“If you have an interest, I’m way open to your direction on how to move forward with RTW and accommodations requests. They have cut my benefits off, so I’m back between a rock and hard place, and it snows a bit where I live, and I’m not willing to look for food banks or welfare offices again. Once was more than enough….” – September 2014
A FEHA/Employment Law and Civil Rights Law Firm, and a Class Action Law firm are also desired. Wassup America?
“Intent” is important in WorkComp. “Intent to Kill” is a matter for the Department of Justice, imho.
The info you provide is helpful, but here’s the bottom line data I’d like to see if I can help you, informally or by representation:
(1) Who are your work comp doctors?
(a) Who is your PTP?
(b) Who are your secondary treating doctors (i.e, in other specialties)?
(c) Do you have any AMEs or QMEs, and if so, who are they?
(2) Have any of the above doctors found you to be MMI yet? As of what date?
(3) If you are MMI per any doctor, what’s your WPI and the apportionment analysis?
(4) Any trials or findings by a work comp judge yet? If so, who and at which WCAB office?
(5) What treatment is authorized? Any IMR determinations yet or in the works?
(6) Are you getting SSDI, or have you applied for it? If so, do you have an MSA? What’s the amount?
If you email me answers to these questions….
(1) Who are your work comp doctors?
I have a list of approximately 35 doctors, by specialty, diagnosis, recommended treatments (not provided) and ICD -9 codes, referred by whom and whether on alleged MPN, authorized exception or self-procured.. I have to look for it and it will follow when I get home (Thursday nite)
(a) Who is your PTP?
Current: Dr. Darren Bergey, Orthopedic Surgeon, since 2/14/2013. Knows nothing about brains, and all efforts to get me to experts failed, organized by attorney #3.
Prior PTP, Dr. Marcel Ponton, QME, Clinical Psychologist (not sure if he is a neuro-psych); Organized by attorney #2, located in Pasadena, 3 hours from my home. I met with him twice…once in April 2012, once in October 2012. He did not perform the neuro-psych tests, his colleague, Dr. Gunn, did. His other colleague, Dr. Chung provided approximately 4 clinical psychology sesssions, focussed primary on stress and pretending there are no cognitive impairments. Dr. Ponton requested neuro-feedback, neurology, neuro-optometry…. to no avail. In October 2012, after threating letter from Defense, he said I could return to work with accommodations as clerk. No medical treatment with him, but somehow after defense threat, I magically got well. Several of his reports have been repeatedly omitted by defense in order to continue to deny medical. Some of his reports read like I got the requested evaluations and treatment, but I didn’t and he only requested; complete failure to obtain medical care. (April 2012 – December 2012; authorized exception to alleged MPN, by Court Order, June 2012.)
After dismissing attorney #2 and requesting hearing for right to medical care and treatment by a specialist, I & A officer and then-defense counsel told me to come prepared with 3 doctors names, which I did, but they were not on the alleged MPN List (I was never properly noticed, that’s another can of worms). So, the two women made me chose another Orthopedic Surgeon who would then “coordinate specialty doctors”. I chose Dr. Jacob Rabinovich, Orthopedic Surgeon and had an eval and he wrote a report. As there was an increasing demand for a QME/AME, I retained counsel #3, and they didn’t like Rabinovich, so they sent me to Dr. Bergey, who is stil the PTP, but wants out as they have been threatened by defense to stop requesting brain injury treatment or they would lose their MPN status. On my right shoulder rotator cuff injury, clearly evidenced as a impacted body part by several reporting doctors, discovered by Dr. Bergey after physical therapy authorized Spring 2013, authorized MRI of shoulder, recommended shoulder surgery (no thanks, I’m familliar with Romano Trust vs Segdwick)….defense then told Dr. Bergey stop reporting it as “industrial injury” so mid-summer 2013 he changed it to “non-industrial”…. a Crowe-Paradis report obtained by defense in Nov 2012 with intent to coerce premature settlement also included the right shoulder….so it’s just silly that once the severity is discovered they want to say “oops, not related”… D’oh.
Attorney #1’s “office manager” was the case manager and was the first to send me to an Orthopedic Surgeon. I told her I needed a brain doctor, she said Work Comp required I start with an Orthopedic Surgeon. His name is Dr. Sunny Gurvindo (?) UPPAL. The office manager also said, “there’s no psych component to a work comp injury”… I said, “It’s not a psych component, it’s my BRAIN.”….
The first doctor I saw, on the date of injury, was local chiropractor, Dr. Jamie Whitlock. I thought I just needed an adjustment. He said I had a concussion. By Wednesday of that awful week, I was getting all sorts of confusing info and directions from employer, so I called EAP for help for confusion. They sent me to a clinical psychologist, Dr. David DeGoede, who administered several tests, referred me to a local neurologist, and told me to get anMRI by any means necessary. (I knew nothing of any MPN, was just following directions of EAP.) Dr. DeGoede became my first PTP.
SUMMARY OF PTPs:
- Dr. Daniel DeGoede, Clinical Psychologist, referred by Wyndham EAP program, paid for by CIGNA (Jan-Apr 2012)
- Dr. Marcel Ponton, Psychologist, referred by attorney #2; also a QME dude. (Apr – Dec 2012)
- Dr. Jacob Rabinovich, Orthopedic Surgeon, one time evaluations; replaced by attorney #3’s doctor: (1 visit)
- Dr. Darren Bergey, Orthopedic Surgeon….. (Feb 2013 to present; wants out)
(b) Who are your secondary treating doctors (i.e, in other specialties)?
- PAST: Bijan Zardouz, insurance company doctor- neurologist, no expertise in TBI, no brain knowledge, designated as 2nd TP by attorney #3, Zardouz thought it was a one time consult and wrote a egregiously incorrect report for top dollar. Defense had omitted more than 300 pages of medical records; took court order to get the missing records to the doctor and requesting a supplemental report. He threatened to sue me for “harassment” for properly serving the omitted records; so I had to convince the Judge to get involved. Rather than just send the omitted records, defense just sent a box of all records again and told them to figure out what they missed. 😕
- CURRENT: Dr. Hilda Chalgujian, Neuro-Psychologist (authorized exception to MPN)….. Dr. Bergey’s office threw up their hands at the last denied medical care or eval or specialist for brain trauma, and told me, “As you can see, they will not authorize any medical treatment we request. You will have to find your own brain doctor.” Through a series of phone calls and emails, I found Dr. Hilda who was willing to help me/treat me. Defense jumped in and asked her to do a comprehensive evaluation (she did a 40 pages report, incuding review of prior doctor evaluations) and Defense agreed in Court to have Dr. Hilda as Secondary Treating Doctor. She is not a work comp doctor and works primarily with head injuries. I see her mostly weekly. Her report was May 2014, progress report over due and expected next week. Dr. Hilda and her report were extremely instrumental in finally getting me some help at an interdisciplinary treatment center like SCRIPPS. She is also disappointed the amount of time was cut so short. I don’t think she thinks I’m employable, but she knows I have to return to work to keep a roof over my head in light of the monsterous behavior I have been subjected to. On Monday I will ask her again about RTW and accommodations and timing.
- CURRENT, SELF PROCURED, DOESN’T FOOL WITH WORK COMP INSURANCE:
Dr. Michael Lobatz, Neurology-Psychiatry, nationally acclaimed, Chief of Staff at SCRIPPS, organizes SCRIPPS BRAIN INJURY REHABILITATION CONFERENCE ANNUALLY FOR PAST TEN YEARS for and with scientists, military, doctors and other rehab providers. I attended, at his invitation, the May 2014 event, and learned a great deal more about TBI, and thanks to Dr. Lobatz, the way was made easier to get into SCRIPPS, and his recommendation was for interdisciplinary treatment for 3 months, 3 x a week. It was reduced further from Dr. Hilda’s request, by the insurance company, to 4 x a week for 4 weeks, extended by 8 more days. No current appointment scheduled with Dr. Lobatz, although he has been kept apprised of Day Injury Program results and progress. He didn’t care if I went to SCRIPPS, Learning Center or that other one in Encino…. just care that I got some help. [There is a program in Newport Beach, a one year program, for cognitive remediation that I am currently applying for…it’s a 3 step interview process, and it’s inexpensive but I would have to relocate, if accepted. and if either Social Security or LTD kicks in for income, or settlement happens.)
(c) Do you have any AMEs or QMEs, and if so, who are they?
A big mess created by Attorney #3
AME/ Forensic Psychiatrist – James O’Brien APRIL 2013 with supplemental reports of Aug 2013 and I think October and October 2013, covering his fraudulent tracks poorly — initial report created on incomplete medical evidence (omission of more than 300 pages of medical records; same as above, Court ordered supplemental report upon delivery of omitted documents by defense. First report indicated that ‘if the finder of facts found evidence of a slip and fall concussion, of course medical treatment would be in order’ and went on to opine, by changing dates of injury to 2013, and used 2012 records to suggest “prior head injury and cognitive failures” etc….. to a full scale “pissing contest” where I suggested he and defense invoke 5th amendment and they moved to secrecy attempting to conceal the records from me and to continue to use them, asking evauating doctors to review but not summarize because of my ‘fragile emotional state’…. by the time his work of fiction (about $10k in fees) was done…. I never had a slip and fall (which was witnessed, and my manager helped me up from the ground)… he further opined that I just had epilepsy and never even fell….. Felony Fraud, imho. I have evidence; DA found my complaints of interest, so did DOJ.
QME/ Neurology – Dr. Ronald Kent – December 2013 – again, issue of omitted records of more than 300 pages by defense, followed by supplemental report (without court order). This doctor spent 35 miinutes with me, his staff regurgitated poorly prior medical evidence, and he said that essentially, women over 35 are not entitled to medical treatment for a brain injury and that since I didn’t get any in the first two years, tooo bad, deal with it. This guy teaches new doctors at UCLA. Those med students would be wise to be afraid, very afraid.
QME/Orthopedic – Dr. Jefrey Holmes – PENDING …. Attorney #4 agreed at an expedited hearing for medical treatment that I had organized….for my right to medical care and to dispute the O’Brien fiction, simply agreed to an Orthopedic eval. It was arranged, postponed, arranged, cancelled, order to compel invoked, was off calendar so didn’t happen, Defense and IW agreed then to postpone till further notice; today Defense asked if it’s time to reschedule; I asked him to wait till I get the accommodations request and interactive process and PROPOSAL FOR RESOLUTION done, or to just plan it for late September or October, late in the afternoon…. He said to let him know when I’m ready…. I told him we’lll tie it to the Proposal for Resolution.
(2) Have any of the above doctors found you to be MMI yet? As of what date?
Nobody has found me MMI yet, although in October 2012 Dr. Ponton suggested I could return to work as a clerk.
(3) If you are MMI per any doctor, what’s your WPI and the apportionment analysis? N/A
Yeah, unbelievable. (4) Any trials or findings by a work comp judge yet? If so, who and at which WCAB office?
Judge Victor Jimenez has been the primary judge I have dealt with. I have had other Judges assigned to the case, but it always gets back to Jimenez. Presiding Judge Sanford-Wachtel gave me his card and encouraged me to contact him if there are issues, after the first failure to provide requested ADA accommodations. The Information & Assistance Officer, Valerie James, has been instrumental in ensuring failure to get medical care and has denied ADA accommodations and even confiscated my cell phone at one hearing; I filed an ADA complaint with DOJ. EEOC called me and said the issues involved were more than two years ago, too bad
.
(5) What treatment is authorized? Any IMR determinations yet or in the works?
Year one,2012: they authorized, as mentioned on my blog, a little chiropractic and a couple clinical psychology sessions.
Year two, 2013 physical therapy and…. a couple MRI’s….
Year three….2014… by court order, a couple chiropractic and some acupuncture (helps a lot with brain and right shoulder…..the first set EXCLUDED BRAIN and authorized right limbs only ….knuckleheads….
[Scripps Brain Injury Day Treatment Center is generally a 154 day program; 16 days were authorized in August 2014 on appeals, and then 8 more days on more appeals….hardly a start to cognitive rehabilitation. The cost was $50K + lodging.
My doctors had requested 3-6 months treatment…. 24 days is not reasonable and the interactive FEHA process for return to work was to begin during that course, but Wyndham refused to participate despite repeated requests that had already been paid for …. just wasted.]
More than $27,000 has been spent, properly submitted for reimbursements for medical miles and expenses for medically necessary treatments and evaluations such as MRI, Vision therapy, prism therapeutic lenses, chiropractic, acupuncture…. I have a summary sheet ……….have requested reimbursements many times, and have filed complaints with Audit Unit.
I have also filed complaints up and down the Coast. They know my name in Sacramento and i have received some pretty nasty letters from the Assistant Medical Director suggesting I will never get medical treatment, so come to grips with that harsh reality.
Any IMR determinations yet or in the works? I don’t know what that is, and I don’t know anything about how to close this up. I think this has to do with PD ratings and things? This is, I believe, where your expertise to set things up to make this finally right??
(6) Are you getting SSDI, or have you applied for it? If so, do you have an MSA? What’s the amount?
I applied for Social Security Disability was denied a couple times, awaiting hearing now….I’m told it will be December January is….. I’m told it will be retroactive and the SocSec office broken the numbers down for me last year (I think it was last year) and said it would be retroactive from 6 months after injury and would put (last year) about $50K in my pocket, and about…. $1800/month. A group called, “The Advocator”, somehow affiliated with my LTD carrier, is pushing the paper there. On my task list is to get them medical records since last we talked. Social security basically said they know I have a brain injury but it’s not bad enough to keep me from being a sales executive. I think they mean no brains are required, or cognitive abilities. Tsk.
Do you do Social Security?? Allegedly the Advocator will provide me with an attorney at the hearing, which causes me fear……I’m also told I can terminate contract with them and retain and attorney without liens. My LTD income is a mess due to the financial chicanery of CNA/EDD and the ‘now we pay, now we don’t, now we do, change the amount’…. so I owe Matrix some paperwork to confirm when my benefits stopped so they can sort out if I owe them or they owe me. That sort of paperwork boggles my brain….. I can type like there’s no tomorrow, but retrieval and recollection and visual scanning to edit are severe challenges. I have a list somewhere of the various challenges and impairments, cuz I can never remember them all…… Muddling through life as best I can seems to be my “new normal”
I have long term disability insurance with Matrix/Reliance. I have a neurology/psychiatry evaluation with one of their doctors on October 27…. a Dr. Jay Jurkowitz in…. I think Riverside or San Bernardino.
My next PTP Orthopedic Surgeon for my Brain Injury 45 day appointment is October 17 at 1 pm in Indio.
My next neuropsych appointment is next Monday.
David DePaolo is familiar with my….challenges, and I have explored possibilities of representation with multiple attorneys in CA… some bothered to consider and others abruptly put it in the “too hard” pile…… See WORK COMP AND BASEBALL OCT 2 2014…. IT MENTIONS MY SITUATION, AND THE SITUATIONS OF OTHER INJURED WORKERS:
http://daviddepaolo.blogspot.com/2014/10/work-comp-and-baseball.html
It is my hope to eventually (maybe now?) retain someone who can wrap it up, and to also ensure that the 4 attorneys who harmed me get little to nothing out of the “15% pot”…. and who ideally will, with encouragement, withdraw their liens.
If any of this may be of interest, and if you agree that submission of a “PROPOSAL FOR RESOLUTION” may be in order before I attempt for force my way back into a job I doubt I can do anymore, I willl find and send the spreadsheet of doctors and their specialities….
I live in Yucca Valley, near Joshua Tree National Park. The WC case is in Riverside. While I understand there has to be cause to move a case, I would be they would be glad to be rid of me and let you move it to LA to get me gone. They know that I know whose side they are on.
If you are interested, and if you could be like the “general contractor” and organize with Nick and any other team players, I am sure that adequate funds could be created to make it financially attractive enough to deal with the mess. I just want out………… I would like $1.3 million and I would like to see these crooks tried, locked up and executed, in accordance with the laws. I’m realistic enough to realize….. those who have the cash kills as they can, without consequences. Fighting back one case at a time is an honorable fight, till last gasps.
If we jointly decide to work together, you might want to know a bit more about me…. I can take my hands off my WorkComp blog for a while, or I can amp it up…… I am open to suggestions and I get it that if I retain counsel, my right to speak out is limited, temporarily.
I also blog about Fukushima, an in progress extinction level event. ASK ABOUT FUKUSHIMA NOW http://askaboutfukushimanow.com/ LUCY OCCUPY SAYS http://lucyoccupy.com/
I think it could be an “easy enough” deal with the work I have accomplished this past year…..getting to SCRIPPS, letting them know my number was $700K before SCRIPPS and that it’s $1.3 million now, based on what I have learned of long term medical needs and consequences of untreated brain injury and untreated rotator cuff tears.
Do you know [xxxx] the structure settlement guy? I have been in touch with him several times. We connected after the CAAA Winter Conference. He thinks I’m a little hot headed….. he may not like me, but he has observed me getting a few things done in spite of the odds.
I hear tales that you work around the clock….. I learned at SCRIPPS about brain fatigue and reserves…. breaks are good for rebooting.
I will head home tomorrow…. coffee with some fellow activists in the morning, so…. onward.
If you have an interest, I’m way open to your direction on how to move forward with RTW and accommodations requests. They have cut my benefits off, so I’m back between a rock and hard place, and it snows a bit where I live, and I’m not willing to look for food banks or welfare offices again. Once was more than enough.
I also lost my “professional credentials”… my Hawaii real estate license, my California real estate borkers license, and my California Notary license, due to cognitive inability to take the continuing ed after paying nearly $1000 for special theraputic glasses and vision therapy, I was able to knock out the CA continuing ed for the broker’s license….that did expire. I have to send them $450 to renew during the grace period; it’s a return to work license required, but I don’t have the $450 to spare with no income from these clowns.
I did have to file for early retirement (DOB 4/8/52)…. so I have pocket money and a will to survive.
Thanks kindly for you consideration Awaiting word from you. I really want out I intend to continue the good fight from the other side….. JAIL BREAK TIME……. HELP ME OUT OF HERE…………….These psychopaths are armed and extremely dangerous. Yeah, I know.
Sincerely,
Linda and Friends
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