“There is NO EXCUSE for the #WorkComp Atrocities in America”
but we might be on to an explanation…..!!!!!!!!!!!!!!
WorkComp Law….and Atrocities…
AS THE FILE CHURNS, Wyndham Sleeps and CNA asks IW:
“…when ARE you going to die?”
Primary Treating Physician for Ayres vs. Wyndham et al is an Orthopedic Surgeon designated as PTP for BRAIN INJURY CASE, because the alleged MPN Network of CNA is apparently losing swathes of doctors for non-payment and ridiculous handling of claims, they have no brain injury experts and damages caused by CNA by refusals to provide medically necessary treatments.
CNA now relies heavily on Corvel Corporation orthopedic surgeons and clinical psychologists to deny brain injury care based on false and incomplete medical evidence, and lack of expertise in the brain department. People complain about that Maximus IMR Gang? …..Corvel says, ‘let them all eat cake!’ as their nurses and sonders churn out denials like they were going out of business. The Corvel ‘doctors’ seem to have fangs in the Social Security denial system too?
Most of the CNA leased/owned independent doctors don’t even know that the brain is a body part located in the head, and one of their neurologists says ‘take an over the counter analgesic’ and their other neurologist says, ‘Look, you didn’t get any medical care the first two years, you’re already over 35, nothing will help you now. Go for a walk, get skinny, use the neuro-optometric theraputic lenses they wouldn’t pay for, but you did, and stop whining about vision and auditory impairments.’
Some real doctors just walk away from the #WorkComp Scams, some stay in it, slugging it out on behalf of injured workers, and others just ride the Dinner Car of the #WorkCompGravy Trains.
Nearly every single request for expert treatment for brain injury by the PTPs have been denied, first by non-doctors, Kim Mall, Attorney for Grancell, then by Daniel Elliott, Adjuster for CNA aka American Casualty. Remember remember, Wyndham Worldwide had (and probably still has) no standard practice for injured workers other than handing them an incomplete DWC-1 form with a shrug and “See any doctor that accepts work comp insurance” with the ‘time-share-salute’.
COASTLINE ACQUIRED BRAIN INJURY PROGRAM NEWPORT BEACH —http://www.coastline.edu/students/students-with-disabilities/acquired-brain-injury/
COASTLINE FOUNDATION http://www.coastline.edu/community/foundation/
The Coastline Foundation continually searches for new and innovative ways to serve the Coastline community. Coastline Community College is a campus without walls, and the Coastline Foundation (like its parent college) knows no barriers. Contact the Foundation at firstname.lastname@example.org or call (714) 241-6154.
LIFE HAPPENS…. They train the trainers! The DOD seeks their expertise. Their ‘Graduates” sing their praises! Compensatory Strategies help many Brain Injury Survivors return to life; sadly, not all are so fortunate. Not everybody survives…..
The Evaluation [QME] by Dr. Jeffrey Holmes, Orthopedic Surgeon, has been aborted again, and to be rescheduled in December, after spending nearly 70 minutes at the appointed time, confirming medical records and sorting through confusion. It was a pleasure to meet Dr. Holmes and his kind and gracious staff. Harvard men can have manners, yes?
As injured worker was quite clear that the good doctor was being invited by Defense to participate in an on-going fraudulent denial of medical treatment scam, and that he deserved to have all the facts so that he could make a legitimate evaluation of the right shoulder injury and other orthopedic challenges.
2012 medical records and 2012 attempt to coerce premature settlement by Defense clearly referenced right shoulder injury, and current hard-fought for Acupuncture has been for the ‘right shoulder only’ and they tried to tell the acupuncturist treatments were not to be used on the brain. D’oh!
(Acupuncture is a whole-body system of treatment, most helpful to some brain injured patients.) The Defense postion letter started out with lies, that just got more egregious, and current defense counsel stated he saw no reason to change anything in Kim’s letter. Birds of Feather poop together?
Current PTP was successful in getting 6 physical therapy sessions authorized in Spring 2013, for a Winter 2012 injury. Then an MRI in Summer 2013 of the shoulder was authorized, determining a need for surgery and a severe shoulder rotator cuff tear. It took a Court Order to get appointments scheduled for Physical Therapy and Acupuncture in 2013. Is that right use of Judge’s time?
Defense attorney Kim Mall (Grancell-Corona) then indicated that the adjuster was wrong, there would be no further evaluation because it was not an accepted body part. She did not want to hear that the adjuster was trying to do the right thing. She squashed it, and no doubt billed on.
Several days in front of a WorkComp Riverside Judge, to deal with issues of omissions of medical records—more than 300 pages left out for 3 doctor reports, so those doctors relied on instruction from the defense, based on their egregiously flawed reports, QME/AME/and 2nd Consult.
Conveniently, those industry leased/owned doctors moved the reported date of injury on some reports a year forward, to 2013, using medical evidence of 2012 to ‘support’ fraudulent claims of ‘pre-existing’ symptoms such as dysfluent speech, impaired cognitive abilities, inability to recognize people, auditory and visual processing….. One made a correction to the date when confronted, but not to the false opinings, or his meds were off too.
No worries, WorkComp Courts REFUSE TO HEAR COMPLAINTS ABOUT ATTORNEY/PROVIDER FRAUD, AND SO DOES THE COMMISSION IN CALIFORNIA. DISTRICT ATTORNEY IS TOO BUSY? CAAA suggests injured worker keeps on looking for a competent legal firm to represent.
DEFENSE FIRM REFUSES TO MEDIATTE, SAYS THE CASE IS “not ripe”… (i.e. Injured worker is still breathing???)
DEFENSE FIRM REFUSES TO PROPERLY PROCESS MEDICAL EXPENSES REIMBURSEMENT REQUESTS FOR NEARLY $30,000, AND INSURANCE CARRIER IS AWARDED $16,000 BONUS BY STATE OF CALIFORNIA – EDD — APPARENTLY OUT OF GENERAL TAXPAYER FUNDS…FOR REFUSAL BY CARRIER TO PAY TEMPORARY TOTAL DISABILITY BENEFITS IN YEAR 1 AND 2 OF INJURY…. Perhaps the WorkComp AUDIT UNIT will do their job and suprise all stakeholders with fines and penalties.
THE INJURED WORKER HAS NOT YET RETURNED TO WORK…. WYNDHAM CONTINUES TO REFUSE TO PARTICIPATE IN THE INTERACTIVE PROCESSES OF #FEHA, AND THE DEFENSE FIRM CONTINUES TO OBFUSCATE TRUTH…SENDING QME DOCTORS BUNDLES OF DISORGANIZED FILES, THAT SEVERAL HAVE BILLED 7-8 HOURS TO “organize” prior to review, and generally, those doctors just have their “staff” write a report following guidelines of defense counsel, fraudulent misrepresentations and all.
These doctors are not apparently accustomed to an injured worker fighting for survival without a lawyer—two threatend to sue for ‘harassment’ when omitted records were properly served with requests for supplement reports reflecting further medical evidence. Several Court hours were wasted (but billed by Defense firm?.)…. to sort out the missing records.
The file was pulled from Kim Mall, and given to Stewart Reubens, in Grancell-Novato office. Stewart doesn’t like to read. His office must be full of rubber stamps?
Date of injury was 1/9/12, despite repeated requests for a brain injury experts—a Physicist, a Neurologist with Brain Injury Expertise, A Neuro-Psychologist, to manage an INTERDISCIPLINARY TEAM OF EXPERTS — Speech Therapy with Cognitive Remediation, Occupational Therapy, Neuro-Vision Therapy, Physical Therapy — TO TREAT A TRAUMATIC BRAIN INJURY CAUSED BY A WITNESSED SLIP AND FALL BACKWARDS AT THE WORLDMARK BY WYNDHM BIG BEAR RESORT ON 1/9/12…..
What can break the impact of a fall backwards besides the SKULL? See picture for help with that question. Hint: THE SKULL. 2ND HINT: Where is the brain located?
Evaluations Evaluations Evaluations…. and #WorkComp Defense now wants MORE EVALUATIONS?!!! For how many more years??
The recent Ortho Eval was aborted again, due to file obfuscation by Defense Firm, to be rescheduled.
While Grancell refuses to honor ADA request for electronic communications, it seems that Stewart sent a letter recently requesting yet another neuro-psychologist evaluation (after DIR told him NO once more) and he is apparently clue-less that such testing cannot be done more often than every 7-9 months, or ‘practice effect’ renders the results bastardized. Or, maybe he does know that, as he knows such a battery of tests was done again in October 2014. All results point to a traumatic brain injury, with requests for treatment.
Even the Grancell leased Forensic Psychiatrist wrote, ‘If there was evidence of a concussion from a slip and fall, injured worker would certainly be entitled to medical treatment….but there was not fall, no concussion, and it was probably just an epilepsy attack.” D’oh! Doc off his meds that day?
Forensic Psychiatrist wrote 3 supplemental reports at the request of Grancell’s Kim Mall, each one more outrageous and egregiously fraudulent than the prior, until they decided to put the reports on the ‘do not regurgitate in summary’ instructions, and also asked to have the name and report dates removed from the Medical Index. Invoking the 5th amendment might have been more efficient? (He also suggested that if IW has civil rights complaints, she take it to The Hague. He provided the direct line for the local DA to facilitate further complaints….THAT’S SCARY THAT HE HAD THAT NUMBER SO HANDY, HUH? d’OH! He refused to believe complaints had already been filed.)
“I hear we are already 200k over our estimate—that’s Team DLA Piper!” wrote then-DLA Piper partner Erich P. Eisenegger in one email.
After another lawyer responded, noting that an attorney colleague, whose first name is Vince, had been added to the group working on the bankruptcy matter, then-DLA Piper attorney Christopher Thomson added his thoughts: “Now Vince has random people working full time on random research projects in standard ‘churn that bill, baby!’ mode,” wrote Thomson. “That bill shall know no limits.”
“Now Vince has random people working full time on random research projects in standard ‘churn that bill, baby!’ mode,” wrote Thomson. “That bill shall know no limits.”
See entire artire ABA Journal article here: http://www.abajournal.com/news/article/sued_by_dla_piper_for_675k_ex-client_discovers_lighthearted_churn_that_bill/
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