3 OF 3 WORKCOMP MAGIC MONEY MATH OR FOLLOW THE MONEY ON THE WORKCOMP GRAVY TRAIN

The point is that any injured worker must keep copies of all events related to their case, including medical records, daily journal, neat copies of receipts for all income and expenses and requests for reimbursements etc.  I quite frankly think it’s monstrous that so many people, as Chris Asvar, Esq.  opined, ‘obviously didn’t do their job’ when he declined to help me in late 2012, and when I asked again in 2013 and 2014…. and that theme continues.

GRAVY TRAIN WRECK

My file of attorney notes and ‘letters of non-engagement’ are pitiful and could be subject to a whole e-book on ATTORNEY JOKES in the World of WorkComp.   This injured worker has spent more than $43,000 on medical miles and medically necessary treatments, unreimbursed.  Also, not uncommon in Workers Comp “Grand Bargain.” That industry “cost and risk shifts by any and every means necessary” is a well tuned machine.

ALL CAPS

OMG, the lawyer crowds are funny peeps… I remember one returned my call about 8 pm one night, clearly in an ‘altered state’ and ranted about how people like me were ‘pariahs’ in the system, and he was swearing up a storm about how he had no life, chad ase load of more than 400, and if he did take my case, that phone call would be the longest conversation we ever had.  Turns out he knows the former defense attorney. I mentioned my allegations of fraud with intent to deny medical care; he went ballistic again and said, ‘She’s not capable of fraud.  Incompetence yes, fraud, no.’

lisa and bart the whole damn system is wrong

Alrighty.  I suggested, “Well, since you know the defense, why don’t you make contact with her and then decide if we will consider going forward.  Another attorney reviewed files and said, “I’m sorry, this is over my head.  There’s too much fraud.”  I cried and said, “What am I supposed to do?  I have a f—-king brain injury, I can’t keep fighting fraud alone.”  He suggested Gloria Allred. Couldn’t get past her gate keepers.

.

Nobody likes WorkComp…. with good cause.  Another attorney told me it didn’t matter if I have video records of ‘them’ committing fraud’… it would never stick.  Another said that Romano Trust vs. Sedgwick gives the green light to the industry to maim and kill injured workers without consequences.  Bummer.

Is that on National Cathedral on purpose?
Is that on National Cathedral on purpose?

That attorney said something about look at how various insurance companies are gobbling up the smaller ones after that case was ‘settled’ with a $100k price on an injured workers head; cheaper than medical care, huh?

IMG_0503

How about the attorney who said, “Nobody will believe YOU have a brain injury.  WorkComp is a very small community, everybody knows everybody.”  I said, “Well, the only reason they wouldn’t believe it is because someone failed at getting the recommended evaluations and medical care from experts.  Intermittent chiropractic is hardly legitimate medical care for a well diagnosed brain injury.”

BRAIN INJURY ADVOCACY GROUP

How about when I appeared for a deposition, which was aborted and they attempted to coerce me to accept a $100,000 settlement, less attorney fees, in November 2012, without benefit of proper evaluations or care.  I told that attorney, “I’M INJURED, NOT STUPID.  I NEED TO KNOW WHAT’S WRONG WITH MY BRAIN, AND WHAT IT WILL TAKE TO GET IT BACK”

APPARENTLY, I DON’T GET IT BACK.   MAY YOU ALL HAVE VERY INTERESTING LIVES, AND REAP 100 FOLD OF WHAT YOU HAVE SOWN.

planting seeds of truth in fertile minds

If you are a numbers Geek, maybe these numbers make sense to you.  They make no sense to me, or to the experts trying to sort out the current shell game. It’s embarrassing to share such a sloppy excel spread sheet…. I used to a database wizard and excel queen.   Anyway, the numbers are from CNA and EDD print outs…. and they don’t match up.

3 OF 3 DISABILITY BENEFITS PER EDD AND WC DAYS ISSUES DATES AMOUNTS TOTALS

3 of 3 workcomp gravy train wreck20150830_20301707_0321 (1)

The WC Offset and Social Security Retroactive Pay back to date of injury, 1/9/12, less 6 month waiting period, seem to rely on accurate numbers in order to calculate:

  1.  (ACE)  Average Current Earnings
  2. (8% of something)
  3. (DIB) Disability insurance benefits
  4. WC (something about wash out agreements over life time)
  5. (3 + 4)  (combined WC and DIB; if 5 is less than 3, no offset)
  6. (5-2) offset
  7. (2-6) reduction in DIB

It is unclear to everybody how Social Security Administration came up with the numbers for their calculations, and what sources were used.  As is apparent here, CNA is all over the place with how much they paid and when.  CNA has not paid any penalties to date for delays in payment, which are apparently substantial consider refusal to pay TTD through most of 2012  (4/16/12 – 2/14/13, with last payment being 5/8/14 in the amount of $1,298.82, issued 5/7/14)

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It appears that the moneys EDD advanced because of the CNA refusal to pay TTD (with it’s refusal to provide medically necessary treatments repeatedly requested and denied in 2012 by non-medial professionals, and in 2013 forward, CorVel corporations continued the deceptions with intent to deny medical care.

SKILL SET AREA APRIL 2015.More than 40 doctors were seen for evaluations and the medical care provided is addressed in other blogs, out of compliance with ACOEM, MTUS and common sense, having caused permanent and irreparable life time incapacitating damage.  (Thanks Wyndham et al)

How many days/weeks TTD did CNA actually pay?  The numbers are all over the place, depending on what page is being reviewed.

 

SOCIAL SECURITY PAID

On May 15, 2015 — A fully favorable decision made by the Social Security Administration, with a deposit made to a closed bank account (not to the existing account for retirement benefits) in the amount of $25,591.  A kind agent of the Treasury Department resolved that issues to everyone’s satisfaction. (Thank you!)

“ACE” is stated as $3,700/month, and the source of the information is quite unclear.  The income numbers stated by SSA match nothing.

SSA also states ‘Your Workers Compensation payment of $4,177.30 — because you receive this payment’ – HUH?  LAST WORKERS’ COMP PAYMENT WAS FOR 1,298.82 ISSUED ON 5/7/2014.

Then SSA sent a letter stating “we paid you $31,654 for February 2013-July 14″ opining an overpayment of $27,078.00  (remember, they only sent $25,591, now they want back $27,078, the only money received since 5/7/14 was the June commencement of basic early retirement money in the amount of $1334, and periodically LTD payments, unless they were being subrogated or offset for some reason or another.

On 8/12/15, credited $1,500 to the ‘overpayment” and now demands $25,578, ‘or else’.   This credit was since the SSA Court generously gave the law firm an additional $1,500, the law firm returned it to SSA, as the agreement was for $4,500, not $6,000.

delusional and unicorns

EDD PRINT OUT SAYS THEY PAID 938 DAYS AND THAT WC PAID 509 DAYS FOR A TOTAL OF 1,447 DAYS FOR A TOTAL OF 127,214.90 FOR A TOTAL BETWEEN EDD AND WC FOR 1013 DAYS.  MAKES SENSE SO FAR?  YEAH, TO ME EITHER.

CNA adjuster alleges on 10/19/14 they “paid” 1/9/12-4/15-12 @ 652.15 per week and 2/15/13-5/8/14 @ 649.41 per week and reimbursed EDD for 1/28/12 to 3/4/13 for a total of $31,400.

WCGT SHELL GAME

CNA “Total WC Ind to Date””

C N A “Total WC Ind to Date”
 $  31,400.00  10/19/14 CNA adjuster alleges on 10/19/14 they “paid” 1/9/12-4/15-12 @ 652.15 per week and 2/15/13-5/8/14 @ 649.41 per week and reimbursed EDD for 1/28/12 to 3/4/13 for a total of $31,400.
 $  22,118.00 7/3/2013 Total WC ind to date
 $  42,899.12 2/28/2014 Notice of termination of benefits; last check was 2/12/14, when “Total WC ind to date” was $42,899.12 — approximately 40 weeks
4/21/2014 “Notice of TTD Resume for 2/14/14 – 4/24/14 @ 649.41 ” w/check for $6494  issued 4/18/14 and a check for 4/25/14 – 5/8/14  for $1298.82 on 5/7/14
 $  82,092.04 5/8/2014 C N A issues another ‘notice of payment termination, again alledging “104 weeks of payments  paid 1/9/12 – 5/8/14 @ 652.15/week for a new total of $82,092.04
LAST PAYMENT ISSUED  5/7/14 for $1298.82
11/3/2014 PD Disability status – repeated refusals to provide estimate PD benefits or advances
 $  87,422.04 1/50/15 PD advance on estimated PD to help get TBI treatment, $5,000, subrogated to LTD carrier, new total paid stated as $87,422.04
WOW, REALLY?

 

EDD says here EDD paid 77,821.38
EDD SAYS WC PAID IW 47,252.31
WC SAYS HERE PAID IW 49,393.52

EDD PRINT OUT SHOWS:

  • EDD PAID IW
BGN DT END DT NUM DYS REASON  AMT ISS DT souce
1/28/2012 2/14/2012 18  $                             801.90 2/15/2012 EDD INFO
2/15/2012 2/28/2012 14  $                             623.70 2/29/2012 EDD INFO
2/29/2012 3/13/2012 14  $                             623.70 3/14/2012 EDD INFO
3/14/2012 3/27/2012 14  $                             623.70 3/28/2012 EDD INFO
3/28/2012 3/31/2012 4  $                             178.20 4/2/2012 EDD INFO
4/1/2012 4/16/2012 16  $                             712.80 4/17/2012 EDD INFO
4/16/2012 5/14/2012 29  $                         2,701.76 5/16/2012 EDD INFO
4/17/2012 4/30/2012 14  $                             623.70 5/1/2012 EDD INFO
5/1/2012 5/14/2012 14  $                             623.70 5/15/2012 EDD INFO
5/15/2012 5/28/2012 14  $                         1,928.00 5/29/2012 EDD INFO
5/29/2012 6/11/2012 14  $                         1,928.00 6/12/2012 EDD INFO
6/12/2012 6/25/2012 14  $                         1,928.00 6/26/2012 EDD INFO
6/26/2012 7/17/2012 22  $                         3,029.71 7/18/2012 EDD INFO
7/18/2012 7/31/2012 14  $                         1,928.00 8/1/2012 EDD INFO
8/1/2012 8/14/2012 14  $                         1,928.00 8/15/2012 EDD INFO
8/15/2012 8/28/2012 14  $                         1,928.00 8/29/2012 EDD INFO
8/29/2012 9/11/2012 14  $                         1,928.00 9/12/2012 EDD INFO
9/12/2012 9/25/2012 14  $                         1,928.00 9/26/2012 EDD INFO
9/26/2012 10/12/2012 17  $                         2,341.14 10/15/2012 EDD INFO
10/13/2012 11/5/2012 24  $                         3,305.15 11/9/2012 EDD INFO
11/6/2012 11/8/2012 3  $                             413.14 11/9/2012 EDD INFO
11/9/2012 11/22/2012 14  $                         1,928.00 11/26/2012 EDD INFO
11/23/2012 12/6/2012 14  $                         1,928.00 12/7/2012 EDD INFO
12/7/2012 12/20/2012 14  $                         1,928.00 12/21/2012 EDD INFO
12/21/2012 1/3/2013 14  $                         1,928.00 1/4/2013 EDD INFO
1/4/2013 1/17/2013 14  $                         1,928.00 1/18/2013 EDD INFO
1/18/2013 1/31/2013 14  $                         1,928.00 2/4/2013 EDD INFO
2/1/2013 2/21/2013 22  $                         3,029.71 2/25/2013 EDD INFO
2/23/2013 3/4/2013 10  $                         1,297.99 3/11/2013 EDD INFO
3/5/2013 5/17/2013 74  $                         3,325.67 5/28/2014 EDD INFO
5/18/2013 7/30/2013 74  $                         3,325.67 5/28/2014 EDD INFO
7/31/2013 10/12/2013 74  $                         3,325.67 5/28/2014 EDD INFO
10/13/2013 12/25/2013 74  $                         3,325.67 5/28/2014 EDD INFO
12/26/2013 3/4/2014 69  $                         3,100.94 5/18/2014 EDD INFO
3/5/2014 5/11/2014 68  $                         3,334.34 5/28/2014 EDD INFO
5/12/2014 5/27/2014 16  $                         2,203.42 5/28/2014 EDD INFO
5/28/2014 6/10/2014 14  $                         1,928.00 6/11/2014 EDD INFO
6/11/2014 6/24/2014 14  $                         1,928.00 6/25/2014 EDD INFO
6/25/2014 7/8/2014 14  $                         1,928.00 7/9/2014 EDD INFO
7/9/2014 7/22/2014 14  $                         1,928.00 7/23/2014 EDD INFO
7/23/2014 7/24/2014 2  $                             246.00 7/25/2014  $                    77,821.38 EDD INFO
  • WC PAID IW PER EDD
BGN DT END DT NUM DYS REASON  AMT ISS DT
1/28/2012 2/14/2012 18 WC  $                         1,676.96
2/15/2012 2/28/2012 14 WC  $                         1,304.30
2/29/2012 3/13/2012 14 WC  $                         1,304.30
3/14/2012 3/27/2012 14 WC  $                         1,304.30
3/28/2012 3/31/2012 4 WC  $                             372.66
4/1/2012 4/15/2012 15 WC  $                         1,397.47
3/5/2013 5/17/2013 74 WC  $                         6,865.19
5/18/2013 6/19/2013 33 WC  $                         3,061.50
6/2/2013 7/10/2013 41 WC  $                         3,803.68
7/31/2013 10/4/2013 66 WC  $                         6,123.01
10/5/2013 10/12/2013 8 WC  $                             742.18
10/13/2013 12/25/2013 74 WC  $                         6,865.19
12/26/2013 1/19/2014 25 WC  $                         2,319.32
1/20/2014 3/4/2014 44 WC  $                         4,082.01
3/5/2014 5/8/2014 65 WC  $                         6,030.24  $                    47,252.31

we the people dec

CNA RECENT PRINT OUT SHOWS:

c n a  Amout Period Issue Date
1/9/2012 1/21/2012      1,304.30 2 1/20/2012
1/23/2012 2/5/2012      1,304.30 2 2/3/2012
2/6/2012 2/19/2012      1,304.30 2 2/16/2012
2/20/2012 3/4/2012      1,304.30 2 3/2/2012
3/5/2012 3/18/2012      1,304.30 2 3/15/2012
3/19/2012 4/1/2012      1,304.30 2 3/29/2012
4/2/2012 4/15/2012      1,304.30 2 4/12/2012
!!!!!!!!!! !!!!!!!!  !!!!!!!!!! !!!!!! ____ Weeks Late; 25% penalties +++
2/15/2013 2/28/2013      1,298.82 2 2/27/2013
3/1/2013 3/14/2013      1,298.82 2 3/13/2013
3/15/2013 3/28/2013      1,298.82 2 3/27/2013
3/29/2013 4/11/2013      1,298.82 2 4/10/2013
4/12/2013 4/23/2013      1,298.82 2 4/24/2013
4/26/2013 5/9/2013      1,298.82 2 5/8/2013
5/1/2013 5/23/2013      1,298.82 2 5/22/2013
5/24/2013 6/6/2013      1,298.82 2 6/5/2013
6/7/2013 6/20/2013      1,298.82 2 6/19/2013
6/21/2013 7/4/2013      1,298.82 2 7/3/2013
7/5/2013 7/18/2013      1,298.82 2 7/17/2013
7/19/2013 8/1/2013      1,298.82 2 7/31/2013
8/2/2013 8/15/2013      1,298.82 2 8/14/2013
8/16/2013 8/29/2013      1,298.82 2 8/28/2013
8/30/2013 9/12/2013      1,298.82 2 9/11/2013
9/13/2013 9/26/2013      1,298.82 2 9/25/2013
9/27/2013 10/10/2013      1,298.82 2 10/9/2013
10/11/2013 10/24/2013      1,298.82 2 10/23/2013
10/25/2013 11/7/2013      1,298.82 2 11/6/2013
11/8/2013 11/21/2013      1,298.82 2 11/12/2013
11/22/2013 12/5/2013      1,298.82 2 12/4/2013
12/6/2013 12/19/2013      1,298.82 2 12/18/2013
12/20/2013 1/2/2014      1,298.82 2 12/30/2013
1/17/2014 1/30/2014      1,298.82 2 1/29/2014
1/31/2014 2/13/2014      1,298.82 2 2/12/2014
!!!!!!!! !!!!!!!  !!!!!! !!!!!!! ___ Weeks late; 25% penalties +++
2/14/2014 4/24/2014      6,494.10 9 4/18/2014
4/25/2014 5/8/2014      1,298.82 2 5/7/2014
   49,393.52 75
 C NA PAID TO IW WEEKS PAID
104 weeks per Labor Code, weekly rate questioned, but at $1,298.82 x 52 checks = $67,538.64
C N A  Reimbursed $31,400 to EDD on 4/29/14  for paying IW $49,49,422 from 2012-2013 because C N A refused to despite Court demand:
 $       31,400.00 = 24.17579 weeks 99/weeks  effective payment?
Lump Sum Permanent Disability Advance
$5,000 1/30/2015 (subrogated by private LTD carrier?!!)

 

WC SHELL GAME TIMES HOW MANY INJURED WORKERS

REMEMBER REMEMBER……WE ARE THE MEDIA NOW…..

AUGUST 31, 2015 IS THE LAST DAY TO NOMINATE FOR

THE WORKCOMP CENTRAL COMP LAUDE AWARDS.

GALA

DID YOU GET YOUR NOMINATIONS IN YET?  MAYBE WE CAN ASK DAVID DEPAOLO TO PRETTY PLEASE EXTEND THE DATE BY TWO MORE WEEKS…..

WATCH FOR MY LIST OF NOMINATIONS, AND THE DNN-LIST…DO NOT NOMINATE/NEEDS IMPROVEMENTS

oh shit button

Have a wonderful radioactive weekend and remember to Dodge the Rads, it’s dangerous out there!”

WE ARE THE MEDIA NOW THANK YOU

2 of 3 WorkComp MAGIC Money Math or FOLLOW THE MONEY on the WorkComp Gravy Train

xmas naughty or nice

WorkCompCentral 4th Annual CompLaude Awards Gala is coming up…. Mark your calendar for Saturday, December 5, 2015.

BTW, August 31, 2015 is the deadline for submissions of YOUR nominees for the WorkCompCentraCompLaude Awards. After the recent news about Director Christine Baker, it seems that the need for your to dig deeply into your database to find good people doing good stuff in America’s work comp system has never been greater.  Here’s the link again.

On the who’s been naughty and who’s been nice, WorkCompCentral has the ‘nice” list being covered, and looks like ProPublica and #InjuredWorkersUniting will simply have to continue cover the ‘naughty’ lists and enlist support, #TEO!

CompLaude 2015 Nominees

For Injured Workers, the need has never been greater for us to tell our stories. We need a #CommitteeOfBloggers.  Tell your story to the good peeps at ProPublica…..they may not be able to get the whole truth out there, but they’re doing a damn good job creating some cognitive dissonance.   Look ’em up under The Demolition of Workers Compensation and find the link to SHARE YOUR STORY aobut “What Happens When Americans are Hurt on the Job? Help ProPublica Investigate” because, afterall, WE ARE THE MEDIA NOW.   #InjuredWorkersUniting  #SilentNoMore.

xmas naughty or nice

HAVE YOU BEEN ALSO BEEN CHEATED OUT OF DISABILITY BENEFITS AS WELL AS DENIED MEDICAL CARE FOR YEARS, CAUSING PERMANENT DISABILITIES TO YOU, TOO?   WE’RE NOT ALONE.

NAIDW 54 million plus

BUT WAIT! THERE’S MORE!   AM I MISSING SOME CALCULATIONS HERE??!!!  NOBODY AT EDD/SSA/CNA/MATRIX/ADVOCATOR/WYNDHAM SEEMS TO BE ABLE TO HELP OUT EITHER.  IT’S IN THE ‘TOO HARD’ PILE EVERYWHERE….

The skewed and repeatedly mis-stated numbers have Social Security Administration in a super quandry over retroactive Social Security Disability benefits.  First, they sent $_____________ to a dead bank account, and the Treasury Department kindly intervened.  Then they sent a letter saying, whoooops, miscalculated, send us back $______ (more than the original amount) within 30 days, or else we’ll terminate all your benefits, but you can appeal it.

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Then it was discovered they generously overpaid the law firm by $1,500 which was reimbursed immediately in June back to SSA, but SSA had apparently just processed that repayment, so they sent a follow up letter acknowledging the reimbursement and reduction in the demand for funds from Injured Worker by same amount.

.

Weeks have passed and SSA has been unable to return calls to the Advocator handling the case.  The time to appeal is fast approaching, hence, this outreach via the internet.  ARE THERE ANY FORENSIC ACCOUNTANTS OUT THERE?  OR CAN THE STATE CONTROLLER’S OFFICE HELP?    (3 OF 3 WILL FILL IN THE BLANKS ON AMOUNTS FOR SSA/EDD/CNA FIASCO…IT’S A TOUGH SHELL GAME TO FIGURE OUT—–> PARTICULARLY WITH A BRAIN INJURY.

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I JUST KNOW IT AIN’T RIGHT….  and it’s in the “too hard” pile on too many desks, another example of ‘obfuscation of facts’ with intent to deny benefits and further harm injured worker?  Sure looks like it, huh?  Not even experts can sort it out.

SOCIAL SECURITY FOLLOW THE MONEY TRAIL

CNA aka American Casualty refused to pay TTD from 4/15/12 – 2/14/13 — and there are extenuating circumstances involving not only WCAB Courts, but Information and Assistance Officers and EDD parties.  Adult Protective Services, State Senator and Assemblyman’s office helped to break the stranglehold that resulted in Injured Worker having to apply for Social Welfare, Public and Private Assistance, including help from the Salvation Army for utilities in early 2014 because of this practice which is apparently “done all the time” according to CNA Adjuster, Daniel Elliott.

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Reimbursement discount was ‘negotiated’ by defense firm with EDD, apparently without any State oversight, and a Judge on appeal said it was ok.  Apparently, some Judges think it’s ok for the State to give away taxpayer dollars to big insurance companies.

[Yikes, CNA has racked up some penalties, haven’t they?  Is there anybody enforcing these rules?]

 Amout Period Issue Date
1/9/2012 1/21/2012      1,304.30 2 1/20/2012
1/23/2012 2/5/2012      1,304.30 2 2/3/2012
2/6/2012 2/19/2012      1,304.30 2 2/16/2012
2/20/2012 3/4/2012      1,304.30 2 3/2/2012
3/5/2012 3/18/2012      1,304.30 2 3/15/2012
3/19/2012 4/1/2012      1,304.30 2 3/29/2012
4/2/2012 4/15/2012      1,304.30 2 4/12/2012
!!!!!!!!!! !!!!!!!!  !!!!!!!!!! !!!!!! ____ Weeks Late; 25% penalties +++
2/15/2013 2/28/2013      1,298.82 2 2/27/2013
3/1/2013 3/14/2013      1,298.82 2 3/13/2013
3/15/2013 3/28/2013      1,298.82 2 3/27/2013
3/29/2013 4/11/2013      1,298.82 2 4/10/2013
4/12/2013 4/23/2013      1,298.82 2 4/24/2013
4/26/2013 5/9/2013      1,298.82 2 5/8/2013
5/1/2013 5/23/2013      1,298.82 2 5/22/2013
5/24/2013 6/6/2013      1,298.82 2 6/5/2013
6/7/2013 6/20/2013      1,298.82 2 6/19/2013
6/21/2013 7/4/2013      1,298.82 2 7/3/2013
7/5/2013 7/18/2013      1,298.82 2 7/17/2013
7/19/2013 8/1/2013      1,298.82 2 7/31/2013
8/2/2013 8/15/2013      1,298.82 2 8/14/2013
8/16/2013 8/29/2013      1,298.82 2 8/28/2013
8/30/2013 9/12/2013      1,298.82 2 9/11/2013
9/13/2013 9/26/2013      1,298.82 2 9/25/2013
9/27/2013 10/10/2013      1,298.82 2 10/9/2013
10/11/2013 10/24/2013      1,298.82 2 10/23/2013
10/25/2013 11/7/2013      1,298.82 2 11/6/2013
11/8/2013 11/21/2013      1,298.82 2 11/12/2013
11/22/2013 12/5/2013      1,298.82 2 12/4/2013
12/6/2013 12/19/2013      1,298.82 2 12/18/2013
12/20/2013 1/2/2014      1,298.82 2 12/30/2013
1/17/2014 1/30/2014      1,298.82 2 1/29/2014
1/31/2014 2/13/2014      1,298.82 2 2/12/2014
!!!!!!!! !!!!!!!  !!!!!! !!!!!!! ___ Weeks late; 25% penalties +++
2/14/2014 4/24/2014      6,494.10 9 4/18/2014
4/25/2014 5/8/2014      1,298.82 2 5/7/2014
   49,393.52 75
 C NA PAID TO IW WEEKS PAID
104 weeks per Labor Code, weekly rate questioned, but at $1,298.82 x 52 checks = $67,538.64
C N A  Reimbursed $31,400 to EDD on 4/29/14  for paying IW $49,49,422 from 2012-2013 because C N A refused to despite Court demand:
 $       31,400.00 = 24.17579 weeks 99/weeks  effective payment?
Lump Sum Permanent Disability Advance
$5,000 1/30/2015 (subrogated by private LTD carrier?!!)

52 additional weeks of disability benefits to have been provided by the State, when the WorkComp system fails after the first 104 weeks, would have meant an additional benefit of 52 weeks x $961/week or $49,972.

So, if CNA had paid 104 weeks at  $649.41 (eow check $1298.82) that would have been:  $67,538.64

And if EDD has paid 52 weeks at $961/week that would have been:   $49,972

Not counting the extreme hardships caused by months of non-payments by anybody, the total TTD benefits that were due between 1/9/12 and 1/9/15 seem to be around about $117,510.64    Injured Worker was actually paid 49,393.52 from CNA and $49,422, for a total of $98,815.52 for the 3 years (approximately $33K, that came in sporadic payments, causing extreme stress and hardship).  

.

This appears to be a shortage of $18,695.12 (yikes, how close is that to the reward CNA received from EDD for refusing to pay TTD and for refusing to provide medical care?  Is that a mere coincidence?   These numbers alll jumble all over my brain.   Social Security Disability was awarded in May 2015, with retroactive pay back to date of injury, 1/9/12, with the 6 month waiting period to 7/2012.  

.

This is where it gets real real fuzzy…. that will be documented, with PDFs of all of ths in 3 of 3 – WorkComp MAGIC Money Math…  

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This seems to happen all the time, to many injured workers…..nobody seems to know how the sad tales end.  

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You’ll know how this one ends, count on it!  Maybe you will even read about it in a ProPublica Report!  ;D

Back pay caper of May 2014 RE WC from SSA print out
2/14/2012 $1,676.96
2/28/2012 $1,304.30
3/13/2012 $1,304.30
3/27/2012 $1,304.30
3/31/2012 $372.66
4/15/2012 $1,397.47
4/16/2012 $712.80
5/17/2013 $6,865.19
7/30/2013 $3,803.68
10/12/2013 $742.18
10/4/2013 $6,123.01
12/25/2013 $6,865.19
3/4/2014 $4,082.01
1/19/2014 $2,319.32
5/8/2014 $6,030.24
C N A paid me $44,903.61
EDD paid approximately $47,922.00 difference EDD gave to C N A, not IW
EDD discounted back to C N A, collecting: $31,654.00 $16,268.00
  of the $31,654 EDD sent me approximately ($21,000.00)
C N A  5/8/2014 Notice states they paid a total of $82,092.04 – they did not.  See above and figure in discounted payback to EDD
See also 9/23/14 statement from C N A Weeks * $
1-9-2012 to 4-15-2012 TTD at $652.15 per week 13 weeks 8477.95
2-5-13 to 5-8-14 TTD at $649.41 per week 38 weeks 24677.58
Reimbursed EDD for period of 1/28/2012 – 3/4/2013 for a total of $31,400. 48 weeks 31171.68
Fred Sachs, C N A 64327.21
99 weeks
C N A alleged total paid $82,092.04 for 1/9/12 – 5/8/14 $82,092.04
C NA  alleges “We have paid the 104 weeks of benefits”
(law says 104 weeks + additional 52 by EDD afterwards as required)
THE MATH DOESN’T ADD UP

The question arises, how many unclean hands did that “negotiated discount” pass through before making it’s way back to EDD?  If this is done all the time, how many times must that discounted $18,000 be multiplied to determine how much money leaves the State in favor of Insurance Profits??

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If every State provides such “negotiated discounts” (aka “kickbacks”??!!)…. how much money is lost by such cost shifting by the State?

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Further cost shifting involves shifting to Social Security Administration, also implicated in this convoluted mess, and they are spending weeks and weeks and weeks of labor hours trying to sort out the calculations.  See below for more on that.  Treasury Department has even had to become involved in May, and will likely need to jump in again before all is said and done?

WC SHELL GAME TIMES HOW MANY INJURED WORKERS

According to the State of California Department of Industrial Relations, here’s the ideal regarding Temporary Disability benefits:

http://www.dir.ca.gov/dwc/TemporaryDisability.htm

But wait!  Is CNA aka American Casualty, THE ONLY INSURANCE CARRIER WITH SPECIAL PRIVILEGES AND DISCOUNTS afforded by DIR no matter what harm is caused to California Injured Workers?  Have any politicians approved these little … what do we call it…. incentives???

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Here’s what they say about attorneys:  http://www.dir.ca.gov/InjuredWorkerGuidebook/FAQsAttorney.pdf   (The warnings are quite inadequate–InjuredWorkers will create some new information for those new to the system. If you make a mistake retaining an attorney who freely violated the ABA Code of Ethics, you’re in for an awful ordeal, and they hang on like leaches to a file, preventing legitimate/competent attorneys from taking over their messes.

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The In-Pro-Per community is a market overlooked by most WorkCompsters…. #InjuredWorkersUniting — perhaps with teams of Paralegals, the WarOnWorkers can be won, SunTzu style, with a Rag-Tag Army of Injured and Disabled Patriots and Others.  Just sayin…THINK OUTSIDE OF THE WORKCOMP GHETTOS.

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See the gaps in which CNA failed to pay a Wyndham Worldwide Injured Worker? Does that mean 25% of each late payment, up to $10,000 is now due and payable, with sanctions?  Who absorbs that extra cost?

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That looks like 45 weeks and 4 days?  So would that would be 25% of…. ($1298.82 divided by…. times 45… no, times 22.5 which equals $29,200) so 25% of $29,200, or $7,300.  Is that correct?  So, if you multiply a practice of cheating injured workers like that times how many million injured workers are there, the plot thickens, huh?

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There’s a rule about penalties for failures to reimburse medical miles which CNA also scoffs at.  Complaints have been filed repeatedly with the Audit Unit; hopeful that Wyndham/CNA’s turn is coming up soon on auditors.   Out of pocket medical expenses for this injured worker have exceeded $43,000.  It seems to be a standard that injured workers who are able to, will often spend more than $50,000 in personal funds to survive the WorkComp system.  Some grand bargain, huh?  Wish for WorkComp only on your most despised enemies, huh?

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“TD payments begin when your doctor says you can’t do your usual work for more than three days or you get hospitalized overnight. Payments must be made every two weeks. Generally, TD stops when you return to work, or when the doctor releases you for work, or says your injury has improved as much as it’s going to.”

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APPARENTLY NOT IN CALIFORNIA!  Does the State Controller know how EDD assumes risks for insurance companies then deeply discounts payback, which also deprives Injured Worker of the additional 52 weeks of State Disability, assuming that the first 104 weeks without medical care failed to result in employee death?

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If you were receiving temporary disability (TD) benefits, the first PD payment is due within 14 days after the final TD payment”   Ooooops, last TD payment was when?  Shown as 5/8/14?   Does that mean that some sort of estimated PD vs. receiving nothing for months and months and months was due?  

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Is the claims administrator required to pay a penalty for delays in PD payments? Yes. If the claims administrator sends a payment late, he or she must pay you an additional 10 percent of the payment.

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Here’s the revised Chapter 5, How it Works     TEMPORARY DISABILITY BENEFITS

What happens if I don’t get my payments on time?

Is the claims administrator required to pay a penalty for delays in TD payments?

“Is the claims administrator required to pay a penalty for delays in TD payments? It depends. The claims administrator must pay you an additional 10 percent of the payment, if: • The claims administrator sends a payment late; and • You filed a claim form for your injury more than 14 days before the payment was due. This is true even if there was a reasonable excuse for the delay. However, there’s no penalty if the claims administrator can’t determine, in the first 14 days after your employer learned about your injury, whether TD benefits must be paid and sends you a delay letter as explained above. You could be awarded a total of 25 percent of each late payment, up to $10,000, if there was no reasonable excuse for the delay…”

When do TD payments end? TD payments end when:

• Your treating doctor says you can return to your usual job (whether or not you actually return to work); or

• You return to your usual job or to modified or alternate work at your regular wages (or at wages associated with a maximum limit on TTD payments); or • You have reached a point where your condition is not improving and not getting worse. (When this happens, your condition is called “permanent and stationary.”); or

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• You were injured on or after January 1, 2008, and received up to 104 weeks of TD benefits within five years from the date of injury, or you were injured sometime on or after April 19, 2004, through December 31, 2007, and received up to 104 weeks of TD benefits within two years from the start of payments. (Workers whose injuries involve acute and chronic hepatitis B, acute and chronic hepatitis C, amputations, severe burns, human immunodeficiency virus, high-velocity eye injuries, chemical burns to the eyes, pulmonary fibrosis, or chronic lung disease may receive up to 240 weeks of TD benefits within five years from the date of injury.)

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When TD payments end, the claims administrator must send you a letter explaining why the payments are ending. The letter must list all TD payments sent to you. This letter must be sent within 14 days after your final TD payment. If your treating doctor says that you will never recover completely, you may be eligible to receive permanent disability benefits or a supplemental job displacement benefit. See Chapter 7. Permanent Disability Benefits, and Chapter 8. Supplemental Job Displacement Benefit  [Ooooops, CNA didn’t do that either…. ]

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[Yikes, CNA has racked up some penalties, haven’t they?  Is there anybody enforcing these rules?]

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http://www.dir.ca.gov/InjuredWorkerGuidebook/Chapter7.pdf

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“What are permanent disability benefits?”

“Most workers recover from their job injuries. But some continue to have problems. If your treating doctor says you will never recover completely or will always be limited in the work you can do, you may have a permanent disability. This means that you may be eligible for permanent disability (PD) benefits. You don’t have to lose your job to be eligible for PD benefits. On the other hand, if you lose income because of a permanent disability, PD benefits may not cover all the income lost.”

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“Other Benefits Besides PD If you have a permanent disability, you may also be eligible to receive: • Medical care for your injury, described later in this chapter. • A supplemental job displacement benefit. To learn about this benefit, see Chapter 8. • Other financial help, such as Social Security disability benefits and benefits offered by some employers and unions. To find out about these benefits, use the resources in Chapter 9”

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When do I receive PD payments? If you have a permanent partial disability, you are eligible to receive the total amount of your PD benefits spread over a fixed number of weeks. If you have a permanent total disability, you are eligible to receive PD payments for the rest of your life. PD payments are due as listed below, except as follows: If your employer offers you work that pays at least 85 percent of the wages and benefits that you were paid at the time of injury or you are working in a job that pays at least 100 percent of the wages and benefits that you were paid at the time of injury, you will not receive PD payments until after a workers’ compensation judge approves a settlement of your case or decides on the PD benefits you will receive. If neither of the above is true:

If you were receiving temporary disability (TD) benefits, the first PD payment is due within 14 days after the final TD payment.

• If you weren’t receiving TD benefits, you should receive the first PD payment within 14 days after the claims administrator learns that you have a permanent disability caused by your injury. After the first payment, PD benefits must be paid every 14 days. PD payments end when you reach the maximum amount allowed by law or when you settle your case and receive a lump sum. Note: This lump sum is reduced by the PD benefits that you already received, including any lump sum advances.

Is the claims administrator required to pay a penalty for delays in PD payments? Yes. If the claims administrator sends a payment late, he or she must pay you an additional 10 percent of the payment. This is true even if there was a reasonable excuse for the delay and even if the claims administrator sends a letter explaining the delay. (Note, however, that this penalty is not required if you did not file a claim form for your injury.) You could be awarded a total of 25 percent of each late payment, up to $10,000, if there was no reasonable excuse for the delay.

#################################

GRAVY TRAIN WRECK

EDD PICKED UP THE COSTS FOR TEMPORARY DISABILITY BENEFITS FOR THIS INJURE WORKER BECAUSE CNA REFUSED TO PAY TTD, ALTHOUGH AGREED UPON IN A COURT HEARING.  THE ADJUSTER INDICATED THAT THEY DO IT ALL THE TIME.  REALLLY??  THE INFORMATION AND ASSISTANCE OFFICER COULD ONLY SAY, ‘Look, the order says they would resume paying “if necessary” so apparently your Dr. Ponton didn’t think it was necessary.”  Really, he continued to call me temporarily totally disabled in every reported, omitted and not, to the Carrier and to WCAB and to EDD, so what part of that could be misunderstood as being “not necessary”????!!!

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For the records, EDD paid over an intermittent period, ending in mid 2014 for final reconciliation, after numerous appeals, a total of approximately $49,400 ….negotiated a discount of Injured Workers Benefits or Your Tax Dollars, providing the WorkComp carrier what appears to be an award for approximately $18,000 for REFUSING TO PAY TEMPORARY TOTAL DISABILITY PAYMENTS IN ACCORDANCE WITH LABOR CODE, AND FOR CAUSING PERMANENT TOTAL DISABILITIES BY FAILING TO PROVIDE MEDICALLY NECESSARY TREATMENTS WHILE RACKING UP WHAT APPEARS TO BE A DRAMATIC MONEY LAUNDERING EFFORT WITH MORE THAN APPROXIMATELY 40 FACE TO FACE MEDICAL EVALUATIONS.

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NUMEROUS CorVel medical evaluations with supportive chicanery continuing the pattern of egregious harm with callous disregard for life and  WITH TOTAL DISREGARD FOR RECOMMENDATIONS FOR TREATMENT.

 

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psychopath advisory
DEFENSE AGAINST THE PSYCHOPATH – STUDY AND SHARE – https://www.youtube.com/watch?v=Gd6P1Ue2aGg

This is the American Workers Compensation System?  Everybody knows.  What’s wrong you people putting up with these most vile practices that are mere profiteering by the maiming and experiments and exterminations of your fellow Americans? Is it really worth your soul to sell out humanity?

 

psychopaths in power know  do you

Well, we know that psychopaths have no remorse, compassion or soul—-is that what we have here, WorkComp is operated by a SWATH OF PSYCHOPATHS?   SOS, MY FELLOW AMERICANS!  SOS!

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“If not you, then who? If not now, then when?”  YOU COULD BE NEXT!

#InjuredWorkersUniting  #SilentNoMore

flag distress signal

WE ARE THE MEDIA NOW –> BE GEEKY!

to be continued

1 of 3 WorkComp MAGIC Money Math or FOLLOW THE MONEY on the WorkComp Gravy Train

Date of Injury:  1/9/2012  — Brain Injury Survivor still on the rest and wait and wait and wait for benefits and medical care program.  WorkComp Carrier has successfully shifted risks and burdens to the State and SSA,  IS THERE A FORENSIC ACCOUNTANT READING THIS? OR DO YOU KNOW ONE TO SEND IT TO?

GRAVY TRAIN FAT CATS

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‘C N A  Reimbursed $31,400 to EDD on 4/29/14  for paying IW $49,422 from 2012-2013 because C N A refused to despite Court demands and Injured Worker Objections”  

WC WorkCompFraud and Money

” Not counting the extreme hardships caused by months of non-payments by anybody, the total TTD benefits that were due between 1/9/12 and 1/9/15 seem to be around about $117,510.64    Injured Worker was actually paid 49,393.52 from CNA and $49,422, for a total of $98,815.52 for the 3 years (approximately $33K, that came in sporadic payments, causing extreme stress and hardship).  

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This appears to be a shortage of $18,695.12 (yikes, how close is that to the reward CNA received from EDD for refusing to pay TTD and for refusing to provide medical care?  Is that a mere coincidence?   These numbers alll jumble all over my brain.  

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Social Security Disability was awarded in May 2015, with retroactive pay back to date of injury, 1/9/12, with the 6 month waiting period to 7/2012.  This is where it gets real real fuzzy…. that will be documented, with PDFs of all of this in 3 of 3 – WorkComp MAGIC Money Math…  This seems to happen all the time…..nobody seems to know how the sad tales end.  

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You’ll know how this one ends, count on it!  Maybe you will even read about it in a ProPublica Report!  ;D “

questions and answers complicated and simple

How many unclean hands do how many such ‘negotiated discounts’ pass through for the ultimate profit and bottom line of insurance carriers across America doing nothing but maiming and permanently disabling injured workers, cheating remaining legitimate WorkComp providers out of their fees, while supporting operations of sonderkommando type doctors willing to write fraudulent reports on behalf of their benefactors?

BRAIN INJURY ADVOCACY GROUP

There is no mechanism in America’s workers comp system for Injured Workers to report Doctor, Attorney, Provider and Employer Fraud.  DA only goes after groups like “Hell’s Angels” …..for what, cutting into the WorkCompster Drug Trafficking?

FUKITOL

D’oh!  At least the HAs are honest about their motives and practices of PROFITS BEFORE LIVES.   Very few peeps in WorkComp can claim such honesty.

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Why would a doctor prescribe a stomach drug for a brain injury survivor and why would a doctor prescribe an expensive creme for brain injury survivor, or why would a doctor prescribe (and mail without knowledge) a hand held ultra-sound device, without instructions for which brain lobe to use it on?  That’s WorkersCompensation.

My Fellow Americans.  Boomers!  Heads up!  The younger people do not have a chance in hell to survive American’s WorkComp rackets!   Mamas!  Don’t let your babies be doctors and lawyers and thugs!  #SOS!  #CommitteesOfBloggers needed ASAP!  #WATMN

wc doc can you see the problem

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Why would a doctor prescribe an ‘epilepsy medication with mood elevators as a precaution for a few years’ for a slip and fall head injury, after a 5 minute meet and greet?

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The more conservative, well-paid industry leased/owned WorkCompsters will prescribe ‘over the counter analgesics’ for brain injury, and some that, in the 60’s would have been categorized as “MCPs,” shrug and indicate that a woman over the age of 35 is not entitled to medical care for a brain injury, particularly after medical has been denied by the carrier for more than 2 years.

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WHAT A #GrandBargain WorkComp is, huh?

go save yourself from the zombies

WE ARE THE MEDIA NOW —> BE GEEKY!

WHITE ROSES AND LINKED IN 5 16 2015

to be continued