Where’s the Money? CNA was awarded nearly $20k FOR REFUSING TO PAY TTD IN 2012 AND 2013 AND NOW….

[Last edited on October 3, 2014 at 10:34 am]

August 24, 2015 – CNA, with the help of Grancell’s law team chicanery, has successfully shifted cost burdens to the State of California, Social Security Administration, and Medicare?  Wyndham paid how much for that useless WorkersCompensation policy?  Appears to be more like a money-laundering racket.

In May 2015, after multiple appeals, Social Security Disability was awarded, and Medicare established.   SSA calculations are apparently like a rat maze based on false and incorrect information repeatedly provided by CNA, along with the Courts “negotiating” rewards to CNA for breaking the law and refusal to pay TTD, even when a Judge told them too.   A more indepth blog will be forthcoming….. this will give you a clue of how they set the ‘SHELL GAME’ for your taxpayer dollars up…

Other paperwork falsely alleges CNA paid me and still pays me approximately $4,000/month.  Holy Moly!  Call the District Attorney.  Sounds like grand theft because such funds don’t make it to my bank account.  I wonder where they go?  Actually, I wonder if the State Controller has a clue on the money that EDD and SSA seem to ‘kick back’ to big companies like CNA aka AMERICAN CASUALTY

 

FOLLOW THE MONEY….  Vote the Poll, “Dodge the Rads — It’s Dangerous Out There”

[Last edited on October 3, 2014 at 10:34 am]

—–Original Message—–
From: Linda Ayres <lindaayres@aol.com>
To: sreubens <sreubens@grancell-law.com>
Cc: wynlinda <wynlinda@gmail.com>; lindaayres <lindaayres@aol.com>; ReoLinda <reolinda@aol.com>
Sent: Fri, Oct 3, 2014 10:25 am
Subject: Fwd: Linda Ayres — CNA 3269102 TTD Termination of Benefits, Authorization for Medically Necessary Treatments, and Reimbursements, QMEs and “Practice Effect” violations

Hi Stewart, Courtesy Copy to you and others.  Have a nice day.

—–Original Message—–
From: Linda Ayres <reolinda@aol.com>
To: fred.sachs <fred.sachs@cna.com>
Cc: SReubens <SReubens@grancell-law.com>; mary.falvey <mary.falvey@wyn.com>; hchalgujia <hchalgujia@aol.com>; tina.jordan <tina.jordan@wyn.com>; melisa.paramo <melisa.paramo@wyn.com>; lindaayres <lindaayres@aol.com>; wynlinda <wynlinda@gmail.com>; reolinda <reolinda@aol.com>; jack.dolan <jack.dolan@latimes.com>; Alyson.Johnson <Alyson.Johnson@wyn.com>; Christine.Dasilva <Christine.Dasilva@wyn.com>; Margo.Happer <Margo.Happer@wyn.com>; merav.benedetti <merav.benedetti@wyn.com>; steven.alessandrini <steven.alessandrini@rci.com>; lori.ford <lori.ford@wyn.com>; info <info@naidw.org>
Sent: Fri, Oct 3, 2014 9:52 am
Subject: Linda Ayres — CNA 3269102 TTD Termination of Benefits, Authorization for Medically Necessary Treatments, and Reimbursements, QMEs and “Practice Effect” violations

Dear Fred:

Thank you for your email of September 23, 2014 with your thoughts on monies paid and terminated TTD.  Matrix advised that they did contact you, but have not yet received a response to their request for a copy of the actual termination notice.  Can you help now?  I have bills due NOW.   TOP PRIORITY…..CASH FLOW issues since you have sent any money since July 2014, and you believe there is none due because of the deep discount provided to CNA by the State of California, relinquishing my rights and benefits.

Prioritized points below, 1-7.  Thanks.  Stress messes with my brain and too many things are coming at me right now.  Sorry for the length of this.  I also remembered I migh be able to do the housekeeping thing… I have supervised Estate housekeeping staff.  More on that below.

Stewart is being mean again, says he is not going to email me anymore, just snail mail.  That’s another ADA violation, but he doesn’t care.  I have had to keep switching email accounts because Grancell blocked me on this account, so I’ll send him a copy in a bit….not jumping through any more hoops for him.  He is tooo mean and he scares me.

Let’s not again burden the State because Wyndham doesn’t like to help injured workers return to work, and wants them kicked to the curb and or dumped into the SSDI and welfare roles.  One friend said if Tina wants me to be a Housekeeper as the only way to return to work, then the panel QME with Dr. Holmes will be imperative.  Even he might have to call for “light duty” for Orthopedic reasons.  Social Security also does not think brain rehabilitation or brain injury is an imediment to selling timeshare.  Hard to figure.  Here’s more on what a doctor told me in January 2012 regarding possiblities of return to work, if’s and thens:

Wyndham‬ Worldwide, Is there a WIDGET ASSEMBLY department??!  http://t.co/HWRyyRPis0  https://askaboutworkerscompgravytrains.com/2013/07/03/wyndham-worldwide-is-there-a-widget-assembly-department/

One of the big take-aways from SCRIPPS was further clarification on how messed up my brain is, and how desperately I need more Speech and Occupational and Vision Therapy to be able to rejoin the work foce.  Let’s work together to get me to Coastline….. It seems the cheapest way for you to go…unless you like paying Grancell to torture and terrorism disabled workers, then, I surrender.

Here is a link to some blogs with facts on my case, including denied medical care, failure to reimburse medical miles, and the whole ugly mess.   If Steward refuses to send you the file, this may be a quick update, it’s accessible on mobile phones too.  https://askaboutworkerscompgravytrains.com/list-of-posts-ask-about-workers-comp-gravy-trains/

Hello Linda,

 

I’ve received your request and forwarded to our recalculation department for review.  Please note that we would need an actual award notice / termination notice from your workers’ compensation carrier indicating you are no longer receiving the $649.41 / wk.  As it stands it appears that you continue to receive the $649.41 / wk (2,814.11 per month) and that offset would still apply.  Once the overpayment is recovered, you would only be entitled to the $100 per month minimum benefit unless a termination of benefit notice is received on the workers’ compensation carriers’ letterhead.  – Matrix

  1.   Please send me and Matrix a copy of the TTD Termination of Benefits document today, please and thank you.

As you can see by the email from Steven Acevedo below, I’m not the only one confused by the complications caused by the CNA refusal to pay TTD the first year, and by the severe discount of my benefits negotiated with the State of California, to my loss of $20,000, and putting me in the position again to rely on public charities and State Funds, that were given to CNA rather than to this injured worker.

Before I get busy with emails on this matter today, will you kindly forward a copy to me today of the actual “termination notice” indicating that you are no longer paying me, effective when and why.  As you can see, it appears to even Matrix that yep, you’re still supposed to be and are paying me, so therefore, they are unable to reinstate my LTD benefits.

The people at Matrix and Reliance are always very helpful and responsive.   I appreciate your efforts to communicate with me, and I understand that Stewart Reubens has decided to ignore more ADA requests for electronic communications and will just mail things to me when he feels like it.  Whatever.  It’s noted.

The entire thread is again attached.

  1.   Please request from Stewart Reubens a copy of the summary of unreimbursed medical miles and expenses dating back to January 2012, submitted repeatedly, on paper and electronically.
  1.   Appeal to Scripps obfuscated by again failure to provide evaluating doctor with medical records as submitted on appeal, when it was obvious the first request was submitted with numerous omitted medical records.
  1.   Dr. Hilda Chalgujian agrees with pursuit of continued treatment at SCRIPPS and or at Coastline Cognitive Rehab, which starts October 20, 2014, if I am accepted to the program.   More evaluations required.   Her RFA is anticipated shortly.   COASTLINE MAY BE THE WAY TO GO.  DOESN’T LOOK LIKE WE CAN SETTLE UP AND I WILL NOT BE COMFORTABLE WITH ALLOWING MORE HARM TO COME TO ME BECAUSE STEWART DOES LIKE ME OR BECAUSE HE HAS HIS EGO INVOLVED IN HARMING A DISABLED WOMAN.
  1.   Stewart doesn’t want you to authorize any medical treatment, but he wants further evaluations at:
  1. a) Orthopedic Surgeon – Dr. Holmes  –  PLEASE ENSURE I HAVE A COPY OF MEDICAL INDEX AND HARD COPY OF RECORDS SENT BEYOND WHAT I ALREADY PROVIDED; PLEASE CONFIRM THAT DR. HOLMES HAS RETAINED ALL THE RECORDS PREVIOUSLY PROVIDED.  As it is a pattern of practice for Grancell to send me to appointments without providing the doctors with complete medical evidence, I will be unable to attend the QME unless I have received proper notice of the records submitted, and copies thereof.  Otherwise, I am happy to comply with helping another doctor make holiday money with another evaluation.

 

  1. b) PLEASE ASK STEWART TO ENSURE I RECEIVE A MILES CHECK FOR THE QME, AS THE ONE SENT PREVIOUSLY WAS EXHAUSTED AS I APPEARED FOR THE APPOINTMENT AS ORDERED BY THE COURT, AND IT HAD BEEN CANCELLED AND NOT REINSTATED.  I have full documentation, so Stewart needs to send another check, to my post office, PO BOX 835 YUCCA VALLEY CA 92286
  1.   Stewart does not want you to authorize any brain injury treatment, following the footsteps of Kim Mall of Grancell-Corona, 24 days at SCRIPPS when 3-6 months were requested is hardly compliance with the responsibility of my employer and it’s agents to provide medically necessary treatment. Yet, Stewart wants another neuro-psych evaluation….. to add to the facts provided in 2012 by Dr. Eileen Kang and Dr. Marcel Ponton, and reiterated by Dr. Hilda Chalgujian.   Their requests for medical treatment were all ignored, so, here I am.    Coastline may be the way to go.
  1. a) Please ensure that any such neuro-psych eval complies with the law and any such evaluator currently treats TBI in his/her practice.  Please know that Matrix is sending me yet another neuro-psych for eval for my long term disability later in month, and practice effect in such exams is common knowledge within that realm of experts.  Please ensure CNA is in compliance whatever laws may pertain to repeated testing in hopes of getting better results and being able to further deny medical treatment.  I get the question about “What season is it?” right this time of year, and I am doing better at listing the presidents, and identifying what day, month, year it is, and what City and County I am in.  I still have challenges with counting from 100 backwards by 7s, and spelling world backwards is hit and miss.

Wow, to think some work comp comp doctors are paid several thousand dollars to adminster those tests, or to supervise a non-licensed person to do so…. Wow, that’s America, huh?

  1.  Steward said he was going to contact Dr. Hilda and Dr. Bergey directly regarding ‘MEDICAL LIMITATIONS’… May I also suggest you re-review the records and statement of Dr. Marcel Ponton, psychologist and QME, and Pasadena treating doctors from April 2012 to December-ish 2012…. It’s in the blog, but here’s a quote, and since none of the recommended treatments happened, there’s little reason to believe anything has changed much on the limitations, huh?

RECORDS REVIEW:

Report to Employer:

Disability or Medical Limitations:  (Physician must review employee’s job description and describe disability and/or restrictions from performing this job). 

HAS PROBLEMS WITH ATTENTION AND CONCENTRATION WHICH WILL IMPACT ABILITY TO EFFECTIVELY PROCESS COMPLEX CLIENT INFORMATION AND OTHER DATA.  Additionally, injured worker has a reactive depression to the conditions and neurobehaviorial symptoms.    Medications Taken and Side Effects:  N/A

Mitigating Measures or Assistance Devices Utilized and Degree of Effectiveness in Reducing Functional Limitation and Effect of Medical Condition on Major Life Activities, Description of Impact and Duration:

Injured worker needs ongoing psychotherpay and cognitive remediation.  Ongoing Rx for neurobehaviorial symptoms as per Physiatrist. Patient has problems with money management at this time, however, is independent with all other ADL’s…..  [Physiatrist recommended treatments and further evaluations were never authorized after initial consult.  Initial consult did result in non-revocation of driver’s license after unfounded report by neurologist with a specialty in epilepsy and fibromyalgia (neither of which IW suffers from), not TBI, saga for another blog]

State Whether Employee Can Perform the Tasks in the Job Description in light of Medical Condition and identify any applicable restrictions and duration:

#Responsibility – will have difficulties with training and development and remembering information to convey to others…

Knowledge and Skills – patient will have problems tracking with company policies and procedures.  Patient may also have problems with organization.

Identify Any Accommodations that Would Enable the Employee to Perform the Tasks that the Employee’s Medical Conditions Precludes from Performing 

Modified duty – performing rote and repetitive tasks that do not require major decision making or constant interaction with the public.

See more:

As to the $27,000+, Stewart again reiterated that nothing I say will encourage him to look at the documents I provided in summary to the multiple requests for medical expenses as far back as 2012, medical miles to PTP, co-pay for the EAP directed doctor, treatment requested by physicians and utterly ignored by Grancell attorney Kim Mall which I then self-procured, and she interrupted with threats to the doctors.  Is there no law against bullying injured workers??     When I look for the TTD TERMINATION,  I will look for the summary again, and send it to you.  The Audit Unit has copies, and while Stewart likes to say it’s all about ‘self-procured medical care for disputed body parts’…. the evidence, had he been willing and able to read it, will clearly show that’s not the case.  For a fast fact check, see when the last time you paid me for medical miles to Dr. Darren Bergey and Dr. Hilda Chalgujian.   Start there, and you’ll see a pattern.

You also mentioned that if SCRIPPS was not authorized for further treatment (which is was not, and again, they refused to review all the medical records I provided, and did not even have the SCRIPPS discharge records… omission of medical records with intent to deny medical care, or just another oooops??)  Anyway…you mentioned, local providers you would recommend are at Eisenhower, Loma Linda or Casa Colina, for speech therapy for high level executive functions, vision, occupational and vocational therapies, but you did not provide the names of any such providers.  Further, clearly you are unfamiliar with my file, or you would see that I have treated at Casa Colina, their Medical Director, Dave Patterson, organized by Daniel Elliott and Attorney Michael Durich (#2) sent me there for an evaluation and to debunk the request by Dr. Waldman to revoke my driver’s license in April 2012. I went to that appointment expecting a complete evaluation for their Brain Rehabilitation Program, and I got a 15 minute evaluation and Dr. Patterson filled out the DMV papers and said I was cleared to drive.  He also referred me to Dr. Eric Ikeda, their Neuro-Optomestrist.  I never saw a report on that meeting, I never was sent to Dr. Ikeda by PTP Marcel Ponton, QME, and in fact, only saw Ponton’s side-kick, Dr. Chung, for 4 session of psychotherpay  (those may be some of the unreimbursed medical miles, too from 2012, we’ll have to look, it was a 2+ hour drive.)   When I requested medical records, I saw there is a notice that I saw Dr. Patterson of Casa Colina in October 2012, which is false. It is a fake part of the medical records index of Ms. Mall.   I did, however, self-procured medical evaluation and treatment with Dr. Patterson in April 2013, but alas, he lost my file, never wrote a report, and refused to see me again.  However, he did refer me to Dr. Ikeda, wherein I received a prescription for the first treating theraputic lenses, and some Vision Therapy, that Ms. Mall also interrupted.   Experts that I have spoken to find it very curious that there is a false notice of a patient meeting with Dr. Patterson, his abrupt loss of my files, failure to provide the promised, and oh yeah, he had recommended me for 3 months at their Brain Injury Rehab place in 2013, and they take work comp.   WHAT DO YOU THINK ABOUT THAT??

I will look for and try to finish the schedule of physician request but attorney denied medical treatments since 2012.  While Stewart thinks it’s not his job to help me get medical care, and he insists that he and his firm have nothing to do with whether or not I get medically necessary treatments for accepted body parts, including my brain, that just makes me wonder if he is suffering from a brain injury, too, or if it’s genetic.

Anyway, oh oh….. Do you read WorkComp Centeral blog?   Guess who they wrote about recently?  Yep!  Let me know if you want the link….. it’s the one about Work Comp and Baseball…..  ahhh, 30 seconds and fame on social media…..  I hope that guy, Jack from the LA Times calls you and Stewart for some of his investigative reporting…

He looks like he is unfraid of deep digging….goodness, he even suggested that some LA Police and Firefighters fake work comp injuries.  I had to comment that as a Citizen, I suspect they are made to wait and wait and wait for medical care just like the rest of us, while the profits are squeezed as the life is squeezed out of us.

Ok, that’s it for me for now.  I think the summarized points brings us up to date.  Still on my action list for you is:

  1. Send you the summarized spreadsheets for the way past due $27,000+
  2. Keep working on the PROPOSAL FOR SETTLEMENT (dropped to the bottom of the pile with Stewart’s continued bad faith and breach of fiduciary responsiblites)
  3. Keep trying to make any ally out of you, since your Fraud guys told me that’s the way to go.  But golly, I’m insured by you guys, why do I have to try to make an ally out of you. I’m not the enemy.  Grancell is.

Sincerely,

Linda Ayres, IN PRO PER

760 368 5243

PO Box 835

Yucca Valley CA 92286

wynlinda@gmail.com

reolinda@aol.com

cc:  Mary Falvey, Wyndham Worldwide Human Resources Executive VP

Tina Jordan,  Wyndham Worldwide Human Resources – Regional Director

Melisa.Paramo Wyndham Worldwide – Manager, Indio, Palm Springs and Big Bear

Wyndham Leave Support

PS Note to Wyndham:  PLEASE ADVISE THE DATE OF THE INDIO SALES EXECUTIVE TRAINING IN NOVEMBER.  The accommodation request form was      submitted by me, and delivered to Dr. Chalgujian and Dr. Bergey, anticipating further discussion and commencement of the Interactive Process, thank you.

cc:  Jack Dolan….  PS  You and your article were mentioned in the Ask About Workers Comp Gravy Trains blog: https://askaboutworkerscompgravytrains.com/2014/10/01/hello-america-can-we-talk-tbi-workcomp-wyndham-cna-grancell-edd-ca-dol-usa-etc-and-complete-systems-fail/   😀  You’re welcome.   BTW, Do you know Larry Kosmont?  I used to work for him.  He’ll probably say nice things about me, and how smart I was and how I was a great “right hand” to him and his.   Peter and Stephen Lowy might remember me, but I did, at the end of my assignment as Executive Assistant to the Chairman of the Board, I help his Dad and Mum run their households in Beverly Hills and NYC, and I coordinated logistics when they flew in on their 747 or were off in the Mediterranean on their yacht.  It was at the time they were buying up shopping centers in the USA.

cc:  Wyndham Worldwide Media Contacts     –  http://www.wyndhamworldwide.com/news-media/media-contacts

Alyson.Johnson@wyn.com, Christine.Dasilva@wyn.com, Margo.Happer@wyn.com, merav.benedetti@wyn.com, steven.alessandrini@rci.com, lori.ford@wyn.com,

cc:  John Araby  – National Association of Injured and Disabled Workers

 

 

—–Original Message—–
From: Steven Acevedo <Steven.Acevedo@matrixcos.com>
To: Linda Ayres <reolinda@aol.com>
Cc: RSLI-Stephen Buch <Stephen.Buch@rsli.com>
Sent: Fri, Oct 3, 2014 7:57 am
Subject: RE: Linda Ayres REINSTATEMENT OF LTD Status of Money?? Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N

Hello Linda,

 

I’ve received your request and forwarded to our recalculation department for review.  Please note that we would need an actual award notice / termination notice from your workers’ compensation carrier indicating you are no longer receiving the $649.41 / wk.  As it stands it appears that you continue to receive the $649.41 / wk (2,814.11 per month) and that offset would still apply.  Once the overpayment is recovered, you would only be entitled to the $100 per month minimum benefit unless a termination of benefit notice is received on the workers’ compensation carriers’ letterhead.

 

 

Steven Acevedo

Integrated Claims Examiner

 

 

Phone: 877-315-9838 ext. 40235

Fax:      914-784-0025

Email:  Steven.Acevedo@matrixcos.com

Web:    www.matrixcos.com

 

NOTICE:  CONFIDENTIALITY AND PROPRIETARY INFORMATION NOTICE: This email, including  attachments, is covered by the Electronic Communications Privacy Act (18 U.S.C. 2510-2521) and contains confidential information belonging to the sender which may be legally privileged.  The information is intended only for the use of the individual or entity to which it is addressed. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance of the contents of this information is strictly prohibited.  If you have received this electronic transmission in error, please immediately notify the sender by return e-mail and delete this message from your computer or arrange for the return of any transmitted information.

From: Linda Ayres [mailto:reolinda@aol.com]
Sent: Friday, October 03, 2014 10:06 AM
To: Steven Acevedo
Cc: RSLI-Stephen Buch; REOLINDA@AOL.COM
Subject: Fwd: Linda Ayres REINSTATEMENT OF LTD Status of Money?? Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N

 

Hi Steve and Steve….

 

Any chance you can update me on the status of the reinstatement of my LTD $1800/month today. Panic is not a good mode for my brain functions.

 

FROM CNA/FRED SACHS:  9/23/14:    Linda,   Per your request below are the periods we have paid temporary disability.  In response to your question regarding reserves, we do not discuss the reserves placed on a file with the injured worker or their legal representation if represented.   1-9-2012 to 4-15-2012 temporary disability at rate of $652.15 per week 2-15-2013 to 5-8-2014 temporary disability at rate of $649.41 per week   Reimbursed EDD for period of 1-28-2012 to 3-4-2013 for a total of $31,400    Fred Sachs, CRIS MCU WC Claim Specialist 714-674-5886 FAX: 714-256-7630

 

 

Till then, I have bills due now.

 

Thanks much.  I need to know so I can plan.  (I’m looking for Steve A’s phone number and will follow up with phone call when I find it.  Plllllllease advise. Thanks.

 

Sincerely,

Linda Ayres, IN Pro Per

760 368 5243

REOLINDA@AOL.COM

 

 

—–Original Message—–
From: Linda Ayres <reolinda@aol.com>
To: steven.acevedo <steven.acevedo@matrixcos.com>
Cc: Stephen.Buch <Stephen.Buch@rsli.com>; reolinda <reolinda@aol.com>; wynlinda <wynlinda@gmail.com>; lindaayres <lindaayres@aol.com>
Sent: Tue, Sep 30, 2014 7:22 am
Subject: Linda Ayres REINSTATEMENT OF LTD Status of Money?? Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N

Hi Steve and Steve…

 

Do we have any word on the status of my $1800 a month, based on the info below?  Bills are do again and I’ve been “holding on” with a hard-core “extend and pretend” strategy since July.  I am reaching the panic point again, or went over the edge upon early termination of SCRIPPS care.

 

 

Could you kindly let me know when my LTD benefits will resume, and if there is any retroactive money coming to me, and when.  If it’s NOT cominig, or there’s an issue, please just let me know.  I will be in touch with Advocator to get additional records to them.  If they do their job and help me get Social Security approval, I can rest a bit and get treatment subsidized by the State or the Military, whoever is behind the program I just found.  Link below.

 

 

 

Bills are due tomorrow.  If I know funds are  coming, I can enroll in the Coastline Brain Injury program that starts October 20, 2014 (for 1-2 years) and could live frugally and get cognitive rehabilitation if I can count on that $1,800, and they I will fight like hell with CNA after sufficient rehabilitation, in a year or two.   They apparently have no intentions of reimbursing my $27K spent for medical care they refused to provide, and they figure the State of California negotiated away my rights and gave them a fat $20K profit, so too bad how sad for me…. Call the Department of Insurance and register another complaint.   D’oh.

 

I need to know what the status of my money is,amounts and when.

 

I see Dr. Hilda this morning, it would be great if I had a clue about the Matrix/Reliance before my 10:30 appointment with her.  She knows I am seeing one of your doctors October 27 for further evaluations. It’s marked on my calendar.

 

 

Also, I need to know because I am trying to get accepted into a one-to-two year brain injury treatment program, with or without CNA.  There’s no reason for me to believe they will do right now, as they have done such wrong all along, and they interrupted the SCRIPPS Brain Rehabilitation Program.  It’s on appeal, and word is expected by the end of the week, on an expedited basis.

 

(I got a call “from Chicago”   :/   that suggested I had mis-directed my recent complaints of FRAUD, and suggesting that I make nice with the adjuster and be a little more patient….   0.0

 

So I tried it again….with a short sweet polite plea for help to get into the Coastline Community College Acquired Brain Injury Program, a 1-2 year plan, that starts October 20, 2014, and would require that I relocate, or at least having lodging for 5 days a week till I get relocated. Fred said he couldn’t authorize it, but he can submit it if one of my doctors requests it…. My goal is to have two of my doctor request it, and at Coastline, they encouraged me to get “as much of SCRIPPS that I can” before coming to them.

 

Here’s the link: http://www.coastline.edu/students/students-with-disabilities/acquired-brain-injury/

 

 

Thanks Steve and Steve…….

Linda Ayres
reolinda@aol.com

 

—–Original Message—–
From: Linda Ayres <reolinda@aol.com>
To: Stephen Buch <Stephen.Buch@rsli.com>
Cc: steven.acevedo <steven.acevedo@matrixcos.com>
Sent: Tue, Sep 23, 2014 1:07 pm
Subject: Re: Fw: Linda Ayres vs. Wyndham Worldwide et al Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N

Thanks Steve and Steve!!!!

Please let me know bottom line Asap.

I am working on not only Return to Work (against doctor opinions) but only a Proposal for Settlement.

Failing that, it will be full on fighting…

Wish me luck!!!!!

Worst case scenario seems to be I try to return to work and fail, and keeep moving forward. I assured them I am NOT going to Foodbanks so they can collect big checks over my injured body.

I hope its nearly over.

Many thanks to you both for all kindness nd patience.

Cheers,
Linda Ayres, In Pro Per

All nuclear reactors leak all of the time.
“Start with the Science.”

We are the Media Now.

From: “Stephen Buch” <Stephen.Buch@rsli.com>

Date: Tue, 23 Sep 2014 15:34:47 -0400

To: <reolinda@aol.com>

Cc: <steven.acevedo@matrixcos.com>

Subject: Re: Fw: Linda Ayres vs. Wyndham Worldwide et al Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N

 

Hi Linda,

 

Steven Acevedo would be the examiner handling this. I’ll forward this email as well as the other to him.

Kind Regards,

 

Steve Buch

WOP/AO Claims Examiner

2001 Market Street
Suite 1500
Philadelphia, PA 19103-7090

Work: (800) 351-7500 ext. 3908

Fax: (267) 256-3535

>>> “Linda Ayres” <reolinda@aol.com> 9/23/2014 3:18 PM >>>
Hi Steve,

Based on CNA statement of what they paid, can you now reinstate my LTD benefits and if so, how sooon??

Please let me know as soon as you can.

I may get to do a trial Return to Work soon…and I need to do the math.

Thanks a bunch.

Linda Ayres, In Pro Per

PS Just had a pretty good meeting with Wyndham HOUR regional Manager and Director.

——Original Message——
From: Sachs,Fred
To: Linda Ayres
Cc: Stewart Reubens
Cc: Stephen Buch
Cc: Sachs,Fred
Subject: RE: Linda Ayres vs. Wyndham Worldwide et al Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N
Sent: Sep 23, 2014 11:11 AM

Linda,   Per your request below are the periods we have paid temporary disability.  In response to your question regarding reserves, we do not discuss the reserves placed on a file with the injured worker or their legal representation if represented.   1-9-2012 to 4-15-2012 temporary disability at rate of $652.15 per week 2-15-2013 to 5-8-2014 temporary disability at rate of $649.41 per week   Reimbursed EDD for period of 1-28-2012 to 3-4-2013 for a total of $31,400    Fred Sachs, CRIS MCU WC Claim Specialist 714-674-5886 FAX: 714-256-7630
From: Linda Ayres [mailto:reolinda@aol.com] Sent: Thursday, September 18, 2014 2:32 PM

To: Sachs,Fred Cc: Tina R Jordan; Stewart Reubens; Stephen Buch; Linda Ayres; Linda Ayres; MBX – WVO Center Subject: Fw: Linda Ayres vs. Wyndham Worldwide et al Policy LTD 121329 Claim 2012 11 13 0149 LTD 01 N

Hi Fred, Below is an e-thread with LTD provider regarding income. They need to know if you will be resuming TTD retroactive or the actual dates paid and stopped. I will let Steve Buch know thaat Scripps was terminated but not completed, and is on apppeal and that discharge records are anticipated next week. By the way, what is the reserve on my claim? I don’t have the marbles to sort out the TTD money stuff on top of all else. I am in full survival mode and will be working on that “Proposal for ReSolution” for you and Stewart plus accommodations and interactive process. As you check on the TTD money and calculations, this reference to the letter from Daniel Elliott may shed some light. “And I found a letter from CNA dated 4/21/2014 indicating “Payment for temporary disability is resuming and sent separately for the period starting 02/14/2014 through 4/24/2014 and will continue until you are able to return to work or your medical condition becomes permanent and stationary.  Your weekly compensation rate is $649.41 based on your earnings of $1 per week…..”    (His calculations are aopparently purposely off and were off-set by EDD for the period they did pay.  )….” If you could put

All nuclear reactors leak all of the time.
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Open Letter to CAAA Members — Why you cause such harm to Injured Workers? You no make enough money?

Years ago I asked an ol’ Sicilian Godfather type character, “Will you tell me, please, what is the secret to making lots of money?”  He said, “I will tell you.  It is very simple.  You find a need, then you fill it.”

What I have discovered about the majority of the members of the California Applicant Attorney’s Association membership is that they are generally burnt out, angry, disgruntled, overworked, screwed out of a decent wage by the chicanery of the Defense firms, and the end result is more casualties in the American Work Force. I’ve talked with plenty of you, from here to Northern California.  Most of you have been polite and cordial, but compassion is a rare quality in your ilk, isn’t it?

lawyers den (2)
https://askaboutworkerscompgravytrains.com/2015/01/01/disappointment-and-frustration-with-the-work-comp-system/
In my case, people say, ‘Oh.  She had 4 attorneys.  She must be hard to work with.’  BLAME THE VICTIM, THAT’S HOW YOU SLEEP AT NIGHT?

Because the majority of CAAA attorneys seem impotent in the Art of Negotiation, and seem to feel condemned to working for what probably figures out to be about $10.00 an hour?   The end result is badly managed work comp cases, workers that don’t get medical care, and as one of the four retained and dismissed in my case advised:

“Most of my clients don’t get medical care, they lose their jobs and their homes; it’s just how it is.”  

That one attempted to coerce me to accept a premature settlement offer for a 1/9/12 brain injury for the ol’ $100,000, less legal fees, in November 2012, without benefit of having seen the specialist doctors recommended repeatedly, and denied not by UR but by the adjuster and the defense counsel.

.

He advised that, “Nobody will believe you have a brain injury. Work comp is a small community….”   I told him I was injured not stupid and that if nobody would believe it  was only because he didn’t do his job and get me to brain injury doctors, as repeatedly recommended by all the evaluating doctors I had been sent to.  How much money did the approximately 40 evaluating doctors plus CorVel & Maximus peeps make off my life so far?  How much do the defense attorneys make by continuously harming me?  And how about those adjusters and their fraud department that backs them up?

wpid-fb_img_1425358698984.jpg

I’ve spent close to $50,000 on medical expenses trying to Survive WorkComp, and to clean up the legal messes CREATED BY YOUR MEMBERS, and have lost professional credentials and earning capacity, and I haven’t worked since 1/9/12.  Just because I can type doesn’t mean my brain injury healed on the rest and wait and wait and wait and wait CNA plan.

Stephen Hawking

If CAAA members learned a bit about negotiations, they might find it reasonable to find alternatives to scavenger, bottom feeder type holds with liens when prior counsel has done nothing but harm the injured worker by doing a poor job, or no job at all.

One  attorney’s I retained, when I advised his office they were being retained because the defense has a nasty pattern and practice of omitting hundreds of pages of medical records with intent (and success) to deny medical care, I was assured I would not be sent to any evaluations until the matter was resolved.  Was that ever a whopper, committed by non-supervised “case manager’ practicing law without a license, another pattern similar to the QME/AME  doctor reports written not by the doctors, but by the non-medical staff.

y u no see lies so obvious lies

Then, in writing, he battered me and accused me of desperately needing mental health care, and arrogantly stated that “There is no conspiracy to omit medical records in your case.”  He sent me to a very dubious AME eval, without medical records, and I am still paying for his incompetence.  By the way, it took nearly 8 hours in Court to get the Judge to order the Defense to send the omitted records to the two involved doctors (of the time) and to request a supplemental report.  Well, she sent them all right, not separately, not identified, but just in a new disorganized box and suggested the doctor find them and see if they made any difference in the conclusions. Then she did it again with the next QME, in December 2013. That’s 2 attorneys and highlights of their arrogance and incompetence.

The first one hardly counts, as it was not an attorney at all, it was a 60 second meet and greet with the attorney, then turned over to the Office Manager, who chanted, “There is no psych component to a WorkComp case” and promptly (next day) had me scheduled with an Orthopedic Surgeon on El Paseo in Palm Desert — FOR A BRAIN INJURY.   I got lost trying to find the front door, and entered through the employee entrance in the back — nobody but me found that odd.    The last one, rather than read the files I sent, and deal with the mess created by #3, merely agreed to yet another Orthopedic evaluation in late 2013.

Primary treating doctor has been an Orthopedic Surgeon (from 2/2013 through 12/2014 — I have had NO PTP since 12/2014—hardly matters, as there has been little-to-no care, just excessive evaluation upon evaluation, in true WorkComp Gravy Train fashion.

That’s 4 attorneys — #1 for 30 days in 2012, #2 for 9 months in 2012, #3 for 90 days in 2013 and #4 for 45 days in 2013/2014.  When I have asked them to release their liens so that I can find an attorney to help me, they just say no.

The office of #3, in an attempt to console me, said, “Oh, it makes no difference to you that he won’t release the lien  You get the same in any event.  It doesn’t matter if you have 1 or 5 or 10 attorneys, they divide up the 15%.”  I said, but you don’t understand, each of the 4 did more harm to me than the other, and I have a brain injury, and I can’t figure this crap out, there’s no integrity, fraud is NOT prosecuted, and the defense just makes stuff up and the WCAB supports it, and I can’t find competent counsel to represent me.

I’ve been told everything from “there’s no money in it” “previous attorneys didn’t do their job”  “the medical records were not properly developed” “there’s too much fraud—it’s over my head” “you’ve already had 1 attorney”  “you’ve already had 2 attorneys”  “you’ve already had 3 attorneys”  “you’ve already have 4 attorneys”  “nobody will be #5”

learning rx   survey 4 2 2015  1031 am

I asked one Judge to authorize me to pay someone hourly to help me. I can’t even find legal aid or a paralegal to help me. It seems that the WorkComp rackets have everything locked down.  There are even federally funded brain injury advocacy groups THAT REFUSE TO HELP AN AMERICAN WITH BRAIN INJURY IF THE INJURY HAPPENED AT WORK!

I have a brain injury plus it’s work comp.  The Information and Assistance office has clearly given me erroneous information SINCE FIRST MEETING IN 2012, and badgered me, abused me, violated ADA and civil rights,  and made it quite whose side she works for.  In Injured Worker circles, the experience of most I & A Officers is the same, so I don’t take it personally.  But, know that when you tell injured workers to see the I & A officer, you’re condemning them to more harm, and your credibility is further reduced.

THE BRAIN INJURY HANDBOOK

WHAT IS A SOLUTION?

I tell you this because it’s identifying a need, that you can fill, and I can only scream about.  Your industry vendors are even afraid to work with/for an Injured Worker, in Pro Per.  Your industry doctors, playing hot shot, even return properly served medical records and threaten to sue an injured worker for daring to properly send such documents. Your vendors make it clear that they only take directions from “the adjuster” or  “The Defense”.

I even asked at WCAB for a list of possible attorneys in 2013.  I found one who answered his own phone.  Trouble is, he no longer works for injured workers.  He works for The Defense.  I got quiet and asked, “Tell me, why did you go to the Dark Side?”” He got quiet and said, “Because that’s where the money is.”

So, for starters, if you are approached by an injured worker with a brain injury, if you know nothing about brain injury, give them immediately a letter of non-engagement, and a referral if you can.

Then, set up some training sessions for your members for negotiations, and start with studies of Psychopaths…ie. DEFENSE AGAINST THE PSYCHOPATH.  It will help your members understand the Defense, and may reveal similar traits that may cause them to just head over to the Dark Side.

Watch it again, and tell your friends and neighbors.  

Defense Against the#Psychopath (Full length) – 
www.youtube.com/watch?v=Gd6P1Ue2aGg  
Defense Against the Psychopath By Stefan Verstappen Defense Against the Psychopath is a documentary Defense Against the Psychopath (Full length)

Then, in each of your offices, set up an InProPer division, or something similar, with a Paralegal component, and an hourly fee, with a provision to take over the case when attorney liens are withdrawn.

DO SOMETHING TO HELP CLEAN UP THE MESS THAT YOUR INCOMPETENT COLLEAGUES CREATE, AND GET THEIR FANGS OUT OF THE LIENS THAT RESULT TO NOTHING FOR ANYBODY.

OH YEAH, OPEN YOUR FANCY CONFERENCES TO INJURED WORKERS, PARTICULARLY YOUR EXHIBIT HALLS.  IF YOU WON’T REPRESENT US, HELP US FIND THE RESOURCES TO REPRESENT OURSELVES.

Do some client follow up…… you may find gross dissatisfaction with your industry by injured workers and doctors.  You can blame injured workers all day long for your own shortcomings, but…in the end, you know the truth.

I will never forget the attorney who called me back around 8 o’clock one evening, screaming and swearing that he was working so late, and when I explained my case, to the best of my abilities, he called me “one of those work comp pariahs” and that he knew the defense counsel.  He assured me that ‘fraud’ was not a possibility; “incompetence, yes, but she is not capable of fraud”…. (That was his opinion; evidence points in the other direction.)

GIVE IT SOME THOUGHT…… IF YOU CAN’T HELP INJURED WORKERS, EITHER FIND SOME WAYS TO HELP THE IN PRO PER POPULATION, OR BE ASSURED, WE WILL DO ALL WE CAN TO GET YOU OUT OF THE EQUATIONS TOTALLY, and FIND WAYS TO HOLD YOU AND YOURS ACCOUNTABLE FOR THE HARM YOU CAUSE TO THE INJURED WORKER POPULATIONS IN CALIFORNIA, AND YOUR COLLEAGUES IN ALL STATES OF THE UNION.

CAN’T WE ALL JUST GET ALONG?

LIONS  SURROUND YOURSELF    find the others

Look for the In Pro Per OBJECTION TO A FRIVOLOUS ORDER TO COMPEL ……COMING UP THIS WEEK….

WorkCompLinda  Twitter

ASK ABOUT WORKERS COMP GRAVY TRAINS   JAN 1 2015
https://askaboutworkerscompgravytrains.com/2015/01/01/disappointment-and-frustration-with-the-work-comp-system/
WE ARE THE    MEDIA NOW

Can a Judge Compel a 2012 Injured Worker to Participate in Felony WorkComp Fraud Scam?

“… I will support and defend the Constitution of the United States and the Constitution of the State of California against all enemies, foreign and domestic…”

“Domestic enemies”….that seems to include the #WorkCompsters and their #WarOnWorkers, wouldn’t you think?

flag distress signal

 

Dear “Supplemental People” —-

US Constitutional 5th and 14th Amendments immediately come to mind, and the secret police type reports Grancell encourages to protect fraudulent medical reports of their payees seems to violate Article 14 of the California Constitution, for starters.

DO YOU HAVE ANY LEGAL CITATIONS TO SUGGEST TO INCLUDE IN MY RESPONSE TO THE JUDGE’S ORDER TO COMPEL ATTENDANCE AT AN ENT DOCTOR EVALUATION …

[Ear, nose and throat; general vicinity of the brain, but still not a brain doctor, but closer than an orthopedic surgeon, huh?]

…. AND YET ANOTHER NEURO-PSYCH EVALUATION, without causing the Defense to provide complete and accurate records, and allowing the Defense to write false cover letters to the doctors, and without allowing due process to injured worker to appear and plead for medical care and cessation of bullying, file churning and fraud, and with denials of requested ADA accommodations for appearance?

I found this on Facebook...seems true.  Is there Civil Code to go with it?
I found this on Facebook…seems true. Is there Civil OR Federal Code to go with it?

As defense is attempting to falsely claim this accident did not occur at work, is Wyndham Worldwide committing fraud, or is it just the Defense Firm personnel and the doctors they have involved in their chicanery via omission of medical records and misleading cover letters?  Now, if they say I did fall backwards on ice and hit my head real hard, as the DWC-1 statement on date of injury so indicates, and is signed by the Admin Manager, and they know I haven’t worked or been right since, then Wyndham appears to be only guilty of collusion to keep the dirty secrets, and human rights failures to come to the aid of an injured worker, and failures to hold their vendors accountable for bullying and egregious harm to an Injured Wyndham Worker.

Duration since Jan 9 2012
How can failures to provide medical care this long in WorkComp “Exclusive Remedy” BE LEGAL?  How many doctors have evaluated and made recommendations for denied medical care over this course? 35? 40? What’s next?   ASK ABOUT WORKERS COMP GRAVY TRAINS NOW

Back in 2013, I asked a Judge to authorize me to pay an hourly consult to a WorkComp lawyer, as indicated in the Christopher A. Ball book for Injured Workers, recommended on the WCAB site.  It is called California Workers’ Comp HOW TO TAKE CHARGE WHEN YOU’RE INJURED ON THE JOB.  The Judge declined; said it was against the law.

why mediate

I have dismissed 4 law firms that seemed very confused about the difference between a broken finger and a brain injury, so not a good fit for attempting to get medical care. I have accomplished more than all 4 of them on my own., and I have accomplished quite little.  So, that leaves me without legal counsel, with a brain injury, fighting organized crime, armed with the will to survive and the ability to type and blog.  Ain’t that nothing, America!

 

Ayres_Linda_Crush_1228aaMEDIATION FASTEST ROUTE

My response, this weekend, with a “DOR” will probably be called:

PETITION TO COMPEL RIGHT ACTION AND COMPLIANCE WITH LABOR CODE AND US CONSTITUTIONAL LAW in the case of Linda Ayres Vs. Wyndham Worldwide, et al

tbi and ice

As you know, on January 9, 2012, in efforts to help my co-workers get inside the office, during a snow storm, in which we were locked out, I told my manager I thought the window at my table might be unlocked, and we walked over to check the window.  It was locked.  My manager made it back to the side walk safely;  I slipped on ice and fell backwards, and hit my head very very hard.  I laid on the ground for I don’t know how long, my keys went flying and when my manager asked, “Are you ok?” I said, “No, I’m not.  I hit my head reallly reallly reallly hard.” Somebody took my briefcase inside the office but I had to go outside later to find my keys, that I do remember, because they were not in my handbag.

brain concussion tbi

After a little while, he helped me up.  I’m in sales.  We are ‘trained’ to leave our troubles at the door.  I dusted all the snow off of me, and went inside to attend the Sales Huddle.  My colleagues had a good laugh.  I forget who said it, but someone said, “Ewwwwwww, Linda has Fukushima Rads all over her now!”  (I had shared with them how radioactive snow is, as the snowflakes latch on to the radioactive isotopes like scavengers, and encouraged dodging the snow flakes, by any means necessary.)  I got “in trouble” for sharing this picture in the break room in 2011… I was told it was not very positive; it illustrates the impact of radiation poisoning.

Whats next Mom
Hello World! Ask About Fukushima Now http://askaboutfukushimanow.com/

 

Later, the Administrative Manager asked if I was going to see a doctor, and I said yes, and I asked, “Do I have to see any special doctor?”  He said, “Just see any doctor that accepts workers comp insurance” and he gave me an incomplete “DWC-1” form — he signed it, but it had no insurance company information on it, and no doctor could accept it, and the office did not return the doctor’s calls.

Remember, Wyndham staff did not offer to call 911 or even bother to take me or offer a ride to Urgent Care or an Emergency Room. Previously, I dropped everything and took a co-worker to Urgent Care as she was complaining of chest pains to everybody.  HR had no plan in place for dealing with such issues, either.  Perhaps staff is “too young or too stupid” to make life affirming decisions.

My guests, at the first wave tour, knew I was clearly dazed and confused, and they got their “gift” without any hard-sell….just gratitude that they were understanding about my confusion, as I told them I had slipped on ice and hit my head real hard that morning.

I went to the doctor after work, God only knows how I drove down that icy mountain road.  For some reason, I don’t know why, an hour trip took over two hours.  When I saw the chiropractor (I thought I just needed a little adjustment for my neck and back) but the doctor said I had a concussion.  I didn’t know what that meant.  He suggested I would feel like I’d been hit by a truck in a few days, but in a few weeks I’d probably be fine  He was right about feeling like I’d been hit by a truck.  I vaguely remember having to use both hands to lift my head up from bed, and I slept a lot –

WWW MMM 13

I went to the Urgent care a few days later, since someone told me people can die from head injuries; they could not take the DWC-1 form, but they kindly accepted the CIGNA employee health insurance (which CIGNA had to fax to them, since I couldn’t find the card).  I got lost going to that doctor’s office, then lost again going home waiting for CIGNA to fax them the card, and disoriented on return.  Defense likes to say that doctor said I wasn’t dizzy, disoriented or confused.  D’oh!  The office is less than 5 miles from home, in rural Yucca Valley.

I had already called the EAP – Employee Assistance Program — because I was so confused, couldn’t think, and was having trouble talking, and my words were slurring.  I haven’t had a drink or drug in over 28 years.  People said I sounded drunk.  Not a good sign.  EAP connected me with a clinical psychologist who referred me to a local neurologist (who refused to see me since it was work comp, at a scheduled appointment; his office perjured and said I failed to appear for appointment; I begged for help or at least a referral when they turned me away.

Webinar Ninja  Draft one  SURVIVING WORK COMP

Turns out, they were actually on what I later learned to be an MPN list…)  The rest of the blogs (https://askaboutworkerscompgravytrains.com/list-of-posts/ has the rest of the details; perhaps a law school may find it of interest; real lawyers don’t give a hoot, nor, apparently, do WorkComp Judges, complicit in the terrors I have experienced as a member of America’s Working Class, injured being a team player, kicked to the curb by the PROFITS BEFORE LIVES CROWD.

As many of you know, I am currently enrolled in the Coastline Community College State run ACQUIRED BRAIN INJURY PROGRAM.  It is a one to two year program, and it helping me tremendously, in learning compensatory skills, and in ‘resocialization’ — being in a community with other brain injury survivors is remarkable, and yes, we compare notes on the chicanery of the legal and insurance psychopaths—the stories are all quite similar.  We do need Nuremberg type trials, and this time, include the lawyers and their ilk.

I am learning a new software to compensate for cognitive impairments…. including loss of working memory…. I haven’t quite figured out how to get the images out of the software into the blog, so I have resorted to copy and paste.  I think you can see the big picture of what I am currently dealing with.  Future blogs may have better presentation, as I am currently studying how this software can make up for my loss of working memory.  It really helps me to see the ‘big picture’ again.

HOW IS THIS LEGAL? DENIALS ALL APPEAR BASED ON FELONY FRAUD AND QME/AME FALSE REPORTS AND WORSE
HOW IS THIS LEGAL? DENIALS ALL APPEAR BASED ON FELONY FRAUD AND QME/AME FALSE REPORTS AND WORSE

We are also learning about learning styles, and how our brain injuries impact our need to focus on strategies to be more “concrete sequential” in our new approach to life.  This software, with several other apps and devices, serves as cognitive aids.

My progress seems measurable, substantiated by the increase in blog views since June 2013…

Capture STATS  AS OF 7 24 2015  911 AM PDT

Bottom line, it’s just more dreadful fraud and legal chicanery.  I could just spit at the vileness of it all.  Anyway, If you have any suggestions on how to best approach the Judge.  I don’t really believe I can be compelled to participate in felony fraud in an ongoing workers compensation scam by  the defense firm and insurance carrier representing my employer, Wyndham Worldwide.

As many of you know, the medical care I have received, I have had to pay for myself, now exceeding over $43,000.  CNA refused to pay TTD benefits in 2012, shifted the cost burden to the State, then finally paid the State back in 2014, at a dramatic discount.  They said it’s legal because EDD “negotiated” a $49k payback to $31,000 payback.  I don’t think the State Controller knows, but lawyers and EDD tell me it “happens all the time.”  As a consequence, instead of “104 weeks of TTD” payable by Work Comp Carrier, followed by ” up to 52 weeks of State Disability” I got cheated out not only medical care that would have possibly facilitated return to work, but I had no income for months and months and months (translation; had to rely on Salvation Army for help!) but I got cheated out of the EDD “up to 52 weeks” and those funds went back to CNA for bottom line profits.

 

Capture ORDER TO COMPEL 1

.  .Capture ORDER TO COMPEL 2

It’s a brain storming tool, and helps compensate for impaired loss of working memory.

It’s a little embarrassing that I cannot figure out how to ‘export’ or ‘transfer’ this info as the software is designed to, but it does serve as an example of my creative work-arounds and compensatory strategies.   The outline text is below.

 

Remember, in my pre-brain-injury life, I was a Database Queen, I served years ago as an Executive Assistant to some serious Captains of Global Industries, and it took smarts and serious speed and cognitive functions to keep them organized, and my work included intense logistics, keeping them on meeting schedules, to private planes, yachts and limos, political events and more.  

So, when I read some of the fraudulent statements of some well paid insurance industry doctors, you might imagine how I could just spit at the audacity of these little thugs.  One government agent, as I told some of the tales of the corrupution and horrors I have been exposed to, asked, “How can they sleep at night?”  I said, “Psychopaths have no sleep problems.”

 

ORDER TO COMPEL  LIST

As many of you also know, I lost professional credentials due to the untreated brain injury.  I lost my Hawaii Real Estate Sales License, California Real Estate Broker’s license, and California Notary Commission.  While I have not hope to be able to restore my Hawaii license, I was able this year to reinstate my California Real Estate Broker’s license, and just yesterday, I took my Oath for my California Notary Commission.   Yes, I take my Oaths seriously, always have, always will:

“I, Linda Ayres, do solemnly affirm that I will support and defend the Constitution of the United States and the Constitution of the State of California against all enemies, foreign and domestic; that I will bear true faith and allegiance to the Constitution of the United States and the Constitution of the State of California; that I take this obligation freely, without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the duties upon which I am about to enter.

OATH BEFORE ORDERS

 

Remember remember also….  All Nuclear Reactors Leak All of the Time

“Have a wonderful radioactive weekend and don’t forget to Dodge the Rads, it’s dangerous out there!”

WE ARE THE MEDIA NOW (2)

“Churn, Baby Churn” Chant of WorkComp Defense Firms in America.

“There is NO EXCUSE for the #WorkComp Atrocities in America”

but we might be on to an explanation…..!!!!!!!!!!!!!!

flag distress signal

WorkComp Law….and Atrocities…

AS THE FILE CHURNS, Wyndham Sleeps and CNA asks IW:

“…when ARE you going to die?”

Primary Treating Physician for Ayres vs. Wyndham et al is an Orthopedic Surgeon designated as PTP for BRAIN INJURY CASE, because the alleged MPN Network of CNA is apparently losing swathes of doctors for non-payment and ridiculous handling of claims, they have no brain injury experts and damages caused by CNA by refusals to provide medically necessary treatments.

CNA now relies heavily on Corvel Corporation orthopedic surgeons and clinical psychologists to deny brain injury care based on false and incomplete medical evidence, and lack of expertise  in the brain department.  People complain about that Maximus IMR Gang?  …..Corvel says, ‘let them all eat cake!’ as their nurses and sonders churn out denials like they were going out of business.  The Corvel ‘doctors’ seem to have fangs in the Social Security denial system too?

Most of the CNA leased/owned independent doctors don’t even know that the brain is a body part located in the head, and one of their neurologists says ‘take an over the counter analgesic’ and their other neurologist says, ‘Look, you didn’t get any medical care the first two years, you’re already over 35, nothing will help you now.  Go for a walk, get skinny, use the neuro-optometric theraputic lenses they wouldn’t pay for, but you did, and stop whining about vision and auditory impairments.’

Some real doctors just walk away from the #WorkComp Scams, some stay in it, slugging it out on behalf of injured workers, and others just ride the Dinner Car of the #WorkCompGravy Trains.

Nearly every single request for expert treatment for brain injury by the PTPs have been denied, first by non-doctors, Kim Mall, Attorney for Grancell, then by Daniel Elliott, Adjuster for CNA aka American Casualty.  Remember remember, Wyndham Worldwide had (and probably still has) no standard practice for injured workers other than handing them an incomplete DWC-1 form with a shrug and “See any doctor that accepts work comp insurance” with the ‘time-share-salute’.

Slow forward:

Ortho Report Oct 2014

Ortho report October 2014  2 of 2

COASTLINE ACQUIRED BRAIN INJURY PROGRAM  NEWPORT BEACH —http://www.coastline.edu/students/students-with-disabilities/acquired-brain-injury/

COASTLINE FOUNDATION http://www.coastline.edu/community/foundation/

The Coastline Foundation continually searches for new and innovative ways to serve the Coastline community. Coastline Community College is a campus without walls, and the Coastline Foundation (like its parent college) knows no barriers. Contact the Foundation at foundation@coastline.edu or call (714) 241-6154.

LIFE HAPPENS…. They train the trainers! The DOD seeks their expertise.  Their ‘Graduates” sing their praises!  Compensatory Strategies help many Brain Injury Survivors return to life; sadly, not all are so fortunate.  Not everybody survives…..

 

The Evaluation [QME]  by Dr. Jeffrey Holmes, Orthopedic Surgeon, has been aborted again, and to be rescheduled in December, after spending nearly 70 minutes at the appointed time, confirming medical records and sorting through confusion.  It was a pleasure to meet Dr. Holmes and his kind and gracious staff.  Harvard men can have manners, yes?

As injured worker was quite clear that the good doctor was being invited by Defense to participate in an on-going fraudulent denial of medical treatment scam, and that he deserved to have all the facts so that he could make a legitimate evaluation of the right shoulder injury and other orthopedic challenges.

2012 medical records and 2012 attempt to coerce premature settlement by Defense clearly referenced right shoulder injury, and current hard-fought for Acupuncture has been for the ‘right shoulder only’ and they tried to tell the acupuncturist treatments were not to be used on the brain.  D’oh!

(Acupuncture is a whole-body system of treatment, most helpful to some brain injured patients.) The Defense postion letter started out with lies, that just got more egregious, and current defense counsel stated he saw no reason to change anything in Kim’s letter.  Birds of Feather poop together?

Current PTP was successful in getting 6 physical therapy sessions authorized in Spring 2013, for a Winter 2012 injury. Then an MRI in Summer 2013 of the shoulder was authorized, determining a need for surgery and a severe shoulder rotator cuff tear.  It took a Court Order to get appointments scheduled for Physical Therapy and Acupuncture in 2013. Is that right use of Judge’s time?

Defense attorney Kim Mall (Grancell-Corona) then indicated that the adjuster was wrong, there would be no further evaluation because it was not an accepted body part.  She did not want to hear that the adjuster was trying to do the right thing.  She squashed it, and no doubt billed on.

 

Work Comp  TBI Wyndham and YOU

Several days in front of a WorkComp Riverside Judge, to deal with issues of omissions of medical records—more than 300 pages left out for 3 doctor reports, so those doctors relied on instruction from the defense, based on their egregiously flawed reports, QME/AME/and 2nd Consult.

 

Conveniently, those industry leased/owned doctors moved the reported date of injury on some reports a year forward, to 2013, using medical evidence of 2012 to ‘support’ fraudulent claims of ‘pre-existing’ symptoms such as dysfluent speech, impaired cognitive abilities, inability to recognize people, auditory and visual processing….. One made a correction to the date when confronted, but not to the false opinings, or his meds were off too.

wpid-img_20141113_185828.jpg

No worries, WorkComp Courts REFUSE TO HEAR COMPLAINTS ABOUT ATTORNEY/PROVIDER FRAUD, AND SO DOES THE COMMISSION IN CALIFORNIA.  DISTRICT ATTORNEY IS TOO BUSY? CAAA suggests injured worker keeps on looking for a competent legal firm to represent.

DEFENSE FIRM REFUSES TO MEDIATTE, SAYS THE CASE IS “not ripe”… (i.e. Injured worker is still breathing???)

DEFENSE FIRM REFUSES TO PROPERLY PROCESS MEDICAL EXPENSES REIMBURSEMENT REQUESTS FOR NEARLY $30,000, AND INSURANCE CARRIER IS AWARDED $16,000 BONUS BY STATE OF CALIFORNIA – EDD — APPARENTLY OUT OF GENERAL TAXPAYER FUNDS…FOR REFUSAL BY CARRIER TO PAY TEMPORARY TOTAL DISABILITY BENEFITS IN YEAR 1 AND 2 OF INJURY…. Perhaps the WorkComp AUDIT UNIT will do their job and suprise all stakeholders with fines and penalties.

THE INJURED WORKER HAS NOT YET RETURNED TO WORK…. WYNDHAM CONTINUES TO REFUSE TO PARTICIPATE IN THE INTERACTIVE PROCESSES OF #FEHA, AND THE DEFENSE FIRM CONTINUES TO OBFUSCATE TRUTH…SENDING QME DOCTORS BUNDLES OF DISORGANIZED FILES, THAT SEVERAL HAVE BILLED 7-8 HOURS TO “organize” prior to review, and generally, those doctors just have their “staff” write a report following guidelines of defense counsel, fraudulent misrepresentations and all.

These doctors are not apparently accustomed to an injured worker fighting for survival without a lawyer—two threatend to sue for ‘harassment’ when omitted records were properly served with requests for supplement reports reflecting further medical evidence.  Several Court hours were wasted (but billed by Defense firm?.)…. to sort out the missing records.

The file was pulled from Kim Mall, and given to Stewart Reubens, in Grancell-Novato office.  Stewart doesn’t like to read.  His office must be full of rubber stamps?

wc CLAIM DENIED

Date of injury was 1/9/12, despite repeated requests for a brain injury experts—a Physicist, a Neurologist with Brain Injury Expertise, A Neuro-Psychologist, to manage an INTERDISCIPLINARY TEAM OF EXPERTS — Speech Therapy with Cognitive Remediation, Occupational Therapy, Neuro-Vision Therapy, Physical Therapy — TO TREAT A TRAUMATIC BRAIN INJURY CAUSED BY A WITNESSED SLIP AND FALL BACKWARDS AT THE WORLDMARK BY WYNDHM BIG BEAR RESORT ON 1/9/12…..

What can break the impact of a fall backwards besides the SKULL?   See picture for help with that question.  Hint: THE SKULL.  2ND HINT: Where is the brain located?

tbi and icelinda-ayres-says-join-me-on-twitter and linked in lindaayres311

Evaluations Evaluations Evaluations…. and #WorkComp Defense now wants MORE EVALUATIONS?!!! For how many more years??

The recent Ortho Eval was aborted again, due to file obfuscation by Defense Firm, to be rescheduled.

While Grancell refuses to honor ADA request for electronic communications, it seems that Stewart sent a letter recently requesting yet another neuro-psychologist evaluation (after DIR told him NO once more) and he is apparently clue-less that such testing cannot be done more often than every 7-9 months, or ‘practice effect’ renders the results bastardized.  Or, maybe he does know that, as he knows such a battery of tests was done again in October 2014.   All results point to a traumatic brain injury, with requests for treatment.

Even the Grancell leased Forensic Psychiatrist wrote, ‘If there was evidence of a concussion from a slip and fall, injured worker would certainly be entitled to medical treatment….but there was not fall, no concussion, and it was probably just an epilepsy attack.”  D’oh! Doc off his meds that day?

Forensic Psychiatrist wrote 3 supplemental reports at the request of Grancell’s Kim Mall, each one more outrageous and egregiously fraudulent than the prior, until they decided to put the reports on the ‘do not regurgitate in summary’ instructions, and also asked to have the name and report dates removed from the Medical Index.  Invoking the 5th amendment might have been more efficient?  (He also suggested that if IW has civil rights complaints, she take it to The Hague.  He provided the direct line for the local DA to facilitate further complaints….THAT’S SCARY THAT HE HAD THAT NUMBER SO HANDY, HUH?  d’OH!  He refused to believe complaints had already been filed.)

'CHURN THAT BILL BABY

“I hear we are already 200k over our estimate—that’s Team DLA Piper!” wrote then-DLA Piper partner Erich P. Eisenegger in one email.

After another lawyer responded, noting that an attorney colleague, whose first name is Vince, had been added to the group working on the bankruptcy matter, then-DLA Piper attorney Christopher Thomson added his thoughts: “Now Vince has random people working full time on random research projects in standard ‘churn that bill, baby!’ mode,” wrote Thomson. “That bill shall know no limits.”

“Now Vince has random people working full time on random research projects in standard ‘churn that bill, baby!’ mode,” wrote Thomson. “That bill shall know no limits.”

See entire artire ABA Journal article here:  http://www.abajournal.com/news/article/sued_by_dla_piper_for_675k_ex-client_discovers_lighthearted_churn_that_bill/

SEE MORE, IF YOU READ:

Courtroom Avenger

 

wpid-img_20141113_185828.jpgLife with TBI is so

WorkComp Wassup America  Nov 2014

WC DOCTORS

 

linda-ayres_profile_qr

Where O Where are the Brave and Smart WorkComp Injured Worker Attorneys?

“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.

WC  WorkComp Kills

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….

Life with TBI is so

(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:

  1. Dr. Daniel DeGoede, Clinical Psychologist, referred by Wyndham EAP program, paid for by CIGNA (Jan-Apr 2012)
  2. Dr. Marcel Ponton, Psychologist, referred by attorney #2; also a QME dude. (Apr – Dec 2012)
  3. Dr. Jacob Rabinovich, Orthopedic Surgeon, one time evaluations; replaced by attorney #3’s doctor: (1 visit)
  4. Dr. Darren Bergey, Orthopedic Surgeon….. (Feb 2013 to present; wants out)

(b)    Who are your secondary treating doctors (i.e, in other specialties)?

  1.  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. 😕
  2.  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.
  3.  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

On further thought, the AME Forensic Psychiatrist and QME Neurologist did write something about WPI and MMI….some ridiculously tiny number.. I can look for it.  In my head, their reports are such works of Fraud, I discount everything in them.   
Their reports are debunked by Dr. Hilda Chalgujian (professionally and nicely)…. and the authorized SCRIPPS time and treatment and recommendations for more treatment clearly debunks their allegations that I have no head injuries or that they are minimal.  
Defense counsel (Kim Mall- Grancell, Corona) attempted to lead them to say that a car crash of 2008 and a prior car crash in 2003 were the cause of problems, even though there was never a previous complaint or treatment for any of the symptoms.   However, Dr. Kent, Neurologist, also moved the date of injury to 2013 in his reports and indicated I sought help for confusion, inability to speak, etc, PRIOR to Industrial Injury, citing 2012 initial evals organized by Dr. David DeGoede (EAP referral) as polite obfuscated evidence and the neuro-psych he sent me to, another authorized exception.  
If settlement is not reached in the foreseeable future, it seems to me the O’Brien, Kent, Zardouz fraud will have to be debunked in trial.  I don’t think any of them would care; they clearly have insurance company ‘protection’ ……..  At one point, O’Brien asked to be removed from the case and his report withdrawn……… since WC seems like the internet, once it is written, it never goes away………..they attempted alternative tactics…. via character assassination.  His findings contradict findings of all other doctors….. a jury might find it of interest, and defense knows it.
When current PTP, Dr. Bergey, was threatend re MPN status for trying to get me help, his office called me, advised me of same, and moved my scheduled appointment up a week so I could come in for my final appointment.  I think they insinuated that for business purposes they had no choice but to call me P & S, and release me.  You might imagine the content of my written response.  My next progress meeting was with Dr. Bergey directly, rather than PA, and his report was stronger  He seems to frown on being threatened by insurance carriers.   Smart guy who does not seem to be  easily intimidated.  He knew when I arrived at his office on 2/14/13 that I needed a brain doctor and it wasn’t him.  They have tried and failed valiantly trying to get me help.   The acupuncture and chiropractic I got this year was not their doings…it took a Court order.  :/   Yeah, unbelievable.  
If you decide to consider my case further, I have all the medical records and I am expecting SCRIPPS discharge report early next week…. I can email you anything I can find.
I don’t want to fool with this for years and years and  years like some of my FB buddies……….they count on that, don’t they?   Count me out….I’ll fight from the side, we do not…forget.

(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”

SOCIAL SECURITY  FOLLOW THE MONEY TRAIL

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

WORK COMP AND BASEBALL... BATTER UP!
WORK COMP AND BASEBALL… BATTER UP!

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.

image (1)

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.

linda-ayres_profile_qr

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.

GOVERNMENT BAD GUYS AND JAIL

Sincerely,

Linda and Friends

flag distress signal

HELP! IF YOU COULD, WOULD YOU HELP ME FIGHT ORGANIZED WORK COMP CRIME?

My Fellow Americans and Fellow Injured Workers… I NEED YOUR HELP TO FIGHT #WORKCOMP CRIMES

I’m tired of fighting these organized criminals.  I have a brain injury and I have a war room of evidence against these monsters.

I have just been accepted into an Orange County—COASTLINE COMMUNITY Cognitive Rehabilitation Program, that starts next week.

These monsters can only continue the DDD…. Delay, Deny, Deceive Sonderkommando actions that any injured worker in America must contend with, as our country crumbles by the actions of such treacherous psychopaths.

DEFENSE AGAINST THE PSYCHOPATH

This entire blog is the trauma-drama…………Please share it with your friends….  Somebody must stand up to these killers in suits.

I did my best.  Take care of one another.  They are killers, make no mistake about that.

WE ARE THE MEDIA NOW.  TILL LAST GASPS….

 

cognitive dissonance turbulence

—–Original Message—–
From: Linda Ayres <lindaayres@aol.com>
To: fred.sachs <fred.sachs@cna.com>
Cc:  sreubens <sreubens@grancell-law.com>; cna_help <cna_help@cna.com>; mary.favey <mary.favey@wyn.com>; tina.jordan <tina.jordan@wyn.com>; melisa.paramo <melisa.paramo@wyn.com>; wvoleavesupportcenter <wvoleavesupportcenter@wyn.com>; fraud <fraud@cna.com>
Sent: Mon, Oct 13, 2014 2:30 pm
Subject: Coastline Cognitive Rehabilitation Program $184/semester, Starts October 20, 2014, Orientation this Saturday at 8 am AYRES VS WYNDHAM ADJ8181903
Dear Fred Sachs, CNA Adjuster et al

I just spoke with the admissions office at Coastline Community Cognitive Rehabilitation Program and I have been accepted into their program.  The fees are due by Friday and the cost is $184.00 per semester. 
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This requires a one year commitment, possibly two years, depending on my cognitive improvements.
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The failures of Wyndham, CNA and Grancell can be righted, to some extent, if there is cooperation to help me get cognitive care now for the injuries that were not treated at the time of injury, not during the first nearly 3 years
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You just spent more than $50,000 at SCRIPPS for their interdisciplinary program that you did not let me complete, and here you can save your companies thousands of dollars and help me get treatment that should allow me to return to work.  One of their graduates was a speaker at the SCRIPPS Brain Injury Rehabilitation Conference I attended in May 2014.  His injury was over 16 years ago, he still has severe cognitive impairments, but via Coastline, he has learned how to compensate for the losses, and is now a successful city manager.  His work comp case is on-going, but his carrier finally saw the light and now provides medically necessary treatments.
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This morning was wasted with emails between me and Stewart since he can bill hourly, probably,  for silly letters and alleging he doesn’t understand what I have stated about the errors in his attempts to make an accurate medical index.
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Let’s decide immediately whether on Monday you will have made arrangements for lodging for the first quarter of my treatment at Coastline, and if Tina Jordan has made arrangements, in compliance with FEHA accommodations requested for a possibly return to work in the Newport Area, possibly the Wyndham Hotel in Irvine, or, if logistically possible with lodging, then a return to sales in Oceanside.  The interactive process was designed to sort these things out, but it was refused.
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Now we have a short window to decide where I must be next Monday, October 20th…… at Coastline with plans to return to work in Orange County, or at Indio, for the Quality Assurance position or a similar position to the sales job, with a guaranteed income while return to work is attempted.
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I await response from Wyndham, from CNA, and from Grancell.   You have collectively harmed me like war criminals….. can you please stop it now, and help me get to Coastline to get some help for the brain injuries exacerbated by the chicanery of Grancell, Stander, Thomas and Reubens, and their staff.
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It is my hope that Wyndham employees, owners, and members will demand an immediate audit of the WorkComp matters of Wyndham Worldwide on a national scale. As a shareholder, I have a small say as well.  As an Injured Worker, and as an American, I say it’s time for some people in authority to step up to the plate and do the right thing.
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Thank you for your consideration.

By copy, we’ll also ask people in America what they think would be the next right action.

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Sincerely,
Linda Ayres, In Pro Per
PO Box 835
Yucca Vallley CA 92286
760 368 5243
PS  If you would kindly reimburse the more than $27,000 I had to pay for medical expenses on my own,  and if you would return the $20,000+ bonus the State of California gave you for refusing to pay temporary total disability payments in 2012/2013, I would haven’t to ask for help to get there, even though you have started the financial terrorism thing again.  Bummer. No income since July 2014, and LTD is skewed up because of your  chicanery and they cannot confirm they will resume and for how long.   BTW, AGGRAVATION IS NOT GOOD FOR A HEALING BRAIN.
 Outreach to Wyndham  10 7 14

 WE ARE THE MEDIA NOW

 

 

Life with TBI is so

#WorkComp Crime Pays INSURANCE COMPANIES big time in California?!?

…. Crime Pays Insurance Companies big time in California

… #WorkComp arena…  awww, don’t worry about it.  No prosecutions likely.  It’s a pattern of practice….. steal from work injury disabled and the nouveaux poor and give it to the big insurance companies.  Yes, California, from the California coffers…. negotiating away civil rights of California workers.  Ought to be some law enforcement, huh?

#WorkComp Crime Pays INSURANCE COMPANIES BIG TIME in CA?! Would you believe CA EDD paid approximately $20K bonus to CNA for REFUSING TO PAY TTD to an Injured employee of #WyndhamWorldwide?? Medically necessary treatments for witnessed slip and fall Traumatic Brain Injury of 1/9/12 still being evaluated for necessity of treatment.  “Rest and wait and wait and wait and wait and wait.”

Polite psychopaths refer to the transaction as negotiations for reimbursements… D’oh.  If the action shifts the burdens to the State, well, that seems to be then considered a complaint with the State rather than a complaint with Department of Insurance for condoning shady actions?  So complicated, isn’t it?

Don’t be tricked by insurance company loopholes!

go save yourself from the zombies

Bottom line:  Failures to provide medically necessary treatment to injured worker (witnessed slip and fall backwards and consequent head trauma of January 9, 2012) and continuous malicious interruptions of self-procured medical treatment, combined with…. refusals to reimburse medical expense incurred due to refusal of Wyndham to provide medically necessary requested treatment, denied first year by Adjuster and Defense Counsel, denied second and third year in complicity with Corvel UR departments and repeated omission of medical records with intent to deny medical treatment….just ain’t right.

The denial of the “brain” being a body part in the head is illustrative of the chicanery employed by Grancell Gang.  #TBI  Traumatic Brain Injury

They have also certainly wasted a great deal of time at WCAB – Riverside, in the Courtroom of Honorable Judge Victor Jimenez.  Complaints of Fraud are not heard in that Courtroom, so a well fought for right to be heard by the Judge took over two years to get a date (ATTEMPTS TO SEE JUDGES OBFUSCATED BY INFORMATION AND ASSISTANCE OFFICER REPEATEDLY), only to be aborted by failures to provide continued ADA accommodations.  It was postponed in July 2014 in order for Injured Worker to properly report fraud with the proper agencies.  STILL LOOKING…..PLOTS THICKENING….AND SICKENING……

wc crime pays in CA

Meanwhile, WyndhamWorldwide Human Resources says it’s not their job to help an employee obtain medical care or even tell them what doctor to go to at the time of injury.  #Wyndham takes the “timeshare salute” to extremes when kicking an InjuredWorker to the Curb.  D’oh!

the game is rigged

Legit doctor reports ignored by Defense, as well as physician requests for treatment since date of injury. Carrier also refuses to pay medical expenses incurred by injured worker …. alleging that the BRAIN IS NOT AN ACCEPTED BODY PART OF THE HEAD REGION. D’OH.

California Republic one star yikes

Yeah. Insurance Carrier, CNA CEO Thomas Motamed, rakes in more than $10.7 million a year personal income, maiming and killing injured workers across American? #8 Insurer. D’oh.

work comp guidelines

Grancell Stander Reubens et al, defense firm, pleads and whines that they are not responsible to help insured get medically necessary treatments, nor are their clients obliged to honor any Labor Codes, nor participate in FEHA interactive process to facilitate return to work.

Grancell also insists that the brain is not a body part located in the head region. D’oh!

 

“No Worker Left Behind”

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NAIDW TBI AWARENESS

 


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WC ADJ8181903 … WorkComp Riverside supports non-payment of TTD to Injured Workers in their Jurisdiction and also repeatedly disregards ADA accommodation requests, and has been known to confiscate smart phone of injured worker to ensure no recording of ‘informal hearings’….

wc workers-comp-fraud  if your company lies

Hmph.

#InjuredWorkersUniting #SilentNoMore

#WorkCompKills…… big time….nationally……it’s a racket.

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