Oh goodness! That alleged #WorkComp “long time activists” gang says they are banning me and removing me from their email distributions lists forever, but gosh golly, they keep sending me emails saying they’re really gonnna do it now, and I better look out! D’oh.!!!!!!!!!!!!!!!!!!!!!!!!!!!
Sadly, they either have Langley 401(k) accounts, have just blown a promotion for a failed attack on an injured worker, or are simply casualties of the #WorkComp Opiate Wars on Injured Workers. They couldn’t be working for CNA, could they? Naaaaaah….the timing and stupidity makes it plausible, but deniable.
Their “leaders” do seem to have long time insurance industry connections. Hmmmm. The attacks are text book out of The Rules of Disinformation and The 8 Traits of Disinformationists.
In any event, their mean spirited and non-sensical blastings are….insignificant in the greater scheme of things.
Remember Remember the 6th of December….
See you There!
I also submitted a few nominations; it was brain-racking to think of those who help vs. those who harm…
NORIN GRANCEL + CNA + THOMAS MOTAMED + LINDA AYRES + WYNDHAM – WWID 415287. OUTRAGED
“Based on the information from you and your doctors, it is clear that you are unable to return to work at this time.”
[BUT THERE VILL STILL BE NO MEDICAL TREATMENTS NOR DISABLITY BENEFITS FOR YOUR BRAIN AND SHOULDER AND NECK AND BACK INJURIES OF JANUARY 9, 2012. AS THE INSURANCE COMPANY HAS ASKED YOU, TELL US, “…WHEN ARE YOU GOING TO DIE?”]
Thank you for providing the documentation from Dr. Bergey and Dr. Chalgujian. Based on Dr. Bergey’s documentation dated October 17, 2014 you are temporarily partially disabled but may return to work if restrictions can be accommodated. However, the letter from Dr. Chalgujian dated October 20, 2014, indicates you remain temporarily totally disabled until December 20, 2014, and thus, cannot work in your role as a Sales Representative or any other role. Although you have requested information related to a sales job, in prior communications, even you have acknowledged that you do not know if you can return to a sales job and you continue to have cognitive impairments. Further, you’ve stated that you are unsure if your physicians will accept the professional liability of releasing you. Based on the information from you and your doctors, it is clear that you are unable to return to work at this time.
However, we understand you had an appointment with Dr. Chalguijian on November 10, 2014. If you were released to return to work – with or without restrictions, please let us know and complete the Accommodation Request Forms (or provide other documentation to support your release to return to work and related restrictions, if any). Once you have been released to return to work and we have information regarding your restrictions, we will continue the interactive process and reevaluate your potential return to work. Thank you.
Subject: Fwd: LINDA AYRES- WYNDHAM – WWID 415287. OUTRAGED
Thank you for your email. I guess that means continued refusal to engage in FEHA interactive process? BUMMER.
That’s quite a response. With all that said…has Mike Dougherty initiated a Claim Review and Audit of CNA and Grancell handling of my claim? I am insured under the #WyndhamWorldWide #WorkComp Insurance policy and I can’t get any help from them. Full breach of fiduciary responsibilities…and severe bad faith.
You realize the additional legal liability to Wyndham from an EEOC perspective, Shane Reidman’s (CNA Fraud investigations unit) question of “…Tell me, Linda, when ARE you going to die?” also needs to be addressed.
Tina, it is obvious from your letter that you also know I need medical treatment.
The breach of fiduciary responsibility by CNA and the obvious deceptive practices of Grancell are outrageous. The refusal of CNA to provide medical care and its failure in 2012 and 2013 to pay temporary total disability benefit is absolutely outrageous .
Tina …what do you suggest I do for medical care, for income, for good, for utilities and to prepare for return to work in some capacity and to save my life?
Intentional harm with intent to kill is a crime in America.
Please advise your suggestions on what I must do next…without medically necessary treatments without disability income without any good faith interactive process and without reimbursement for out of pocket medical expenses incurred because CNA and Wyndham kicked me to the curb and believe they are ABOVE THE LAW??
I look forward to a legitimate response. If your job been done properly at the time of injury. ..this mess would not likely be as horrific.
Make it right, Tina, and clean up this mess and assure Wyndham Worldwide Workers that what is happening to me stops eith my case. COME CLEAN. …RIGHT THE WRONGS. Talk to Shane.
LINDA AYRES, IN PRO PER
PS Will there be a #Wyndham table at the #WorkCompCentral #CompLaudeAwards on December 6 at the Sheraton Gateway LAX?
AS YOU KNOW I HAVE BEEN SELECTED AS A FINALIST IN THE INJURED WORKER CATEGORY.
I HOPE TO HAVE A POSITIVE TURN OF EVENTS TO REPORT REGARDING THE HORRIFIC MISHANDLING OF MY CLAIM. CONTINUING PATTERNS IF HARM ARE NOT A GOOD THING IN THE PUBLIC PRIVATE SECTOR.
One good thing…this case is now of national interest …serving to expose harm and corruption. ..and right now…Wyndham and CNA are right behind Ralph’s Market and Sedgwick… (Romano Trust vs Sedgwick) establishing a lethal pattern of continuous harm to injured workers in California.
PS Remember remember, the State of California approved a bonus of approximately $16,000 paid to CNA Insurance by California EDD for REFUSAL TO PAY TTD BENEFITS IN 2012, 2013, SHIFTING BURDEN TO THE STATE, AND LEAVING ME WITHOUT MEDICAL TREATMENT, DISABILITY INCOME, ABILITY TO WORK, NOR HELP IN GETTING HELP TO RETURN TO WORK.
SOCIAL SECURITY OFFICE SAYS THEY ALSO KNOW I HAVE BRAIN INJURY, BUT NO BRAINS ARE REQUIRED TO SELL TIMESHARES. D’OH. THAT’S ON APPEAL TOO.
Why America is NOT the greatest country in the world…
Then read this:
#WorkComp #Talk about an Insurance Racket!!! #WyndhamWorldwide…. not only have their representatives refused to provide reasonable and appropriate medical care for nearly 1,000 days to a California injured worker:
They caused the injured worker compounded injuries by failure to treat, and further caused IW to have to apply for ‘welfare’ and other assistance via the Salvation Army and United Way (as a recommended remedy by State & Utility representatives) to keep utilities on and roof over head (while #CNA enjoys a nice tax-payer provided free loan, as a pattern and practice , from the #StateOfCalifornia for nearly $50,000 (times how many other injured workers??!!)
Is that another example of FREELOADING CORPORATE WELFARE SANCTIONED BY THE STATE?
NOW THEY WANT TO have a useless TALK ABOUT A TOKEN/nuisance SETTLEMENT….
….FOR THE ‘MINOR brain INJURIES’ after providing, since 1/9/12, a few chiropractic sessions, 6 physical therapy sessions, approximately 14 clinical psychology appointments in 2012 that included conversations with the adjuster regarding severity of injuries, and one doctor suggested self-procured ‘day planner’ for $500 for brain injured people, while offering a pirated CD to help injured worker ‘breathe 7 breaths a minute’, along with techniques to ‘mask BRAIN INJURIES’ with admonition from their doctors to “never tell anybody you have brain injury, it comes with a stigma’.
#NAIDW, National Association of Injured and Disabled Workers, has been a great source of hope, with their slogan, “NO INJURED WORKER LEFT BEHIND”…. Seek them out on the web!
Then, #Wyndham defense firm SUGGESTS FURTHER SHIFT OF MEDICAL ‘TREATMENT’ with BAMBOOZLING DISREGARD….TO THE OBAMA CARE/AFFORDABLE CARE ACT PROGRAM, WHICH WE ALL KNOW DOES NOT EXIST EITHER.
TALK ABOUT A RACKET, HUH? Racketeering??!
The theory of the Wyndham Defense Firm seems to be solidly perched in complicity in fraudulently created medical reports by 3 of their doctors. Out of 35, their 3 paid-‘doctors’, without expertise in brain injury, minimize the extent of the injuries, brain and orthopedic, and suggest ‘over the counter analgesics’ a MTUS recommended guidelines for diagnosed injuries, with clear intent to deny medically necessary treatment and to expedite death.
Does WorkComp insist on sending brain injured workers to ‘podiatrists’ for evaluations?? Ought to be some law enforcement, huh?
It sounds like more than 30 doctors will have to be investigated for #WorkCompFraud if the 3 insurance company owned doctor’s reports are not pure FRAUD… IF THERE WAS NO INJURY TO THIS WORKER, OR IF IT WAS MINIMAL, WHY HAS SHE NOT BEEN RETURNED TO WORK, WITH OR WITHOUT ACCOMMODATIONS, FOR NEARLY 1,000 DAYS???!!!!
Or…..for a more efficient legal investigation, perhaps a review of the 3 insurance doctors and the defense counsel and insurance adjuster is in order by the Office of the District Attorney, as they have been most instrumental in the failure to provide medically necessary treatment. Oh, let’s be sure to consider CORVEL, Crowe Paradis and MAXIMUS collusion as well. WORK COMP IS A BILLION DOLLAR INDUSTRY…..LOTS OF OPPORTUNITIES TAKEN FOR ACTS OF FRAUD, WITH PLAUSIBLE DENIABILITY, HUH?
See the David DePaolo story on WorkComp Grand Jury Indictments….somebody is doing their job, at least it’s a start:
“A couple of stories in this morning’s WorkCompCentral News provide substantial evidence (you knew I had to work that in!) of that concept.”
“A grand jury indictment was unsealed yesterday alleging a huge financial kickback scheme involving compound drugs, doctors and pharmacists, some of whom are “regular” names in California workers’ compensation and within the Greater Los Angeles area (recall that recent studies reflect dramatically higher costs in that geographic zone compared to the rest of the state).”
‘Puzzling, Baffling, Mysterious, Befuddlng’….. with your tax paid dollars…… THINK THINK THINK.
Should the corporate slogan for #WyndhamWorldwide aka #WorkMarkbyWyndham be something along lines of:
“WyndhamWorldwide. NO INJURED WORKER PROVIDED WITH MEDICAL CARE. PERJURY AND FRAUD PREVAIL; Policy & Procedure: DENY MEDICAL CARE BY ANY MEANS NECESSARY. HERE HERE TO THE CORPORATE BOTTOM LINES” ???? !!!!
#OccupyWyndham #OccupyWorkComp #OccupyWorldMark
#WorkComp? Americans Maiming and Killing Injured Americans for Profit
Friends don’t let Friends stay ignorant. …nor fight work comp crimes alone. …
PERSONAL NOTE……PS.. I have a confession. On 1/9/12, I slipped on ice and conked my head really hard while working for #WyndhamWorldwide, at the #WorldMark by Wyndham Big Bear California resort. I did tell a few of you, and even asked you to keep an eye on my posts to see if I moved too far off-center…..No complaints, so that’s a good thing!
When one thing doesn’t work. …We do something else.
We are the media now.
Expose #WorkCompFraud#WorkComp #injuredworkers. ..ONE VOICE.
CLASS ACTION TIME???
TELL YOUR FRIENDS AND NEIGHBORS. …
There’s more in this blog: #WorkCompFraud? 888 Days….. #TBI Injured Worker Still on the ‘Rest and Wait’ Program…. #ADJ8181903http://t.co/aRzrMzUifC
*******************************************************On the date of the fall, the manager told me to work my full shift (selling dream vacations) and then the other manager told me to “see any doctor that accepts #workers compensation insurance”. I did as instructed, and also called the Employee Assistance Program, because I was so desperately ‘dazed and confused’. On 2/4/12 I lost consciousness at home and conked my head twice more, “second impact” is not a good thing. The brain does not appreciate it.I knew enough about brain injury not to go to sleep once I regained consciousness, so I wrote a letter to the Wyndham HR manager telling her if I die because of this, I hope my family sues the hell out of them for denying medical care. She wrote back and eventually told me legal department told her not to communicate with me. D’oh. Transparent cover-up strategy.Then, I posted some #Fukushima posts, since the local hospital is also known to …. provide less than humane medical care, so I didn’t know if those would be my last posts to you all, so I wanted to be sure you had as much information and as many links on #Fukushima that I could get to you before heading to the ER to find out more about the loss of consciousness that results in further injuries, apparently, including a right rotator cuff tear.While I took medical paperwork regarding the TBI/Concussion, they kept saying, “Do you feel safe at home?” because I had a black-eye, too. Slow to think, I thought, “well, I just lost consciousness and conked my head again, and was out about 20 minutes or so the second time, and I live on 5 acres, and this hospital scares me because I have heard terrible stories about it….but I didn’t want to risk the 40 mile drive to a real hospital…. and I thought about feeding the bunnies and road runners etc.” then I just said, “yes”.I asked one doctor, “OMG, what I do if I don’t get all my marbles back?” He said, “Well, you could assemble widgets perhaps.” I grimaced and said, “I LIVE IN RURAL AMERICA. THERE ARE NO WIDGET ASSEMBLY JOBS HERE.”Fortunately, for me, the part of my brain that can type was less impacted. I didn’t leave the house for nearly 2 years, so I had plenty of time to research and post and repost and repost and repost to you, creating and participating in various groups and pages, and learning to blog and Tweet and Pin etc. FB has been THERAPUTIC, AND MUCH LIKE ASSEMBLING WIDGETS.Other friends have said things like, “With your missing marbles, you still have plenty more than most.” Others have said, “You’re a lot more fun now! Less intense!” Others have said, “never tell anybody you have a brain injury, it comes with a stigma”…. D’oh!!! I can pretend with the best of them….for just so long, and then I get looks like, “OMG, did she just say that out loud??” What I have learned in FB TBI support groups, and one and one with friends, the symptoms of TBI are what they are, and most people muddle through compensatory actions….. so, we all have a brain, and with the advances in neuro-sciences, we get to discover new ways to use them.I have made some good virtual friends in this Journey, Fukushima and Traumatic Brain Injury. FRIENDS DON’T LET FRIENDS STAY IGNORANT. LET’S MAKE SOME MORE NOISE…..WORK COMP IS KILLING US….. ADD IT TO THE MIX OF OTHER DEPOPULATION EVENTS, WITH PLAUSIBLE DENIABILITY.
WE ARE THE MEDIA NOW. WE DO NOT…FORGET.The liars, psychopaths and criminals I have been exposed to are surpassed only by the pro-nukers in and around social media.In November 2012, the then attorney attempted to coerce me to accept a settlement offer, without benefit of seeing a brain doctor, for $100,000, less his fees. I said, “Dude, I am injured, not stupid. I need to know what’s wrong with my brain and what it will take to get it fixed. I can’t “settle” anything till I have the facts. [Look for a future blog on Attorneys and WorkComp…… you won’t believe some of the stories, and what their incompetence does to harm injured workers…..]What I have learned about #Workers Compensation will be outlined more fully in subsequent blogs. Check out some of the early ones, and if you have a story, add it in the comments or send me an email. WynLINDA@gmail.com.
WE DO NOT HAVE THE RIGHT TO REMAIN SILENT. WHAT THEY HAVE DONE TO ME, I KNOW THEY HAVE DONE TO SOME OF YOU, AND EVEN MORE. LET’S SEE WHAT WE CAN DO ABOUT GETTING A CLASS ACTION SUIT MOVING….MAYBE WE CAN CONSOLIDATE EFFORTS AGAINST THE INSURANCE CRIMINALS AND THE DOCTORS OWNED/LEASED BY THEM…… BY JOINING UP WITH INJURED VETERANS IN AMERICA. THEY, TOO, ARE BEING DISPOSED OF.
MADDER THAN HELL, HERE…… AND WAIT FOR THE RANTS ON THE CROOKED DOCTORS AND LAWYERS….. Y’ALL AIN’T SEEN NUTHING YET…..
WE ARE THE MEDIA NOW. LIVE LIFE IN ALL CAPS TODAY.~~~~~~~~~~~~’Linda, Lucy…’.”WHAT DIFFERENCE DOES IT MAKE” The neurologist and neuro-psychologists say that because my employer, Wyndham, and it’s agents, denied medical care for the past nearly 888 days, nothing much more can be done. “Embrace the New You” they say. If you will share this with your friends and neighbors, perhaps we can shine a little light on the devastation of American’s Criminal Work Comp System.I have spent more than $23,000 in self-procured medical care and miles to help save my life, and post to you between fight. They won’t reimburse it, either. “Those dirty rats!”
Hello California! Got a Job? Got Injured on the Job? Look Out…… the issues are rampant in the USA!
What’s happening at the VA is happening in the Civilian Camps also….. follow the money trails to see where they lead??!!!
WorkComp seems to be another billion dollar hoax of the insurance industry — you know the folks who stole the homes of so many Americans? It’s been quiet, but those heists are still in progress, too. It’s said that ‘Mortgage servicers are currently holding in excess of $57 billion in seriously delinquent FHA loans…..
Remember remember….WE ARE THE MEDIA NOW. CARRY ON AND ON AND ON.
Meanwhile, back to work-place injuries, and specifically, TRAUMATIC BRAIN INJURY…… Here’s are some links about one Sales Executive’s experience with seeking basic reasonable and appropriate medical care for a conk on the head of 888 days ago……. To date, the only ‘authorized’ medical care has been:
TRAUMATIC BRAIN INJURY MEDICAL TREATMENT AUTHORIZED FOR EMPLOYEE OF WYNDHAM WORLDWIDE SINCE DATE OF INJURY, 1/9/2012:
2012 – a few chiropractic and a few clinical psychology sessions
2013 – 8 physical therapy sessions (that revealed a torn rotator cuff, and was then deemed ‘not an industrial injury’ after surgery was recommended by the primary treating orthopedic surgeon) Orthopedic Surgeon is the specialty doctor required by WCAB-Riverside to coordinate a multi-disciplinary team of specialists and treatments, and the URs are also handled by Orthopedic Surgeons — for BRAIN INJURIES….. with full disregard for ACOEM guidelines, NIH guidelines, and even specialist recommendations.
2014 – 6 Acupuncture and 6 Chiropractic sessions, requested by PTP in August 2013 were authorized, by Court Order, in February 2014.
Self-Procured Medical Care, in line with the California law that allows an injured worker to obtain medical care when the insurance provider fails to authorize over a reasonable period of time. Anybody else think 888 days is long enough to wait for medical care and medical miles and treatment reimbursements?
At one point in Court, the Injured Worker, totally dismayed, looked at the Judge and said, “So, Your Honor, what you are saying is that there is NO LAW IN THE STATE OF CALIFORNIA THAT REQUIRES AN EMPLOYER TO PROVIDE IMMEDIATE REASONABLE AND APPROPRIATE MEDICAL CARE???” The Judge’s comments are ‘off the record’.
In a current bad-faith action, another Orthopedic “Evaluation” is being requested by the DEFENSE
Here are some links….. more follow. The INJURED WORKER has been unsuccessful in retaining COMPETENT LEGAL REPRESENTATION, so is on her own, in pro-per, with a brain injury. The course has involved several attempts to be heard by the Courts, to no avail… yet.
Lucy Occupy To the doctors, lawyers, insurance company adjusters and third party providers, along with #Wyndham Management et al…. just remember….we are the media now… and we do not…..forget the ethical and moral breaches, and blatant disregard for human life over profits and bottom lines. ASK ABOUT #WorkersComp Gravy Trains now…. ask and tell
Injured #Wyndham Worker – Driven to Madness …. 8,696 dangerous miles desperately seeking immediate reasonable and appropriate #TBI medical care
JAN 2012 – 340.80 miles
FEB 2012 – 370.60 miles
MAR 2012 – 499.40 miles
APR 2012 – 810.20 miles
MAY 2012 – no treatment and benefits terminated
JUN 2012 – 2,021 miles
JUL 2012 – 400 miles
AUG 2012 – 400 miles
SEP 2012 – no treatment
OCT 2012 – 246 miles
NOV 2012 – 75 miles (aborted deposition and premature ridiculous settlement offer WITHOUT brain injury evaluation or treatments, with said settlement demanding termination of job and any future medical benefits)
NOV 2012 – 847.60 (urgently self-procured medical evaluation and treatment with brain-injury-treatment expert and functional neurologist)
DEC 2012 – 279 miles (defense counsel demanded termination of brain-injury treatment and threatened treating doctor with legal action if treatment continued)
JAN 2013 – 90.00 miles
FEB 2013 – 107.40 miles
MAR 2013 – 246.20 miles
APR 2013 – 211.60
MAY 2013 – 444 miles
JUN 2013 – 1,243.20 (urgently self-procured medical evaluation and treatment with brain-injury-treatment team of experts including physiatrist, neuro-optometrist, vocational rehabilitation-vision with recommendations for treatment with speech therapist with cognitive remediation, vestibular balance disorder evaluation and in-patient rehabilitation in order to restore /replace some cognitive deficits–DENIED AGAIN BY INSURANCE COMPANY ADJUSTER, A NON-PHYSICIAN, IN VIOLATION OF LABOR CODE)
JUL 2013 – 64.00
8,696 MILES…. and still fighting denials of reasonable and appropriate medical care for diagnosed injuries!! Unreimbursed miles!
DIAGNOSES: 854 Closed head injury, 784 Headaches, 310.2 Post concussive syndrome, 850.1 Concussion with brief loss of consciousness, 850.9 Head Concussion, 309.81 PTSD, 310.2 Post concussive syndrome, 780.93 Closed Head Injury with amnesia, 921.00 Contusion (left orbit), 750.90 Concussion, 959.01 Head Trauma, 959.01 Cognitive Changes following head trauma, 850.0 Concussion, 959.00 Head Trauma (Contusion x 2) with Impaired Memory, Speech, Balance and Vision, 850-854, 959.01 Somatic/cognitive dysfunction and emotional dysfunction, 310, 310.8, 438 Mild cognitive dysfunction, memory processing, 850 Mild TBI positive lapse of consciousness, 310.20 Post Concussive syndrome, 309.28 Mood Disorder secondary to Post Concussive Syndrome, 959.01 Head injury, Lobe Disorders: frontal, parietal, cerebellar dysfunction, motor dysfunction, segmental dysfunctions, Closed Head Injury with Ongoing Sequelae, Psychological sequelae, possibly secondary to industrial injury, 959.01 Closed head injury with cognitive dysfunction and speech dysfunction, 784.00 post traumatic headaches, brain based vision impairments, brain-based vestibular and balance disorders + secondary to head trauma, NECK, BACK, Shoulder PAIN and related ICD-9 codes
8,696 MILES TRAVELING IN SQUARE CIRCLES TO ‘VISIT’ VARIOUS APPARENTLY Insurance and Legal ‘SHOPPED DOCTORS’
…. in order for the insurance company to obtain bogus reports, based on the incompetence and lack of expertise in neurosciences and functional neurology. The various apparently ‘shopped’ reports from various providers of the Workers Comp Gravy Train provide ammunition for the insurance company defense counsel to fabricate an image of ‘no injury’ or ‘100% recovery from injuries’ without benefit of any medical treatment of evaluations in accordance to LABOR CODES. Legal counsel was knowingly or unknowingly complicit in the deceptions, and failed miserably in properly representing Injured Worker, without expertise in representing a brain-injured client. All three dismissed law groups appeared to compare a TRAUMATIC BRAIN INJURY to a broken leg, and applied the same theories of legal practice.
The unreimbursed medical miles since April 2012 to date amount to $2,649.00, plus maximum penalties to be ordered by the Court. The requests were submitted in a timely basis, 8 or 10 times to both the Adjuster and Defense Counsel, and each subsequent follow up is met with “we didn’t get it” “please send it again” “we thought we paid that” “we don’t have it” “what medical miles are you inquiring about”. The same fabricated responses hold true for requests for self-procured medical treatment, to-date in the amount of approximately $13,000.00, plus penalties and perhaps trials and jail-time for some of the providers. The county district attorney offices have been funded with several million dollars for fiscal year 2014, in order to FIGHT WORKERS COMP FRAUD. Let’s hope they focus on the real criminals in the system, who are maiming and killing injured workers, all the way to the bank.
An unreasonable failure to timely pay reimbursement for mileage to and from medical appointments is a basis for an award of a 10% penalty against the entire medical treatment portion (species) of benefits, past present and future. Payments after 30 days of request for reimbursement may be unreasonable, and it is up to the court to decide what constitutes a reasonable or unreasonable time to reimburse an applicant for covered expenses. Avalon Bay Foods v. WCAB (Moore) 63 CCC 902 (California Supreme Court) says that when an insurance company is 60 days or more late in paying medically related transportation expenses (mileage reimbursement), there is a Labor Code S5814 penalty owed on all medical treatment benefits (of which mileage is a part).
Medical care that had been self-organized [due to MPN issues, for another blog], in conjunction with Adjuster, was terminated because Injured Worker IMMEDIATELY requested a second neurologist–with an expertise in TRAUMATIC BRAIN INJURY — rather than “epilepsy and fibromyalgia”. The first neurologist was an absent-mind-professor type, who even had to borrow the injured worker’s pen to complete the ‘visit’. Without medical evidence, said ‘professional’ ‘offered’ preventive ANTI-SEIZURE pharmaceuticals, with liver killing side-effects, amongst others. This practice was deemed unfounded by the medical profession in — 2004….. to immediately offer anti-seizure meds when a 2nd impact blow to the head occurs after an untreated concussion/traumatic injury. Said ‘professional’ also insisted on a ‘SLEEP DEPRIVED EEG’ 3 weeks into the future, which are known to CAUSE seizures.
Since Injured Worker had very high ‘pre-morbid’ intelligence levels, and still had sufficient street sense to have “WTF” sirens go off at the bizarre demand, contrary to ‘rest the brain’ by other doctors. The danger was apparent to the brain-injury survivor….that to drive 220 miles, SLEEP DEPRIVED WITH A BRAIN INJURY, was simply INSANE. The insurance company adjuster wanted this doctor to be the new ‘primary treating doctor’ [over the injured workers’ dead body, we presume!]. Injured worker then hired Attorney #2. On Easter Sunday, 2012, said doctor called injured worker to again discuss liver-and-other-organ killing pharmaceutical, ‘seizure medications with mood elevators’ to also help address [dumb down] the apparent anger issues. Said doctor was offended when injured worker replied, “I don’t take drugs.”
He muttered something about ‘these are not drugs, they are pharmaceutical medicine’. There was no ‘meeting of the minds’ in this doctor-patient arrangement and in retaliation, more than one month after the 15 minute visit/evaluation, this neurologist [referred to as the ‘Neuro-Nazi’ by injured worker and friends!] so he then threatened that if a prescription was not accepted and called in to a local pharmacy, he would report the patient to the Department of Motor Vehicles, to have driver’s license revoked, which he did.
The injured worker fought the good fight, and intends to include this doctor in a report for fraud investigations. Furthermore, the demanded ‘Sleep deprived EEG’ could only be done in his office, by his technician [for his profit.] BOOOOOO. DANGER DANGER.
The second neurologist was ‘authorized’ more than a year later, and his specialties were… non-existent. His medical opinion and expensive report indicated complete healing, magical as it may seem to all, and that the only continued treatment suggested was “over the counter analgesic.” The football crowd may have a good laugh at that doctor.
The “forensic psychiatrist’ could not keep the dates or facts straight in his $4,000 bogus report, and clearly indicated, regarding injuries sustained in 2012: “”Neuro-Psychiatric symptoms include a loss of consciousness on February 4, 2013, and a history of a closed head injury on January 9, 2013. Her loss of consciousness was apparently due to a swollen brain and interrupted chiropractic care.” For treatment, this arm-chair-rocket scientist, further states: “Treatment should only be provided industrially if the Finder-of-Facts finds some evidence of an industrially-related concussion injury.” [The skewing of facts is probably due to the short time spent with patient, although under penalty of perjury, he alleged he spent 7 hours with injured worker. Uh oh. Fraud Alert! Perhaps this doctor should be drug tested.]
Further stated: ‘IMPAIRMENT: Residual impairment due to chronic maladaptive coping mechanisms, preexisting personality conflicts, poor anger management skills.”
DOES THIS MEET ACOEM GUIDELINES FOR TREATMENT AND EXPERTISE for BODY PART INJURIES INCLUDING BRAIN, HEAD, EYE, NECK, BACK, SHOULDER, OTHER BODY-PART SYSTEMS?? Draw Your Own Conclusions!
The WORK COMP Gravy Train of doctors/providers/legal counsel sent the trusting brain-injured worker to many apparently ‘shopped doctors’ without any brain-injury expertise , (causing brain injured worker, at 10 months post-injury, to SEARCH FOR AND SELF-PROCURE reasonable and appropriate medical care —> because ‘authorities’ refused to provide reasonable and appropriate medical care). This list includes evaluations ONLY, no treatment (other than the stated exceptions of some chiropractic, some chat-therapy with clinical psychologist(s), and a few cervical physical therapy sessions: : 2 chiropractors (1 declined due to paperwork/authorization madness and apprehensions payment would be withheld by adjuster), 2 neuropsychologist (1 declined to treat when Injured Worker appeared for appointment, due to Work Comp, although it was later discovered said doctor was the only local neurologist on alleged MPN list), 3 clinical psychologists, 9 MDS (3 family practice, 5 orthopedic surgeons [for brain injury, d’oh!] 2 neurologists, and others: 1 DC with specialty in functional neurology, 1 accupuncturist, 1 EEG neuro-feedback phD (who provided the only EEG, self-procured, unreimbursed), 1 physiatrist, 1 speech therapist (MA, CCC-LS LSP), 1 physical therapist, 1 optometrist, 1 neuro-optometrist, 1 vocational rehabilitation vision specialist, 1 doctor of unknown credentials who repeated tests taken within 30 days, causing‘practice effect’ in results, and 1 forensic psychiatrist.
PENALTIES FOR FAILURE TO PROVIDE MEDICAL CARE in accordance with WCAB guidelines. This violation appears to be a $10,000+ penalties, which could include prosecution for fraud and collusion to maim and kill injured workers for corporate profits.
Knight v. United Parcel Service and Liberty Mutual Insurance Company, 71 CCC 1423 In this case, the Board held that an employer or insurer’s failure to provide required notice to an employee of rights under the medical provider network (MPN) that results in A NEGLECT OR REFUSAL TO PROVIDE REASONABLE MEDICAL TREATMENT RENDERS THE EMPLOYER OR INSURER LIABLE FOR REASONABLE MEDICAL TREATMENT SELF-PROCURED by the employee.
Krueger v. Republic Indemnity Company of America, 28CWCR44 says I have the right to change treating doctors at any time pursuant to Labor Code S4060. It also rules that AD Rule 9785 is invalid. The case says AD Rule 9785 is invalid because it is inconsistent with the right of an injured worker to the “free choice of physician” guaranteed by Labor Code S4600. Therefore, under this case the injured worker need not request a QME evaluation in order to obtain medical care. Under the laws as set forth in the court case Emporium-Capwell Co. v. WCAB (Tidwell) 48CCC801 (1983), the injured worker has the right to change treating doctors at any time after waiting the appropriate time from the date of injury.
Under LC S5814, applicant may be entitled to a sum equal to 25% of the value of the treatment or service denied, if the doctor requires authorization for a medical procedures or treatment and the insurance company unreasonably delays or refuses to authorize it.
Injured Workers May Sue Under Racketeering Law Based On Scheme To Deny Them Workers Compensation Benefits
“Injured workers may pursue civil claims for damages under the federal racketeering law known as RICO (Racketeer Influenced Corrupt Organizations) based on a scheme to wrongfully deny them workers compensation benefits the Sixth Circuit ruled today in Brown v. Cassens Transport Co., No. 05-2089. The plaintiffs, a group of six injured workers, claimed that their employer, Cassens Transport Company, the company that administered Cassens’s workers compensation claims, Crawford & Company, and a doctor, Saul Margules, “employed mail and wire fraud in a scheme to deny them worker’s compensation benefits.” More specifically, the injured workers alleged that “Cassens and Crawford deliberately selected and paid unqualified doctors, including Margules, to give fraudulent medical opinions that would support the denial of worker’s compensation benefits, and that defendants ignored other medical evidence in denying them benefits.” ….
The court also addressed two other RICO issues. First, that reliance by the injured workers on defendants’ fraudulent misrepresentations was not an element of a civil RICO claim based on a Supreme Court ruling in Bridge v. Phoenix Bond & Indem. Co., No. 07-210 (June 9, 2008). Second, the workers pleaded a compensable RICO injury because “the defendants’ fraudulent acts were a ‘substantial and foreseeable cause’ of the injuried alleged by the plaintiffs: the deprivation of their workers’ compensation benefits and expenses for attorney fees and medical care.”
This case outlines a path by which injured workers may obtain relief from schemes by employers, insurance companies and doctors aimed not at dealing with the true and real facts but at wrongfully denying benefits to truly and legitimately injured workers. It should also raise a flag of caution for those insurance companies and doctors that reflexively oppose and deny the claims of truly and legitimately injured workers….”
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