I know I’m going to get flamed for this blog post, but I have always committed to telling the story the way I see it.
I have taken on insurance companies and their executives, doctors and other medical vendors, attorneys and the legal profession.
Politicians of course haven’t escaped my vitriol, and employers also haven’t escaped criticism.
The only workers’ compensation population that hasn’t been met with cynicism has been injured workers.
There’s two sides to every story, as they say.
Most in the work injury protection schema do good deeds most of the time for most people. There are some times when things go awry, either intentionally or negligently. I get that. There are also laws and regulations that don’t work effectively, or have contraindications which contaminate too large a population. I get that too.
Workers’ compensation, or any form of work injury protection system, requires a lot of people to synchronize. Synchronicity is not easy. Sometimes the harmony goes awry. That’s how life is.
Recipients of system failures get a raw deal. Sometimes it’s corrected. Sometimes not. Sometimes the correction doesn’t meet the expectations of the recipient and other times it exceeds expectations.
Most move on, find their new paths in life and return some positive energy back to the world. They aren’t in the same place they were before injury, and certainly it’s a struggle to shift directions, particularly later in life and particularly if unprepared financially and emotionally for an alteration to the expected path.
The vast majority do move on, find positivity in life, strive to make the most out of it, and refuse to let life get in the way of living.
However, there’s a vociferous militant minority of the injured worker population who have made it their mission to inform the world of the injustices imparted on them by “the system” and all its nefarious participants.
They have ridiculed most all work comp sectors named above, but have spared me for the most part.
I’m sure that will change now.
Here’s my gripe: these unmodulated venters are all about negativity, and offer nothing to resolve either their own issues, or the issues facing the workers’ compensation institution.
These folks have taken to the immediacy and vast reach of the Internet to let the world know about the work injury commercial complex; how all of workers’ compensation is out to get them, and you too. They rail about injustice, and about conspiracy, profits, and ill will towards all.
They hijack award systems to claim, incorrectly and falsely, victory andacknowledgment.
But never, ever, is there a solution suggested, or any attempt to make a positive change.
Just victimization. You may not choose to BECOME a victim, but you do choose to REMAIN a victim…
You all know who I’m talking about. I know you’re upset at bloggers, at TPAs, and a whole host of other people connected to the work comp environment, and this is fueled by your personal experiences. I completely understand your emotions and what you believe in.
You have drawn ire from people in the industry, but it’s not because you are being vilified, or because they have a disdain for the injured worker with a voice, or any other malicious reason.
It is very simple – you offer nothing positive relative to change.
Anyone can complain. Few do anything to effectuate change.
Drawing attention to the negative does nothing to further the conversation, offers no solutions, provides no road map.
It’s easy to foment revolution, but revolution without offering a solution (and not nationalization of work comp or calling in the National Guard) simply ends with anarchy.
Some have gone as far as criticizing their own – people who are working hard at making changes in their own way. There is a visible injured worker population who are doing something POSITIVE. They have taken their rage, disgust, observations, and done something that helps others. It is long, it is tough, it is out of the ordinary – but it is effective, demonstrates a solution and one that will likely result in positive change as organizations review and study what is being done and then implementing it it their own systems.
It simply is not enough to complain. Everyone has a complaint. A complaint without a solution is bullshit. You may as well just dig a hole and hide because no one is going to pay attention.
Everyone knows that bad things happens in work comp and that there are profiteers off of the injured. That’s no secret.
So what are YOU going to do about it?
Working outside of the system, criticizing others, denigrating the institution, doesn’t help anyone, anywhere, and in fact makes one simply a militant.
The answer is to work WITH the system. Everyone does it in their own way. They work, and work hard, with other people that WANT to make a difference understanding that this is not a one person job; hell, it’s not even a job for a community, but a job for an industry of people.
Maybe I call them as I see them, but I also work with the top leaders to help with change.
It doesn’t happen quickly. Heck, sometimes it doesn’t happen at all.
But other than publish vicious attacks, why not study the system, study the law, the regulations, and PROPOSE solutions that a politician or regulator or chief executive, or any other leader can endorse and work with?
What has happened, through this militant virulence is that your credibility as an activist is suspect because you attack everyone (and I’m sure to end up on that attack list because of this post).
Here’s the deal: Too many people don’t want to assume the same level of responsibility that they presume for their rights.
If you want change then make change happen with action. Actually DO something POSITIVE. Blogging, calling others names, denigrating the institution – none of that matters.
What’s YOUR solution? How are YOU going to step up and BE change?
Just submitted an update to the good peeps at ProPublica. FYI: I love what you folks are doing! Amp it up! People are dying in the WorkComp Ghettos and Gulags in the USA and elsewhere. Here’s an update: Do YOU want outcomes like this for your WorkPlace Injuries? Guaranteed by CNA? Works for Wyndham–You Too? https://lnkd.in/b9Ubefq Full story here: ASK ABOUT WORKERS COMP GRAVY TRAINS https://lnkd.in/btH3gtS
……As part of our ongoing investigation, we invite you—whether you are an injured worker, claims adjuster, an employer or lawyer—to tell us about your experience navigating the workers’ comp system. Have something we should look into? Fill out the form below and we may be in touch. If you have an idea to fix workers’ comp, lower costs or help injured workers return to work, we’d love to hear that, too.
Who are you? * Employee Claims Adjuster/Insurance Employer Lawyer State Regulator Doctor/Medical Staff
What’s your workers’ comp story? *
Tell us about your experience with workers’ compensation.
What was injured? * Head Neck, Including Throat Trunk (chest, internal organs, back, pelvic region) Upper Extremities (shoulders, arms, hands, fingers) Lower Extremities (toes, knees, legs) Body Systems (nervous, respiratory, circular, gastrointestinal) Multiple Body Parts (two or more of the regions above) Other Body Parts (prosthetic, orthopedic) Nonclassifiable
Check all that apply.
Approximate date of injury
In what industry did the injury take place? *
Natural resources and mining
Trade, transportation, and utilities
Professional and business services
Education and health services
Leisure and hospitality
Were you (or was the employee) disabled? * Not disabled Temporarily Permanently
Was a claim filed? * Yes No
What is the status of the claim?
Name of employer
City where this happened *
State where this happened *
Is there anything else we should know?
A journalist may contact you for additional details about your story. We will never share your personal information or without your permission.
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Check below to receive email updates from ProPublica * for the workers’ compensation investigation only for all ProPublica’s major investigations for ProPublica’s daily newsletter
My Dear Fellow Americans — aka “The Unsuspecting Public” — yes, we were warned about all of it. How few listened? Well, what is, is. In the meantime, ASK ABOUT YOUR #RADIATION THIS WEEK. Start with CNN’s version of the number of nuke reactors near you – https://lnkd.in/b97tkSv Then, ask about #Radiation and #WorkComp and #Timeshares, just for a well rounded opinion… https://lnkd.in/bMvk4n8 Then, if you’re still ok with doing nothing/saying nothing about things, and silencing those who do, well
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]
From: Linda Ayres <email@example.com>
To: sreubens <firstname.lastname@example.org>
Cc: wynlinda <email@example.com>; lindaayres <firstname.lastname@example.org>; ReoLinda <email@example.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.
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:
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.
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
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.
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.
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.
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.
Stewart doesn’t want you to authorize any medical treatment, but he wants further evaluations at:
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.
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
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.
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?
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?
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.
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:
Send you the summarized spreadsheets for the way past due $27,000+
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)
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.
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.
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.
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From: Linda Ayres [mailto:firstname.lastname@example.org] 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.
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.
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.
To: Linda Ayres
Cc: Stewart Reubens
Cc: Stephen Buch
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:email@example.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
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To: Tina Jordan, Regional HR Director – Southern California Wyndham Vacation Ownership
Michael Dougherty, Director, Risk Management at Wyndham Worldwide
cc: Supplemental Stakeholders, including Shauna Chiappella, Senior Trial Attorney at CNA Insurance (thanks for viewing my profile on LinkedIn)
In response to Tina’s email of this morning, please note that Mediation proposed last year may be possible this year with HON. STEVEN SIEMERS, Retired WCJ of Oakland. Awaiting word. The big question is: DO THEY WANT TO SETTLE THE CASE OR ?????
Your email is quite hope dashing, as it indicates just more of the same abuse that I have experienced since the date of injury.
Tina, please tell how you misinterpret the following statement to mean I still held any hope of returning to work tomorrow:
“Let’s aim for 12/14/15 return to work, and please send me a job description to go with those accommodations forms you want filled out…. remember, there’s been no medical care, so wishin and hopin isn’t going to bring about changes.” The full email is below again for your convenience.
I am supposed to return to Coastline Acquired Brain Injury program in Newport Beach tomorrow, not Wyndham Worldwide – Palm Springs or Indio. I may have to reinstate a GoFundMe efforts in order to make that happen now, or just stay home. Remember, Social Security Administration is investigating the CNA allegations of monies paid to Injured Worker that were not received by the Injured Worker according to everybody’s records but CNA’s. That event may involve the State Controller and hopefully, finally, other authorities. It’s too complicated for me to sort out, so I have handed my files over and the experts can sort it out. The false or mis-statements statements by CNA have caused SSA extreme excess work to determine monies due to me for retroactive social security disability. False statements by Grancell have made it into the EDD records, all worthy of further investigations.
We’ll keep the aim on RETURN TO WORK FOR DECEMBER 2015, through the authorized extended leave through 12/14/15.
The apparent trickery and chicanery of your very polite letter below mis-stating the current status is very upsetting to me, and further illustrates nothing but more Wyndham bad faith to me. I received a similarly high-fructose email from Stewart on Friday…. filled with empty words.
It’s really quite the “circle jerk” isn’t it, and the circle includes more and more professionals every month.
Maybe you are too stressed with all the horrible events that have been happening at Wyndham -Southern California— what with spouses of managers committing suicide, another manager being arrested for…killing his wife?! then running off to a CABO timeshare???!!!!— and strokes and general discontent and fear and loathing on the sales floors? I’m hoping that the good people at ProPublica will add Wyndham’s WorkComp program to their series on The Demolition of Workers Compensation. You and Michael Dougherty have certainly helped Wyndham Worldwide to earn a place in their series.
If there is anything I can do to help make it easier for you to help me, please let me know. I would imagine you have a swath of injured workers, like me, also unprotected from the CNA WorkComp Carrier and it’s defense teams.
My apologies that the email of Friday below was so complex and confusing to you, Tina. We don’t have enough ducks lined up for return to work yet—a primary treating doctor, for starters, and the non-response from all stakeholders for weeks missed some deadlines. There are more issues in the email, and earlier ones you promised to respond to, but have not yet done so.
Stewart says it’s not his job and neither Fred nor I have been able to find a local doctor with brain injury expertise that accepts work comp insurance since December 2014, when the Orthopedic Surgeon gave up due to apparent threats of termination of referrals, and insistence that he change the well documented right shoulder injury to “non-industrial” after an MRI was authorized, finding severe tearing, and treatment with acupuncture was also authorized, ‘for the right shoulder only’ in late 2014. He firmed it up in his final December 2014 report, contrary to medical evidence in his possession, at, apparently, the threat of economic consequences to his office. Grancell has their own reports regarding that “body part” too. clearly identified in the Crowe-Paradis report of November 2012, when they attempted to “settle” for $100,000 less attorney fees….. and there’s more …dubious activities with intent to deny medical care. These issues will impact mediation, imho.
But, thanks for sending the forms. We’ll keep those forms handy for return to work still estimated on or about 12/14/15.
If you read the earlier email again, either here or on the web, you will see that I advised that I return to Coastline Acquired Brain Injury program tomorrow, 8/24/15, in Newport Beach since our collective efforts to find a primary treating doctor, organize mediation and trial return to work also failed again.
I made it clear to Stewart and the potential mediator that 8/24/15 was a serious deadline for either return to work or return to Coastline. Neither considered that and therefore mediation was aborted. They also made sure that my right to be seen by the Judge on this Petition for Order to Compel the ENT evaluation was delayed another many weeks. That’s not neutral, at all. Had their been disclosures by both parties that 8/24/15 was an impossiblity (although allegedly mediation takes a day, and cuts through Court delays, and we resumed the conversation regarding mediation in late June, I believe)
Your silence made the final decision, combined with the fact that there is no doctor to return me to work yet. Stewart says it’s not his job, and Fred and I have also failed to find someone. (Fred sent me the same ol’ defunct list that Daniel sent in 2012…. of doctors that haven’t accepted work comp patients for years; mercy, when will CNA update that bogus MPN list?)
As the unpaid leave was extended through December 14, 2015, that apparently gives us time to find a doctor, go to Court, file complaints, allow SSA time for their investigations, initiated interactive process and identify accommodations and then see where we end up.
If neutral mediation is possible, great; if there is no intention to settle, no surprise. Nothing changes when nothing changes.
We have received your emails expressing your interest in returning to work next week. As part of our ongoing interactive process and to allow us to determine your ability to return to work at this time, we need you to please provide the attached job description and medical release forms to a health care provider(s) who can verify your ability to perform the essential job functions of the sales representative job, with or without accommodation. If you require any accommodations, we ask that you please work with your health care provider(s) to complete the attached accommodation request form.
We also wanted to let you know that we are still open to participating in a mediation to resolve your workers’ compensation claims and any related issues. We will be providing some names of proposed mediators and are open to further suggestions from you.
From: lindaayres <firstname.lastname@example.org>
To: tina.jordan <email@example.com>; michael.dougherty <firstname.lastname@example.org>
Cc: Fred.sachs <Fred.email@example.com>; patricia.lee <firstname.lastname@example.org>; michael.dougherty <email@example.com>; workcomplinda <firstname.lastname@example.org>; scott.mixon <email@example.com>; wvoleavesupportcenter <firstname.lastname@example.org>; sreubens <email@example.com>; michael.grabell <firstname.lastname@example.org>; lindaayres <email@example.com>; kmall <firstname.lastname@example.org>; mary.falvey <email@example.com>; tina.jordan <firstname.lastname@example.org>; sreubens <email@example.com>; michael.dougherty <firstname.lastname@example.org>; christopher.petrosini <email@example.com>; fred.sachs <firstname.lastname@example.org>; tara.chmiel <email@example.com>; marybeth.stolworthy <firstname.lastname@example.org>
Sent: Fri, Aug 21, 2015 3:31 pm
Subject: Linda Ayres — doesn’t get to return to work yet, No PTP, No Medical Care, No Benefits… WTF Wyndham Alert! #CountOnMe
Dear Tina and Michael and Wyndham Leave Support:
Nobody got back to me about return to work for Monday, August 24, 2015, so I will resume Coastline Acquired Brain Injury program, as long as I can afford to. It would be nice since you have authorized CNA to continue to churn the file through year end without audit or interention, at least, if they could advance some estimated PD funds of approximately $25K to offset costs.
As you can see from Stewart’s email below, he says:
” I am unable to locate a PTP for you. If you locate one, please let us know the name and address of the doctor and his/her willingness to accept you as a workers Compensation Patient.”
Yeah, ain’t that been the story since 1/9/12!!! That sure is some WorkComp coverage. Remember, Daniel Elliott couldn’t find any doctors either, I had to find them thru Cigna EAP, then through the rollodex’s of those doctors.
I got mail today from Stewart that seemed to be rubbing it in that he somehow got the Judge to participate in the 3D – delay, denial, deceive churn deal again. Yes, there is apparently an ENT eval scheduled for November, and Court for October. Yawn.
Let’s aim for 12/14/15 return to work, and please send me a job description to go with those accommodations forms you want filled out…. remember, there’s been no medical care, so wishin and hopin isn’t going to bring about changes.
Conked on the head by falling backwards on ice…. and all related cognitive issues…. She seems to be self employed so she gets medical care early; had it not been for CNA and the bogus WorkComp policy, I would have seen legit doctors, got care, and possibly been back at work that first year. Y’all know that, but y’all keep letting CNA and Grancell harm me. Shame on you. Sounds like age, gender and disability discrimination, still.
I have been looking for a doctor, too. I would love to return to Dr. Gilbert Jaudy of the Jaudy Treatment Center in Palm Desert, the best doctor I have seen for TBI, self-procured in 2012. Kim threatened him to cease and desist treating (like she did to most of my doctors!) and Dr. Jaudy does not take work comp insurance. They could have me back to work for sure, in pretty good shape, by December. Talk to CNA, would you please.
Oh, I found another group that might help since mediation was such a bust. You can find them on LinkedIn… John Kallas “The WorkComp Employee Assistance Program, The Alternative to Litigation, workcompeap.com” They are in Mission Viejo and won’t work me or Stewart, they only work upon request from the employer. Here’s the website: http://www.smartcompinsurance.com/ LOOK AT THIS, PRETTY PLEASE: http://www.smartcompinsurance.com/injured/worker.aspx It’s worth a try?
CNA has certainly been useless to everybody but themselves and Grancell’s law firm, huh? Jump in Tina and Michael, let’s wrap this up?
Oh oh…. funny story I have to tell all of you. As I was reading the EDD notes, they allege that “20% of my brain injury is from a prior brain injury”…. I have been puzzling over that since the only people who say I have a prior brain injury are Kim Mall and Stewart Reubens of Grancell, and that got 3 doctors to write it in their reports. Thing is, there’s no medical evidence nor have I ever been treated for a brain injury before. And Wyndham certainly didn’t hire me and put me on special projects because I had an attitude problem, or any cognitive failures. You can certainly check with managers whom I helped with their reports, and even making new people feel welcome and oriented was always my standard behavior. But anyhow, since Kim and Stewart make stuff up all the time, and repeat it, and it gets into records, here’s what I think is going on.
While I wrote down every time on the intake form of all the nearly 40 doctors I’ve been evaluated by in the previous accidents field:
1993 – car collision and 2008 car collision. Now, in 1993, I was treated by an Orthopedic Surgeon and a Chiropractor. In 2008, I was treated by …. get ready for this, it’s almost funny…. a Hand Surgeon and a PODIATRIST. Seriously. Now, none of these 4 doctors ever said, suggested or treated for a brain injury, nor did they send me to any brain injury doctors. Now, fast forward to 2012, I have been “treated” with chiropractic and acupuncture for a well diagnosed brain injury, and in 2014 I got a few speech therapy and occupational therapy sessions. In 2012 I got a few sessions (thanks to EAP!) with a clinical psychologist and in 2014, Dr. Hilda, a brain injury expert, agreed to treat me, but Kim Mall wanted more evaluations to go with it. Boy oh Boy, Dr. Hilda know’s her brain stuff and helped me see just how …. hopeless recovery is since I didn’t get early treatment.
Don’t you think it’s odd that the deception by Kim Mall and Stewart Reubens about a prior brain injury made it to the QME/AME reports, suggesting “20 %” of my current issues are based on previous brain injury? I still think it smacks of “felony fraud’ but what I know, I have a head injury, huh?
I only noticed the EDD remarks because there is great confusion at the government agencies about just how much CNA paid in disability benefits. While they say they paid 104 weeks, they really paid the injured worker (me) approximately 64 weeks by May 2014, then a bit more. There’s confusion as to the total amount the paid to me….whether they should have paid (104 weeks x $649.41 or 652.15) which would have been $67,538.64 or $67,823.60. The subsequent 52 weeks of EDD that should have followed (but CNA apparently “always” (per Daniel Elliott) costs shifts to the State and refused to pay TTD, so the State pays it, and if CNA has to pay it back, it gets highly discount; highly complicated) Anyhow, had the law been honored, EDD would have paid in the 3rd set of 52 weeks approximatley $1928/mo, or $23,136. Now, EDD paid ME it looks like $47922.00 (but earlier records said $49k, but they might be holding out for a lien of $1,500) EDD records that talk about “80% of the brain injury being industrial” indicate CNA paid ME $47,252.31 and paid EDD $31,400 (Kim Mall apparently negotiated that deal with them). A Judge said the difference was not my money, so the Taxpayers took a hit on that CNA profit. But, from the sheets Fred Sachs sent me about money then sent me, it add up to about 54 weeks, for a total of $35,106.50. Maybe Fred and Stewart can see that I get a corrected copy? There is also an issue that I have been allegedly receiving monthly payments of over $4,000 from CNA? Wow, where is that money going? It sure doesn’t come to me. YOU know I HAD TO GET HELP FROM THE SALVATION TO KEEP MY LIGHTS ON!
CNA alleges in some of the paper work that they have paid me $42,899.12, or $82,092.04 or $87,422.04. AS OF 7/3/13 I HAVE A STATEMENT FROM CNA THAT THEY HAD PAID ME TO DATE $22,118.00 AND BY 2/2/14 THEY HAD PAID ME A TOTAL OF $42,899.12. SSA is working real hard to sort out the shell game.
I can hardly count since the brain injury let alone figure out a shell game. The Social Security Administration is trying to sort it all out. I suspect the State Controller will need to be involved – again.
Hey, good news, ProPublic Chairman Paul Steiger actually looked at my LinkedIn profile today. (Blushing!) Or someone from his office. I sent an inmail suggesting further exploration of the Wyndham WorkComp fiasco, of which my story is not at all unusual. I also also told him I intend to nominate MIchael Grabell, ProPublica Investigative Reporter who did The Demolition of Workers Compensation series — I plan to nominate Michael for the WorkCompCentral CompLaude Awards (You may recall, last year, I was one of four finalists in the Injured Worker Category.) Sorry, nobody with Wyndham, CNA or Grancell gets my nomination this year; maybe next year in a ‘vastly improved or rehabilitated WorkCompster category.) BTW, LinkedIn Profiles are soooooooooooo important and I see that most of you are pretty… how do I say, “social media illterates”….. so, maybe a position can be created for me to help Wyndham Executives. Tina, If I may use part of your profile as a little example? Tina Jordan
Goodness! Almost looks like you are moonlighting with Hilton? You’re probably not the only Wyndham Worker with such faux pax; fix it, and you’ll be fine. Michael Dougherty’s profile looks like he and Stewart Reubens are in hard-core collusion, worthy of federal investigations. I laugh every time I look at it. ROTFLMAO! Guys, I hope you get to “share a cell!”
Shareholder/branch manager at Grancell, Lebovitz, stander Reubens & Thomas
I have worked with Michael for quite a while now. Since the time I have worked with him, he has successfully moved his program from its prior claims administrator to its present Third Party Administrator. In addition, Wyndham has continued to expand its business which includes aquiring other companies. This requires the integration of the new businesses into his existing program. This has been accomplished in an admirable fashion.
Not many states can boast the complexity, frequency and severity of Workers Compensation like California. I think Michael’s grasp on the California system through its many iterations as well as his knowledge of Workers’ Compensation in other states has truly benefited his employer in his ability to strategize, collaborate and manage the entire program.
Michael’s ability to work with all partners in his program and draw on their skills especially in complex cases is key in management and expeditious claim resolution.
Please let me know by 330 if Dr Reichardt has been paid and if he can be the Primary Treating Doctor, effective imediately. He has, as I have told you before, brain injury experience with professional athletes.
So, you can’t find a PTP that takes work comp insurance with Brain Injury expertise nor can I.
Who can release me to trial return to work then? An ENT? We have hearing aid doctors in my rural town. Will a note of trial release to work be satisfied by such a doctor? Please let me know and I’ll see if I can get an appointment. How about a chiropractor note? A chiropractor was the first doctor to schedule me out.
If fred has paid Dr Reichardt past due bills of more than $2.000, he might do it. He has served as a QME…. He did tell me he would be willing to be my PTP. Shall I ask him today? I have an appointment at 330?
If you can approve him, then have Tina send the forms necessary for return to work, or if a note will do,,. We can aim for August 24th since I obviously cannot return to Coastline without your help?
The only accommodation I will request is the Palm Springs office after trAining and a lumbar support chair, like they provide at Coastline for those of us with Orthopedic issues and Brain Injuries.
I hope Dr Reichardt is still willing and if so, if he might be willing to authoriize a trial return to work despite medical evidence to the contrary. He is a very optimistic doctor, and could probably teach Tony Robbins a thing or two! 🙂
When is the next local Wyndham training?
I can adjust start date to accommodate. Like if its next week or early Sept too. As I told you, I’m not going to the Salvation Army to keep my utilities and home again. Ever.
I will also check with some of the LinkedIn litigation and brain injury groups and ask for support, describing briefly how CNA has had no one for over 3.5 years and just can’t find one now either so CNA, by counsel suggestion, hopes to rely on an Ear Nose and Throat doctor…as perhaps better than an An Orthopedic surgeon for managing brain injury issues.
Churn churn Churn….
Your recollection and assessments are incorrect.
This is not the first incident of WCAB favoring Defense. It goes to Kim…..in apparent collusion with the I and A officer, giving the Judges incomplete info in order to set the Judges up, too. Tsk tsk tsk. What a web.
Its amazing what y’all can get away with, isn’t it?
WCAB denied my ADA accommodations request about ths Order to Compel, then I screamed and they approved it, changed the date, then cancelled the hearing in your favor denying me due process…again. A pattern and practice of WCAB Riverside. My DOJ complints are being updated to reflect this new act of ADA violations and request for further investigations. I have yet to be heard in over 3.5 years by a Judge re my right to medical care. Surely some decent political rep may find that at least –odd if not alarming.
Ms. Snyder’s failure to disclose her conflict of dates to commence mediation, in light of my clearly expressed timeline/deadline was the issue. Her act seems quite self-serving and un-neutral.
I apologize to you for believing I had found someone we could both work with. I understand her crowd is defense based but I believed she could be neutral. Apparently, I was wrong.
I’m in timeshare sales, I value vacations for others also. I despise peeps who live by harming others “profits before lives”…… Had she disclosed she could not meet the 8/24/15 deadline, you and I could have made a decision. Sounds like you and she decided without me. That’s not neutral.
There are two Judges that may be willing to mediate….I think it is Judge Vittoe and the other one Snyder mentioned in Newport Beach.
I will put out another request for another mediator list via LinkedIn, describing the difficulties we are having find a neutral party. I found an association of mediators on LinkedIn.
I’ll just keep blogging..I want help David find some decent people to acknowledge at the WorkComp Laude event. No easy task and he shouldn’t have to do it alone.
Who has been Naughty or Nice in the Mega Billion Dollar “PROFITS BEFORE LIVES” #WorkComp Industries? David DePaolo, you take the NICE LIST, Injured Workers will deal with the NAUGHTY LIST. “Let’s get right to it!” (Poll included below; voting practice!)
As you know, the fabulous #WorkCompCentral annual #CompLaude Awards is coming up, and their team is counting on YOU to discover and nominate some of the best of the best in the field of Workers Compensation.
This year, it is a national event, with, we hear, a touch of international flair with a keynote speaker. Perhaps next year the Awards Nominations will expand even future, to including all nations. For those in the industry who may be challenged to understand the meaning of “on or before August 31, 2015“ (as was the case in a recently aborted mediation effort) what it means is NOT AFTER AUGUST 31, 2015.
KISS! Here’s the link to the Nomination site; make your nominations on or before August 31,2015. PARTICIPATE. FIND THE GOOD PEEPS IN WORKCOMP, NOMINATE THEM, ACKNOWLEDGE THEM, AND STRENGTHEN THEIR HANDS. My PUBLIC Acknowledgement list follows soon to confirm that yes, I have met some fine, decent people in my fight to survive WorkComp Terrorism and Chicanery as an Injured, now Permanently Disabled Older American Female Worker since 1/9/12….from that, nominations will be submitted to the WorkCompCentral team BY OR BEFORE AUGUST 31, 2015.
In WorkComp, as is Life, identification of problems is a first step in establishing solutions.
In addition to the ‘problems” identified in the InjuredWorkerBlog, #IWblog, ASK ABOUT WORKERS COMP GRAVY TRAINS, another way of looking at the content might be as a suggestion to ASK ABOUT WORKERS COMP CORRUPTION AND SKULLDUGGERY. In more than 3.5 years, no agency or institution or law firm or organization has been found to be qualified, able and willing step up to the plate and cause resolution and settlement of the tragic handling of California Workers Case, Linda Ayres Vs. Wyndham Worldwide, ADJ8181903. So it is.
Since there are unlikely to be any investigations of the deviant handling and skulduggery involved in this case by the District Attorney, the FBI, the Department of Justice, the Department of Insurance, the Department of Labor— best possible next action seems to be to just create a DNN LIST — DO NOT NOMINATE — for CompLaude Awards, Best Companies, Best this or That—-pending further investigations by an organization such as ProPublic and NPR, the facilitators of THE DEMOLITION OF WORKERS COMPENSATION.
Watch for the #WorkComp #DNN List …. coming soon:
Medical Comp DNN
Legal Comp DNN
Comp Bloggers DNN
Individual Comp DNN
Injured Worker Comp DNN
Leadership Comp DNN
Employer Comp DNN
Service Comp DNN
WorkComp Commissioners and Judges DNN
Law Enforcement Agencies DNN
International Recognitions DNN
With a special category to also include WorkCompsters- #SMFH
Through a sifting/filtering process, then this Injured Worker can get right to the NOMINATIONS FOR THE 2015 WORKCOMP CENTRAL #CompLaude Awards. David DePaolo gets big kudos for creating such a valiant national effort. I really do have several nominations to submit. It’s been a busy month, dodging Rads, and dealing with frivolous orders to compel, and more financial chicanery and terrorism. Watch for the DNN List…. It may Annoy or it may Inspire and Surprise!
Thanks to Medicare and the 3.5 years of WorkComp delay, deny, deceive, I have some legitimate doctor appointments this week! Thanks for reading and sharing. More follows very soon! You’ll appreciate the DNN list, too.
Oh Oh… PS…. If you have never taken a look at the ASK ABOUT WORKERS COMP GRAVY TRAINS blog page of RESOURCES, CHECK IT OUT. It includes some of my favorite peeps and services and providers. It will be revised to include others. Will you be listed on the “Naughty or Nice List”…
“The U.S. Attorney’s Office for Northern California expects to prosecute an applicants’ attorney for his role in a scheme involving an allegedly corrupt union boss, kickbacks for client referrals, banking violations, laundering proceeds from medical marijuana dispensaries, tax fraud schemes and even the infamous Hells Angels, according to documents unsealed Wednesday by the U.S. District Court for Northern California.”
The above picture is from the 2014 CompLaude Gala — yes, I was privileged to attend, as one of four InjuredWorker Nominated Finalists.
Yes, I took plenty of “heat” from the InjuredWorker community for attending. I arrived early, and met many of the exhibitors, and even attempted to maintain contact with some.
We apparently scare them apparently as much as they can scare us. ‘Can’t we all just get along? You could be next in the casualties of the mega billion dollar profitable WorkComp industries in America.’ We gotta convince them to change the business model from “Profits Before Lives” to something more Millenial Friendly, wouldn’t you agree?
NOW IS THE TIME FOR ALL PEOPLE OF GOODWILL TO COME TO THE AID OF HUMANITY.
Last year, the brilliant WorkCompCentral CompLaude event was California nominees only.
THIS YEAR, #WorkCompCentral has opened it to national nominations. Next year —-perhaps will be the first international Comp Laude Awards — as our neighbors are experiencing the same tragic mis-handling of work place injuries as we are.
The Canadian, Australian and UK injured workers seem to have more of a pro-active fight against the bad stuff on social media and in the Courts, whereas the majority of industry peeps AND Injured Americans appear to be addicted and practicing learned helplessness at the hands of the not-so-nice perpetrators of the industry. It’s time for change.
FIND THOSE WORKING TO MAKE WORK COMP A SAFER SYSTEM FOR INJURED WORKERS EVERYWHERE, AND STRENGTHEN THEIR HANDS! IF NOT YOU, THEN WHO? IF NOT NOW, THEN WHEN?
By the way, if any Injured Workers are interested in gathering there, with an Exhibit Table so they can see that we are human, and their industry failures have life and death consequences to real human beings, let me know know also by 8/31/15 and we’ll see what we can pull together.
Maybe my employer, Wyndham Worldwide, or it’s WorkComp Carrier, CNA, or their Defense Firm, Grancell Stander Reubens Thomas Kinsey will buy a booth and a table for an eclectic group of Injured Workers to facilitate participation? My injury happened 1/9/12 —- TBI — and you know how that’s going. You too, huh?
Well, if we cannot attend the gala, we can certainly #OccupyVirtually — lots of pictures and tweeting happen at the all day event!
MARK YOUR CALENDAR; SATURDAY, DECEMBER 5, 2015. SAVE THE DATE.
Description of Comp Laude™ Awards Nomination Categories
The following five categories are restricted to INDIVIDUAL (PERSON) NOMINATIONS:
Medical Comp Laude – can be a physician, a surgeon, a nurse, a physical therapist, a pain management specialist, acupuncturist, chiropractor, etc. Anyone with a professional designation in the MEDICAL field.
Legal Comp Laude – a Judge / judicial officer, applicants’ attorney, defense attorney, etc. Anyone with a professional designation in the LEGAL field.
Individual Comp Laude – Any individual (person) who is not a medical or legal professional but carries some designation as a workers’ comp professional; i.e. a Risk Manager, Human Resources Manager, Hearing Rep, Lien Rep, Safety Coordinator; Occupational Specialist; claims adjuster; RTW / SAW coordinator; bill reviewer; etc. Anyone with a professional designation in the workers’ compensation industry that is not in the medical or legal profession.
Injured Worker Comp Laude – Any individual who has been injured on the job.
Leadership Comp Laude – Any person who is considered an industry mentor / expert professional / speaker / educator / presenter.
The following two categories are restricted to COMPANY NOMINATIONS:
Employer Comp Laude – A public or private employer company.
Service Comp Laude – Any company that provides services related to the workers’ compensation industry: legal firm, managed care company; insurance carrier; medical practice (physician group, nurse case management, physical therapy); Pharmacy Benefit Management (PBM); Third Party Administrator (TPA); Medical Bill Review Services; Medical Supplies; language / translation; copy services, etc.
Thank you for your interest in the Comp Laude™ Awards!
Before you can make a nomination, WorkCompCentral asks that you login to their website and create an account. Just do it. If you have survived WorkComp, then you survive another login account and passcode. Remember, nominations are due by 8/31/15…. and you have to name people, and write something nice about them on the nomination form. Start thinking, thanks.
MEDICAL COMP LAUDE
LEGAL COMP LAUDE
INDIVIDUAL COMP LAUDE
INJURED WORKER COMP LAUDE
LEADERSHIP COMP LAUDE
Employer Comp Laude
Service Comp Laude
THINK LOCALLY * ACT GLOBALLY * OCCUPY VIRTUALLY
This has been a PSA-Public Service Message to/for/and on behalf of Injured Workers Everywhere!
A Friend recently wrote this about the years I have been fighting #WorkCompsters:
“…But their 1st choice is to kick it down the road, and make your life miserable. They’ve already done that. You have quite a trail of deceit etc. to tell at court. The trouble with judges is that they come from the legal profession. I’m back to thinking that they don’t want to go to trial. Even if they get a positive determination ~ you can appeal. And they’d like you to go away….”
CHANGE OF HEARING DATE — AGAIN – CHURN BABY CHURN – ORDER TO COMPEL ENT EVAL FOR TBI! D’OH PLUS DOCTOR SHOPPING FOR YET ANOTHER NEURO-PSYCH EVAL…. TILL YOU GET ONE TO AGREE WITH O’BRIEN? LOL….. He may have been off his meds, ya think?
Last year Fred suggested I come up with a proposal for you both. I researched and worked very hard on the calculations that I sent to both of you and the number I came up with was $1.3 million, in an acceptable structured settlement format, full complete release.
If I recall, you laughed and insisted on the same number Kim offered in Nov 2012—the standard cost of life for an injured worker in lieu of medical care ala Romano Trust vs Sedgwick—$100,000.
When Steve Chapman was involved with Dan Elliott to initiate conversations on settlement in early 2014, the number taken from my pre-SCRIPPS calculations was $700k.
What I have learned about my untreated brain injuries, risk of epilepsy, dementia and shortened life span, along with inability to work and devastating cognitive impairments…is not pretty. Your clients have effectively destroyed my life.
If there had been good faith efforts to help me get medical care and these were the results, that would be one sad story that I would have to just deal with. The abuse I have been subjected to that has caused permanent and irreparable harm is another story all together.
Make me an offer I can’t refuse.
I would imagine Steve Chapman could use his computers to do some “transparent calculations. I don’t like him and he doesn’t like me…but he may indeed do the right thing. Give him a call.
He won’t waste any more of his time time…He didn’t seem to think mediation would happen either.
I can be a reasonable woman, or not.
Tired of Fighting, but will fight till my last gasps, if necessary.
Thursday, August 13, 2015 11:57 AM
Thu, Aug 13, 2015 11:33 am
Due to the upcoming hearing, we canceled Dr. Smith’s examination date
We will be rescheduling both appointment dates for a time after the October hearing
Thu, Aug 13, 2015 1:00 pm
RE: Change of hearing date
Thu, Aug 13, 2015 2:02 pm
Churn churn Churn….
…..Your recollection and assessments are incorrect.
This is not the first incident of WCAB favoring Defense. It goes [back] to Kim [in December 2012]…..in apparent collusion with the I and A officer, giving the Judges incomplete info in order to set the Judges up, too. Tsk tsk tsk. What a web.
Its amazing what y’all can get away with, isn’t it?
WCAB denied my ADA accommodations request about this Order to Compel, then I screamed and they approved it, changed the date, then cancelled the hearing in your favor denying me due process…again. A pattern and practice of WCAB Riverside. My DOJ complaints are being updated to reflect this new act of ADA violations and request for further investigations. I have yet to be heard in over 3.5 years by a Judge re my right to medical care. [You know, that pesky little issue that’s part of the Labor Code?] Surely some decent political rep may find that at least –odd if not alarming.
[The selected mediator’s] failure to disclose her conflict of dates to commence mediation, in light of my clearly expressed timeline/deadline was the issue. Her act seems quite self-serving and un-neutral. I apologize to you for believing I had found someone we could both work with. I understand her crowd is defense based but I believed she could be neutral. Apparently, I was wrong.
[You might be right, though. I suppose I could have responded to the September 21, 2015 proposed date the two of you agreed on after you wasted several more weeks since mediation was proposed this year, with a concise, ‘WHAT PART OF “BY OR BEFORE AUGUST 24, 2015 or maybe next year” WAS UNCLEAR?’
Was I unclear also that withdrawal of the Petition for Order to Compel and ENT evaluations for a TBI, along with excessive additional doctor shopping neuro-psych eval petition was necessary, or that the 8/25/15 date would stand for due process and my right to get in front of a Judge, and that mediation to participate in further 3D practices and file churning by Defense—is not my idea of NEUTRAL MEDIATION?
Lookie here what happens…. Defense Wins Again…at the expense of another Injured Worker. (It’s no wonder there’s just a small community of mediators, huh? Just an arm of the Defense and WCAB? Thanks Mediator and Judge Hill! )
Silly me, brain injury can make communication real tough, huh? I did suggest that advance estimated PD or payment of lodging to facilitate continued participation at Coastline Acquired Brain Injury Program in Newport Beach, which commences August 24, 2015, be mediated, to no avail.]
I’m in timeshare sales, I value vacations for others also. I despise peeps who live by harming others “profits before lives”…… Had she disclosed she could not meet the 8/24/15 deadline, you and I could have made a decision. Sounds like you and she decided without me. That’s not neutral.
There are two Judges that may be willing to mediate….I think it is Judge [ ] and the other one [the mediator] mentioned in Newport Beach.
I will put out another request for another mediator list via LinkedIn, describing the difficulties we are having find a neutral party. I found an association of mediators on LinkedIn.
I’ll just keep blogging..I want to help David find some decent people to acknowledge at the WorkComp Laude* event. No easy task and he shouldn’t have to do it alone.
Linda Ayres, In Pro Per
FYI– SOS sent out on LinkedIn yesterday — For What It’s Worth!
“…I am unable to locate a PTP for you. If you locate one, please let us know the name and address of the doctor and his/her willingness to accept you as a workers Compensation Patient…” Please refer to Labor Code and Constitution of the United States of America…