35 other doctors, and several brain injury experts.  Mr. Reubens has indicated that the adjuster, Fred Sachs, in his suggestion that I draft a “Proposal for Settlement” was participating in more insurance industry trickery.  I have not heard back from Fred to confirm or deny the insinuation of Stewart, and I am hopeful it was just another error in judgement and bullying by Grancell’s attorney.  Be that what it is, it is clear that the continued denial of medical treatment will continue until they kill me, so please, let me return to work in a solid position such as this one, starting out at Indio, and transferring to Palm Springs as soon as that store opens.
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If CNA, Grancell and their 3 “independent doctors” and the Corvel team of obstructionists who all disagree with the extent of my injuries as clearly documented by approximately 35 other doctors, and several brain injury experts this year, then, by review of my experience and time with Wyndham since 2005, in multiple sales locations, I am a natural for this position.  I understand the starting pay is close to $50,000 annually plus bonuses and immediate benefits, and since I would not have to relocate, I can accept that.
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I will then have access to medical treatment through the employee benefits again, and get the necessary medical help that has been denied all along.  This would also mean I would not have to relocate, and it’s clear than neither CNA nor Grancell will help me get into the Coastline Cognitive Retraining Program, as they failed to respond on a timely basis to the Request for Authorization from Dr. Hilda Chalgujian of last week.
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Please let me know when we can meet to explore this immediate opportunity, to be further considered with the list of FEHA oriented accommodations.  If we can meet early next week, next Friday I could plead with Dr. Bergey and Dr. Chalgujian to release me to this job, on a 45-day trial basis.  Then we will allll know what I can do, and if I can do it, great….. win win win.   We can then all let the attorneys and the attorney general duke out the rest.
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Please let me know what other information you may need from both doctors, and please confirm that there is no intention to provide medically necessary treatment, and that you understand my return to work is under duress and with intent to survive the horrors of the Wyndham work comp total system failure for this injured worker.  I look forward to being a contributing member of the teams again, by any means necessary.
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I look forward to hearing from you shortly to schedule a meeting at Indio for this position.  Thank you.   If I could start October 20, 2014, that would be great.   Makes sense?  Yaaaaay!  See you soon!
Sincerely,
Linda Ayres, In Pro Per
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General CNA Central Help?
The CNA Help Desk is available to answer all of your questions or help with your problems. Call 1-800-CNA-HELP or email cna.help@cna.com
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Job Description 

Quality Assurance Representative – Indio/Palm Springs, CA  1412942

Description

 

This position is responsible for supporting the sales effort by assisting in generating revenue and increasing the retention of sales while staying in compliance with all Company Policies, Business Rules and Government Requirements, and in a manner which results in satisfied owners. Position is also responsible for the oversight of accurate completion of all required sales documents ensuring compliance with all Company Policies and Government Requirements. And last, position upholds outstanding customer service levels and supports the sales effort to the fullest while staying in compliance.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
This is not inclusive of all duties, just the essential functions of the position. Other duties may be assigned.
  • Strategize with the Site Leader to identify and implement methods that increase retention rates.
  • Responsible for overseeing the accurate completion of all required contractual documents,  Owner documents and/or Governmental Agency requirements.
  • Increase retention by overseeing and personally following up on outstanding contracts
  • Ensure compliance with Company Policies and Governmental Agency requirements.
  • Oversee that sales staff ensures Owner understanding of Company and Government required documents. Assist the  Owner in understanding the Policies and Procedures of WorldMark.
  • Provide Owners with the highest level of customer service possible. Be a point of contact for Owners that have not transmitted into the system and assist them promptly and thoroughly with any questions, concerns and/or reservation requests..
  • Assist the Site Leader in training staff to assure understanding and adherence to Business rules and Sales Compliance Policies.
  • Advise the Site Leader of incorrect or inappropriate information being presented to the owners and/or new Owners. Assist Site Leader in the training and correction of these issues.
  • Responsible for working with Site Leader to ensure that all Sales misrepresentation issues are answered and resolved with Consumer Affairs in a timely manner.
  • Work with Contract Processing, Consumer Finance and Owner Services to resolve all Owner contract issues such as: incomplete Owner information/paperwork, Suspense Logs, and/or Legal or contractual disputes. Process all rescissions in a timely manner consistent with Company Policy.
  • Function as the site contact for all Corporate and Regional communication coming into the site.
  • Actively participate in daily Sales Meetings and attend Sales Training/Functions.
  • Audit Sales reporting for accuracy and keep Site Leader appraised of current status in a timely fashion.
  • Function as the main point of contact with the Sales Staff with Payroll issues.
  • Work with the Office Administrator to audit Commissions and resolve issues before Payroll deadlines.
  • Research any Compensation issues in CSS to the best of your ability.
  • Work with Office Administrator to communicate any issues that need correction to Regional Payroll Supervisor.
  • Assist Company/Region/Project Director in hitting Sales goals by:
  • Working the site pending portfolio to complete down payments ahead of schedule.
  • Work on getting replacement funds for down payment defaults.
  • Retrieve necessary information/documents/signatures to transmit contracts that are in suspense.
  • Function as the site contact for all customer service training, and as needed, other training.
  • Represent the Company in a highly professional manner at all times.
  • Responsible for supervising Upgrade Quality Assurance Representatives. This includes training, evaluating and monitoring employee performance. Responsible for training other Sales Staff to complete contractual paperwork as needed.
Qualifications

 

EDUCATION AND/OR EXPERIENCE:
Minimum requirements necessary for this position:
  • Must possess a California Real Estate License
  • Wyndham Vacation Ownership Sales , Quality Assurance, or Sales Administration experience, or minimum 2 years experience as a Quality Assurance Representative for another timeshare company.
SKILLS AND ABILITIES:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities necessary to perform these duties successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
  • Possesses strong business acumen and business sense.
  • Demonstrates flexibility and adaptability. Handles day-to-day challenges confidently and willing to adjust to multiple demands, shifting priorities, ambiguity and rapid change.
  • Detail-oriented.
  • Ability to manage multiple tasks with the appropriate sense of urgency.
  • Hands-on positive work ethic. Leads for results and success, persists despite obstacles and opposition. Committed to organizational goals.
  • Fosters open communication. Provides timely, high-quality information up and down the Organization.
  • Keen ability to interact with clients at all levels of the Organization.
  • Excellent presentation, oral, written and interpersonal skills needed.
  • Energetic, results-oriented professional
  • Must have effective manager-level communication skills.
LICENCES, CERTIFICATES AND REGISTRATIONS:
Maintain appropriate State License/Certificate based on State Requirements.
OTHER REQUIREMENTS:
Possess working knowledge of CSS, IRIS, Salepoint, Microsoft Outlook, Word and Excel.
Job Sales
Primary Location United States of America- California-Indio
Employee Status Regular
Schedule Full-time
Organization Worldmark by Wyndham
Posting Date Oct 8, 2014

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ASK ABOUT WORKERS COMP GRAVY TRAINS

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InjuredWorkers Resources….. Add to It!

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For more on Timeshare and RTW, also see:

https://askaboutworkerscompgravytrains.com/2014/07/02/ps-i-have-a-confession-by-a-timeshare-sales-executive-tbi-survivor/

Life with TBI is so

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By the way, the termination of TTD Benefits again in July 2014, along with the $20k bonus CNA received from the State of California for REFUSING to pay TTD in 2012/2013, combined with continued failure to provide medically treatments, combined further with refusal to participate in interactive process and help with RTW matters appears to require another call to ADULT PROTECTIVE SERVICES for on-going abuse and financial domestic terrorism, along with more unhappiness complaints to DOJ, DOL, DA, CAAA, AG, EEOC, ADA, WTF ETC

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