How? Have untrained staff, incapable of handling a work place injury, unable to offer medical support, transportation to an emergency room, or call 911. Ensure that staff do not know how to complete a DWC-1 form, know nothing about alleged MPN-Provider Networks, never send a get well card and never inquire over the years of denied medical care how the employee is doing; above all, never extend a get well wish, and threaten abled working staff to NEVER SPEAK TO AN INJURED WORKER, under any circumstances. Refer always to HR.
Then, hope for a newbie Adjuster who can “just follow orders” and rely upon EAP referred doctors for referrals to other specialists. Hope that adjuster seriously follows PLAY BOOK that apparently deems it necessary to terminate all benefits upon diagnosis of serious injury, including Brain Injury and commence acts of emotional, mental and financial terrorism.
Hope for a designated defense counsel that will go to any means necessary to “win the case” with plenty of Court time and other billable hours on matters related to legal chicanery and obfuscation of facts. When both are replaced after a few years, hope for seasoned, jaded professionals without hearts or souls. Higher on the food chain, the more intense the outcomes.
Count on AME/QME/IMR doctor reports written by non-medical staff, signed by industry leased/owned professionals for the big bucks, and know that legitimate doctors will also be cheated out of agreed upon fees and more.
Hope for a Risk Management team to successfully shift all risk and cost burdens to State and Federal agencies, without fear or caution. If necessary, hope for a fraud unit that will call injured workers and ask, “So tell me, ______, when ARE you going to die?”
Count on total violation of Civil Rights—-because WorkCompsters appear to be above the law, with no regard or respect for the Constitution of these United States of America and callous disregard for life and liberty.
Subject: LINDA AYRES VS. WYNDHAM WORLDWIDE ; Re: Hotel Vouchers, Mediation, Status and Updates
“…Timeshare….a fantastic industry to work in…..FACT!” UNLESS…………..
Thanks very much. The vouchers are a huge relief for me. I can make some tentative plans now, pending your further response.
Friends in the industry have suggested that I do what I can to initiate mediation toward settlement. I have done all I can do for a few years and have been merely insulted in addition to further injuries. It’s hopeless for me to try to deal with these people, even though Workers Comp is supposed to be an “Exclusive Remedy”….. it’s a farce. That’s a given.
If you and Michael Dougherty et al all want to approach the carrier and defense firm, I would be open to mediation in Los Angeles, but I won’t suggest it to them again.
They are copied herewith because that’s apparently the law, according to Stewart Reubens. I have been evaluated by approximately 40 doctors in person, and how more have reviewed records? Defense has enough evidence; they know what a brain injury is, and what my future medical picture could look like, and how they have successfully and dramatically shortened my life span, and continue to do so.
You and Michael might want to have them submit a proposal to me, that I can review with someone who is not in an adversarial position against me, and perhaps we can settle up. If not, well, when nothing changes, nothing changes. I am open to anything reasonable. $100K was offered in November 2012 when the extent of injuries was obfuscated by refusals by the carrier/defense to authorize specialty evaluations and treatments. I was 59 when the injury happened. Tic Toc. They are wasting what’s left of my impaired life.
Here is an article about: CLOSE “IN PRO PER” CLAIMS
“….Sometimes the SRA has a bona fide complaint, but without professional assistance has not been able to communicate it. The neutral mediator is often able to re-state the concern in a way the parties can address and put past them. The mediator can help each party see the other side’s point of view.”
“Animosity can obstruct effective communication. Caucusing allows parties to avoid direct confrontation. The parties are separated, and the mediator shuttles between rooms. The mediator presents the parties’ views in a way most likely to lead to resolution.”
“Minimally, mediation can improve communication and relations between the parties…..”
I think, based on my experiences of each of them, Grancell wants this to be a till-death-do-us-part claim term.
It’s more profitable for the law firm. If Teddy Synder, Esq. would mediate this case, I have been watching her posts for quite a while. I don’t sense that she is owned by the industry, so I would imagine she could mediate this case. You or Michael could check with her office? Or ask Fred Sachs to? It’s not in Grancell’s financial interests to move this case anywhere; they apparently gets paid no matter what, huh?
Remember, I have been seen by approximately 40 doctors, and I did not get reasonable nor appropriate medical care at the time of the accident, not even an offer for a ride to the emergency room after my manager helped me up after laying on the ground for who knows how long, and I needed help to get up, and I was very dazed and confused. The sales meeting happened shortly after that, and everybody had a good laugh about my fall. I had a 9 am tour. All I remember about it is apologizing to them that I was confused, and that I had fallen on the ice earlier and hit my head, and they were owners and didn’t want to upgrade, so with apologies, I remember saying, “Let’s get your gift.” That’s was probably their favorite ever update.
It was after that that the admin manager asked if I was going to see a doctor and I recall saying, “Yes, do I have to see any special doctor?” He said, as I have often quoted, “Just see any doctor that takes workers comp insurance” and gave me an incomplete DWC-1 form, without any insurance info on it. I called a local chiropractor and asked if he accepts work comp and the office said he did. So down the icy mountain I drove, God only knows how; I don’t remember any of it. I do remember getting to the doctor’s office just before 5, so I don’t know why it took so long to get there.
I thought I just needed an “adjustment” and that I would be fine. The doctors said I had a concussion along with the mis-alignments. He said I would probably feel like I’d been hit by a truck in a few days, and he was certainly right on that.
I didn’t know what a concussion was, I just knew I couldn’t think anymore, and my eyes looked like, so the office told me later, that ‘nobody was home”. I had trouble speaking immediately, and the receptionist was often exasperated by my huge challenges to make a simply return appointment.
I called EAP, and they sent me to a LOCAL clinical psychologist, Dr. DeGoede. While waiting to see the clinical psychologist in a few days, I went to the Urgent Care, using my CIGNA employee health benefits, and CIGNA even had to fax my ID card to them before they would see me. So everybody knew it was a WorkComp injury. I got lost going there, I was very tired, they said they couldn’t see me till they had the CIGNA card, so I told them I would go home to sleep and asked them to call me when they got the fax. I got lost going home (about 5 miles away) , and returning to the office. It was not part of the alleged MPN at the time (I knew nothing of an MPN still) but he has since benefited financially by becoming a referral member. It was the Urgent Care doctor who prescribed the MRI of my brain, which I got and paid for with a $371 co-pay with CIGNA insurance.
The clinical psychologist referred me to a local neurologist, who turns out was on the alleged MPN, but refused to see me when I appeared, with the hand written referral letter. That neurologist’s office perjured later and said I failed to appear. I begged for help or a referral to someone who could help.
CNA had no neurologists nor neuro-psychologists, (apparently still don’t) so they relied on Dr. DeGoede’s rollodex to find Dr. Eileen Kang, Neuropsychologist in Fullerton. She didn’t know the neurologist her office referred me to at the Orange County Neurology Center, but they could see me within weeks, not months, due to cancellations. I’m sure that neurologist gets plenty of cancellations. He wanted me to drive, sleep deprived, more than 100 miles each way for an EEG in his office. I asked then adjuster to get me an EEG closer to home, and a neurologist closer to home (this was about 2 hours away, and I was in no condition to be driving period, let alone driving sleep-deprived. That’s when I began to think, “LOOK, I’M INJURED NOT STUPID”
As soon as it was clear I had a brain injury, then adjuster terminated benefits (April 2012; injury was January 9, 2012) . Remember, the first adjuster, while I was represented, accepted a call from me and told me if I was NOT represented, he would help me get medical care. It sounded to me like that was the only way I was going to get care, and since the law firm didn’t under grasp that the brain is a body part, and not a “psych-component” I was willing to work with him.
That’s how we got the initial evaluations, until it was too clear for CNA that they had a brain injury case. The first law firm I retained there was no attorney supervising the office manager who sent me to the first orthopedic surgeon…. I think you know how it went from bad to worse from there…..Remember, upon confirmation of brain injury is when all the reallly bad stuff began to happen.
CNA never even authorized an MRI of my brain and took over a year to payback my CIGNA co-pay of $371, and actually, apparently doubled paid the provider. They never provided the neuro-optometry evaluations requested repeatedly since 2012, nor will they schedule the one authorized this year. They refused to reimburse for self-procured neuro-optometry and lenses and vision therapy.
The auditory processing piece recommended at SCRIPPS includes a software program for approximately $100 bucks for auditory retraining, to go along with the proposed hearing devices. CNA refused to get the cognitive remediation therapy repeatedly requested, they refused to even get a speech therapy evaluations and I didn’t get speech therapy till August 2014, when SCRIPPS was authorized for a fraction of the time medically necessary. We all already know the rest of that story.
Remember, it’s not loss of hearing at issue, it’s the auditory PROCESSING, like it’s not vision at issue, it’s the VISION PROCESSING. It’s a brain injury. The brain in command center. I have not seen an endocrinologist nor have I had any ongoing treatment other than acupuncture, which has measurable results. I suspect it will be necessary for a life-time, as I have experienced extreme dizziness and nausea if I go too many weeks between sessions, as happened in recent weeks. I’m back to a weekly plan, for as long as I can afford it. Chiropractic, self-procured for pain management, and also in conjunction with right shoulder mobility, takes place several times a month, no thanks to CNA.
The Orthopedic issues have always been secondary to the brain injury to me, and acupuncture, self-procured since August 2013, is the only ongoing medical care I have received, with measurable improvements that have also eliminated the suggested need for right shoulder surgery, although the defense apparently resorted to extortion to convince the PTP to falsely state the right shoulder injury was “Non-Industrial” when a fast glance at the Crowe-Paradis future medical piece clearly showed the right shoulder, the need for further MRI’s etc. Defense resorts to chicanery; I stand in truth. When my manager helped me up from the ground, heard my response to his question, “Are you ok?” and I said, “No, I’m not. I hit my head reallly really hard” the direction Grancell has taken this case is dubious, at best, but I don’t think Stewart reads much, and I suspect there is some serious CYA happening.
I got an EEG in 2012, because the adjuster threatened me that if I did not get one by March 30th, he would terminate my benefits. Defense likes to show that as an EEG of 2010, because of the doctor’s typo on the cover letter, which clearly references the 2012 evaluations and the actual EEGs show the 2012 dates. Obfuscation with intent to deny medical care has been continuous. That EEG was omitted repeatedly, moved around the medical index from 2012, to 2012, then separated and scattered about…. to ensure falsehoods of ‘pre-existing evidence of EEG’ had some plausible deniability to the staff’s writing reports for the doctors in question.
It took till 2014 for CNA to get an EEG for the 2012 brain injury, and then they refused to have a follow up, as recommended by the neurologist, to have a doctor review the EEG with medical records. I have spent more than $43,000 to survive the Wyndham WorkComp plan, and the only real progress I have made is my sheer will to survive, and the compensatory strategies I am learning at Coastline Acquired Brain Injury Program (since October 2014). Fellowship with other Brain Injury survivors is also very helpful in accepting this “new normal”…. everybody in my class is exceptionally intelligent, and we all have different struggles, depending on which brain lobes are involved. Based on my symptoms, all of lobes are involved. It’s not just that I get a little dizzy and some headaches, believe me, it’s not just that.
You see, if I had received medical care at the beginning, and as recommended and I was stuck with these cognitive deficits, I would shrug and say, ‘bummer, let’s work around it”…. but because I am a victim of what appears to be aggressive criminal conduct, with intent and success in causing permanent harm to my brain, for the profit of several/many people, not only do I have to fight to work around my cognitive impairments, I have fight to stay alive, and the legal stress and the financial stress are of some of the worst things that a Brain Injury Survivor can deal with.
In 2014, a structured settlement guy attempted to open lines of communication with the carrier toward settlement and/or mediation, I also asked both the 2 adjusters and current defense counsel to engage in mediation. I sense they threatened him because he never provided me with anything that looked like he had done anything to determine the numbers, and actually just relied on my guestimates. In a face to face meeting, he actually snarled at me and said, “THEY WILL NEVER TALK TO YOU.”
“Yikes, ok, Dude, chill. Nice to meet you, too.” was my reaction.
It was suggested that I do the math myself and propose a settlement number. I know they have computers to sort that out, and I gave it my best shot at $700,000, and after attending the SCRIPPS 9th Annual Brain Injury Conference in May 2014, where I learned of the long term risks involved in my injuries on top of current impairments, the estimated number rose to $1.3 million, also considering shortened life span from the initial fall, and the continuously shortening of my life due to the failures to have been provided with medical care, and all attempts at self-procured care interrupted with threats by the defense counsel.
My efforts were met with further insults to injuries. Not only did they just say “No”…. a representative from the Carrier actually called me, said he did not care that I haven’t received medical care for more than 2.5 years (at the time) and then asked, “So tell me, Linda, when ARE you going to die?” A while later, the defense attorney, in a politely framed but completely vile agenda suggested that since I am so challenged in dealing with the legal processes (pure chicanery in my book!) of Work Comp, that I consider a Court Appointed Conservator. Combined with the omission of medical records, false statements to doctors with intent to deny medical care, and causing permanent and irreparable brain damage to me, I have no interest in anything from them other than an immediate and reasonable settlement offer.
If you and Michael Dougherty, on behalf of Wyndham, pow-wow with the Wyndham agents, CNA and Grancell, perhaps you can encourage settlement or mediation. I have no reason to believe they will act in good faith, as they have not done so from the very beginning. Remember, they terminated benefits in April 2012 upon confirmed diagnosis of brain injury, which could be considered a criminal act. Yes, I know they can work around it. The truth is what it is regardless of lies surrounding it.
If I keep trying to edit this to make it shorter, I will keep adding to it.
In addition to the points of the earlier email, an extension to my leave so I can finish up at Coastline (last day of program for 2015 is December 10) I am hopeful that by then I can return to work with minimal accommodations, and if you’re willing, we can plan on a transition return to work while I am still at Coastline (full 2 week training, then back to 2-3 days at Coastline with 2-3 days on the sales floor, with an aim to be full time and well equipped for high season, starting December 14th-ish.
This is the longer version so that if you and Michael want to approach CNA and Grancell with a request for mediation, settlement and or claim audit, you have plenty to work with. [Ditto for any Civil Rights Litigation Firms!] You don’t have to be a lawyer to see the problems in this case. I wish I could speak like I can type, but I can’t. I used to be able to. My speech is improving, it is much slower, but as a sales person, I do my best to make it appear that I am being pensive and deliberate as I search for words and untangle my thoughts.
I will look for your response to the other issues at your earliest convenience. The vouchers will keep me going for a while. Thanks again, Tina, that gives me a spark of hope.