Thank you for taking the time to nominate someone for a Comp Laude™ Award!
Please review the information you have provided:
Nominee type: person
First name: Peter M.
Last name: Schaeffer, Esq.
Employer: The Law Offices of Dr. Peter M. Schaeffer – Riverside – Temecula – Palm Springs
Category: Legal Comp Laude
Years known: 1 year or less
Dr. Peter has had a successful career “Workers Compensation & Employment Lawyer helping injured workers get the treatment they need & the money they deserve !” nearly 20 years. With a compassionate private outreach to a struggling Injured Worker via social media; Dr. Peter granted permission for Injured Worker to use the private message in the Injured Worker’s internationally reaching blog – on the January 1, 2015 first blog of the year issue. “DISAPPOINTMENT AND FRUSTRATION WITH THE WORK COMP SYSTEM” — written in such a manner as to appeal not only to Injured Workers, but to other attorneys in the fields, excerpted below: “Good Morning: I truly feel your disappointment and frustration with the work comp system. When I began doing WC almost 20 years ago it was a rather fair system for injured workers but was being abused by a few scammers and unethical doctors and chiropractors who operated mill type clinics screwing the insurance companies at every turn… they knew how to play the system….” The entire blog can be read here: https://askaboutworkerscompgravytrains.com/2015/01/01/disappointment-and-frustration-with-the-work-comp-system/, Thank you, again, Dr. Peter, on behalf of Injured Workers Everywhere!
Dr. Peter has facilitated and encouraged discussions regarding opportunities regarding interviewing doctors who have also left the industry, and opportunities to interview and gather information for further discussions in social media, with aim and intent toward positive change. May the suggestion be followed by other industry leaders with large memberships–including but not limited to the CAAA.
Successfully convinced the Injured Worker that yet another person of goodwill had been discovered within the confines of the Workers Comp legal system, one willing to courageously speak up and out, with intentions to save lives and facilitate corrective changes and more positive outcomes for injured workers everywhere.
Successfully encouraged Injured Worker to not lose hope to fear or discouragement by periodic LinkedIn inmails and profile views, giving tangible evidence that InjuredWorkers are not alone.
Dr. Peter is in that small group of kind, compassionate and intelligent attorneys who did not apparently slide into the dark side for the devasating “profits before lives” business model; In fact, it’s likely that he has successfully applied the well known principles of Napoleon Hill and THINK AND GROW RICH.
Why this nominee deserves a Comp Laude™ Award:
Dr. Peter is most deserving of a CompLaude Award for Legal, Individual, Leadership categories by the very act of compassion, understanding, and will to good, along with the courage to reach out and connect with a non-client Injured Worker. Dr. Peter’s long term experience in the industry enables him to clearly state the known issues, and fairly concludes that “the system Sucks !” not only clients but doctors, and co-workers. Dr. Peter indicates his clear belief that “Fair play and due process died in California with the passage of SB 863.”
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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How did I know that Coastline ABI Program was for me? There was No Place Left to Go! #WorkComp is not an Exclusive Remedy. #WorkComp is NO REMEDY AT ALL!
“In describing this class of traumatic brain injury”, says Asvar, “the term ‘mild’ is an absolute misnomer given the severity of possible complications and repercussions.” He adds, “Dismissing someone’s brain injury as ‘mild’ is akin to saying someone is ‘mildly’ paraplegic.” Chris Asvar, Esq. http://www.asvarlaw.com/casestudies/
Upon diagnosis of my brain injury, insurance benefits were cut off and all hope for medical care was dashed. After more than 2.5 years of muddling along on the California Worker’s Compensation and legal chicanery program of rest and wait and wait and wait, essentially without medical care and only sporadic ‘benefits’ and some assistance from The Salvation Army– my search for help became more diligent. A graduate of Coastline ABI, 16+ years post-injury, told me to ‘Get to Coastline, by any means necessary, immediately.’ That encounter was May 2014; by October 2014, I was gratefully enrolled in the Coastline ABI Program.
As another ‘High IQ TBI Survivor’ and based on my early research upon diagnosis, I discovered it was indicated how important interdisciplinary teamwork and treatment was for mitigating impairments that result from brain injury, since the brain is the Master Control Center.
Doctors recommended evaluations in the fields of neurology, neuro-optometry, orthopedic and MRI’s (basic and with a TBI protocol) and suggested chiropractic, acupuncture, vision, occupational and physical therapy, speech therapy with cognitive remediation, creating a ‘structured schedule’ and rest and wait and wait and wait.
The 8th largest insurance provider of the world’s largest hospitality company and their defense firm simply said no. My employer failed to intervene, the defense firm has used every means necessary to obfuscate facts and deny medical care. The carrier said they did not care that I had not received any medical care and in fact, their fraud department representative had the audacity to call on the phone and ask, ‘….So tell me, Linda, when ARE you going to die?’ (A medicated injured worker could be pushed over the edge by such a vile attack; a non-medicated injured worker might be inclined to FIGHT BACK. I am such a non-medicated Brain Injury Survivor.)
The insurance carrier failed repeatedly to provide the recommended evals and treatments, so I read the reports and began to search out the right team of doctors, without help, and without insurance benefits, as my employee health insurance had expired, and return to work has been impossible to date. Perseverance is different from PERSEVERATING.
When I found a very knowledgeable neuro-psychologist, very familiar with head injuries, light began to glimmer down the tunnel. I obtained an MRI with a TBI protocol, and met with a terrific neurologist/psychiatrist at Scripps – Encinitas. His primary recommendation was “Embrace the New You” and when I sighed and whispered, “But I don’t know who she is, and she’s is not as fast or as smart as I used to be. They may have to rehabilitate me to become a neuro-scientist!”
WorkComp neurologists (2) suggested a) over the counter analgesics and b) that a woman over 35 with a closed head injury does not need any treatment, particularly since none was provided in the first 2 years. The WorkComp forensic psychiatrist, to support false allegations in order to deny medical care, also moved the date of injury from January 2012 to January 2013 in the report, and used medical records from 2012 to allege ‘pre-existing conditions.’ (These 3 doctors give a grave appearance of felony fraud, at the beckoning of the defense counsel, but that’s for another blog….and for the Department of Justice, perhaps. They were paid handsomely for their reports and supplemental reports (supplemental reports necessary due to the pattern and practice by defense of omitting approximately 300 pages of medical evidence to ‘defend’ the claim.)
The good and private (non WorkComp) neurologist recommended 3-6 months at the SCRIPPS Brain Injury Day Treatment Center or any of the various excellent programs that offer an interdisciplinary approach that includes speech, occupational and physical therapy. The insurance company agreed to 16 days, with an appeal for 8 more, then terminated the help. Granted, such help is most beneficial in the first months or years, and ‘RESTORATIVE” strategies seem limited so late in the ‘recovery game.’ That was more than 2.5 years post-injury.
In response to my suggestion that I may have to be rehabilitated and trained as a neuro-scientist, the Doctor quietly said that the full day 9th Annual Scripps Brain Injury Symposium was happening the following weekend, and that the audience is primarily doctors, military personnel, and other providers from interdisciplinary teams. He said I was welcome to attend. I attended. I met some brilliant and wonderful experts in the field of Brain Injury and Rehabilation from the medical and military and scientific communities. I also met a graduate of Coastline Acquired Brain Injury Program, who shared his journey, and encouraged me to get to Coastline, by any means necessary.
“Dismissing someone’s brain injury as ‘mild’ is akin to saying someone is ‘mildly’ paraplegic.” – Asvar
While my employer has failed to provide medically necessary treatments, and has failed to intervene in the egregious breaches of fiduciary responsibilities to provide care and rehabilitation for a witnessed slip and fall backwards on ice in Big Bear, California, they did extend an employee discount so that I could stay in a Wyndham Worldwide Ramada Inn, with a wonderful, warm and welcoming staff, who seriously practice the Wyndham corporate policy of CountOnMe practices.
#InjuredWorkersUniting #SilentNoMore …… the Compensatory vs. Restorative Strategies facilitated by the outstanding staff at Coastline is unparalleled. “I’ll be back!”
If you are an Injured Worker and you are not following all of these blogs, and commenting as you can, you’re not doing enough. Let’s go. Add the names of others you have discovered…. after all,
WE ARE THE MEDIA NOW….
LexisNexis Shazaaaaam….. What a list! FOLLOW THESE BLOGS! Comment regularly…and as succinctly as possible….. and share their valuable posts in your own groups here and there…and create more InjuredWorker Advocate and Support and Networking groups, here and there….
lexisnexis.com•The LexisNexis Legal Newsroom Workers’ Compensation has selected its 2014 honorees for the Top Blogs for Workers’ Compensation and Workplace Issues. Congratulations to all the honorees! As 2014 winds down, the LexisNexis Legal Newsroom Workers’…
ARE YOU AN INJURED WORKER WITH A STORY AND A BLOG? LET’S SEE THOSE LINKS! LET’S START WITH THE USA, CANADA, UK, AND AUSTRALIA…. If we build the list, the blogs will come….Afterall, WE ARE THE MEDIA NOW.
Most of us are familiar with the #Top 25 Workers Comp Industry blogs…
It’s time to identify and support the TOP50 WorkersComp blogs by and for Injured Workers, globally.
Eventually, the two lists may become one.
You may have attorneys telling you to Stay Outta Social Media…. Ask yourself who that serves? Hint: FOLLOW THE MONEY TRAIL. In the USA, the First Amendment is Still in Place…. and the only way the atrocities can continue is by keeping their dirty secrets.
WE ARE THE MEDIA NOW….. Let’s organize a preliminary list by July 4, 2015….. If you have a networking group on LinkedIn, share that. If you have groups in other social media platforms, share that.
INDUSTRY PEOPLE OF GOODWILL WELCOME; INDUSTRY PSYCHOPATHS WILL NOT BE TOLERATED. In fact, they may be added to the list of misfits for a December expose.
Group preliminary description: This group intends to identify the TOP 50 #WorkersComp blogs BY InjuredWorkers, globally. This group intends to identify and support social media efforts to bring light to the darkened places of WorkersCompensation atrocities. This group intends to develop a Speakers Bureau for Injured Workers willing and able to speak to industry groups at the many fancy conferences held around the world.
WE ARE THE MEDIA NOW
* EXPECT US BY JUNE * JOIN US
This group also intends to identify each December, for possible ‘rehabilitation’ and/or investigations and possible indictments– some of the worst of the worst offenders/participants in the WorkComp Gravy Trains, harming injured workers everyone based on a business model of PROFITS BEFORE LIVES.
Tell your story to your friends and neighbors, create a blog and join the #CommitteesOfBloggers for Positive Change and Restitution efforts for injuries caused by the WorkCompsters.
#WorkCompChat? Fascinating that #CNA insurance might find my #LinkedIn profile of such interest? Classic #RockPaperScissors?
Let’s hope it is a good sign and that audits may be conducted to ensure that the horrors I experience by their failures and refusals to provide medically necessary treatments since date of injury, 1/9/12, must not and will not happen to other injured #Wyndham Worldwide Employees. This is an outrage to Shareholders and Injured Worker alike.
If Work Comp is an “exclusive remedy” stripping injured workers of all civil and human rights, how on earth and under the Constitution can it be “adversarial” in blatant failures to provide medically necessary treatment causing impossibilities for return to work? Seems to be a bit of an oxymoron, doesn’t it
We May Need Citizens Tribunals to help injured workers in USA, CANADA, UK and Australia and elsewhere?
It’s awesome to see/hear/read about the issues outside of the USA. It is indeed a global war on workers!
U.S. Rated Alarmingly High in Global Survey of Worst Places for Workers’ Rights
It was self-procured and his office received threatening cease and desist treating demand, as have all self-procured providers, even though WorkComp has continuously and maliciously and callously refused to provide reasonable and appropriate medical care since date of injury, and has interfered with every attempt by Injured Worker to survive, and has made sure that return to work was an impossibility….
It is hoped that this case will be used to expose major corruption in some very dark places in America…..Take a look, it’s less than ten minutes….
While there is plausible deniability in many expert conclusions about why injured workers do not get medical care and do not get to return to work, the biggest deal is that without Injured Workers to use and dispose of like cash cows, Workers Comp Grand Fraud would not exist. The CEO of the carrier for the woman in the video earns more than $10.7 million a year….. maiming and killing disabled workers? Ought to be some law enforcement.
If you don’t have these problems in Australia, good for you. However, if you dig deeper, you may find that like the USA, like Canada, and like the UK and elsewhere, you have same crime gangs operating there. Carl Icahn, an American icon, is known to be a Shareholder Activist. His approach to abuse may be the only viable solution left.
In the USA even our law enforcement and fire fighters are denied immediate reasonable and appropriate medical care, then they are blamed as being malingerers.
While there is plenty of plausible deniability and efforts to ‘blame the victim’ in work comp matters, the bottom line is that when Injured Workers are denied medical care for years (as happens in the USA as a pattern of practice, in order to keep the WorkCompGravy Train rolling (those evaluations are very expensive, and appeals are also cash flow event) often injuries are made worse, and even result in death.
Romano Trust vs Sedgwick, a horrific case in California where an injured worker was denied medical care for years, then given poor medical care that resulted in complications, complications not treated, Injured Worker died, attorneys attempted to indict adjuster for murder, Courts kicked it out, carrier paid a little fine and THE WORK COMP GRAVY TRAIN ROLLS ON…..
U.S. Rated Alarmingly High in Global Survey of Worst Places for Workers’ Rights
One brain injured worker from the hospitality industry has tried valiantly to return to work for over three years, but the employer says without a doctors release there can be no return to work, and the doctors say without medical care there can be no return to work, with or without accommodations. Employer has repeatedly refused to engage in mandated interactive process since October 2012.
One California Injured worker has tried valiant ly and repeatedly to return to work, and even attended her employer’s PUBLIC JOB FAIR, only to be turned away.
Human resources said nobody could talk to her, and she could not return to work without a medical release, and no doctor would provide a medical release without medical treatment over the past 3 years, and the self-procured care was not enough for recovery from Traumatic Brain Injury.
The employer also refuses to have a claim audit, or lift a finger to investigate how tens of thousands of dollars have been spent that have not resulted in medically necessary treatment.
This particular injured worker has tried every means necessary to attempt return to work including spending more than $30,000 for medically necessary treatments… Recommended but denied by the insurance carrier, and clear corruption and fraud.
The injured worker even attended a public career fair hosted by her employer, and was told nobody could speak to her, nor could they help her get medical care, return to work, or even charitable funding to keep the lights on. It is a multinational company… With no heart, no soul, and no good faith treatment of injured workers.
In America, injured workers are the cash cows that keep the work comp system going. Our lawmakers have sent a clear message to the industry in a case called Romano Trust vs Sedgwick (see below) that it is okay to deny medical care for years, and if death results, there is merely a $100,000 fine to the offending insurance Corporation.
Without the cash cows, The injured workers, the Worker’s Compensation Gravy Train would come to a screeching halt. The corruption in America is the core of the war on workers. The business model is similar to the nuclear business model… Profits before lives.
Plausible deniability…..and the War on Workers rages on….
Currently, the Injured Worker is subjected to more defense chicanery and grasping at straws attempts by defense to obtain yet another evaluation, this time from an EAR NOSE AND THROAT DOCTOR for the Brain Injury.
An ORTHOPEDIC SURGEON had been the primary treating doctor for a while, who recently withdrew from the case after a series of threats made by defense on issues of requested specialty evals and treatment for a brain injury.
Bone doctors are not brain doctors, nor are ENT doctors. That’s not ‘ignorance’….that’s clear cut fraud with intent to deny medical care, combined with omission of medical records with further intent to harm as a pattern of practice.
Is the American dilemma becoming clearer?
Some attorneys say that very event (ROMANO TRUST) gave the Insurance Community a LICENSE TO KILL INJURED WORKERS IN AMERICA, and they seem to take their licence very seriously. It’s comforting to know that in Australia you don’t have the same levels of corruption that we have here in the USA, and that they have in the UK and Canada.
Here’s a blow by blow story about one American Injured Worker….denied immediate medical care and denied all levels of expert evaluations and medical care for over 3 years.
Injured worker self-procured the recommended treatments that the carrier REFUSED TO PROVIDE, and has spent more than $30,000 on care to survive WorkComp, while doctors and lawyers and other providers ride comfortably in the dining cars of the WorkCompGravy Train.
ASK ABOUT WORKERS COMP GRAVY TRAINS https://askaboutworkerscompgravytrains.com/
If you dig deeper in your own country, you may find the problems are the same. Nobody in America likes to talk about the corruption either, it’s politically ‘incorrect’….. but as Einstein reminded us, “Those who have the privilege to know have the DUTY to act.”
Thank you for having open conversations about WorkComp in Australia. We may need Citizens Tribunals to help injured workers in USA, CANADA, UK and Australia.
Here’s a headline: Workers comp fails injured workers, Labor Dept. says
By L.M. Sixel April 29, 2015 Updated: April 29, 2015 6:32pm
Employees and taxpayers foot most of the bill when workers get injured on the job, a new report from the U.S. Occupational Safety and Health Administration finds.
Those Who have the privilege to know have the duty to act… Tell your friends and neighbors about the work comp crimes… And tell them to tell their friends and neighbors… America has a new attorney general… Maybe she can make a difference!
Till then.. Remember remember… We are the media now
Few studies discuss the true causes of the absolute failures of the Grand Bargain, known by injured workers as the Grand Work Comp Fraud.
As evidenced at Doctor’s Trials of Nuremberg, when doctors are criminals, there are grave social problems. When the criminal activities of doctors are supported and protected by criminal lawyers, the problems are compounded for all concerned.
Work comp insurance systems are a mega billion dollar crime syndicate, fleecing, maiming, torturing injured workers, causing permanent disabilities and premature deaths for injured workers and reaping extreme profits for the sonderkommando involved.
No, we don’t need more studies. All involved know the truths of the atrocities. But, if more studies are desired, begin to study how cops and firefighters are tortured and abused by the WorkCompsters when injured on the job.
Think harder and include the plight of injured veterans, being denied medically necessary treatments and “incapcitation pay” while self righteous and arrogant psychopaths allege the horror stories are exceptions rather than the rules of the work comp killing games.
When doctors and lawyers and judges and their ilk breach oaths of office… take heart in knowing there are others who take their Oath seriously,
…and will responsibly honor Oath before orders.
Start the 21st Century Doctors and Lawyers Trials in America and Canada and UK. Hold the multinational crime syndicate’s participants accountable for the extermination practices of Workers Compensation Grand Fraud. . . Prepare the gallows.