COMPEL THIS! WorkComp Defense to provide medically necessary treatments as part of Exclusive Remedy

Linked In photo July 2015  LINDA
“WE ARE THE MEDIA NOW”

NOW, 2015

Honorable Judge Robert B. Hill

Workers’ Compensation Administrative Law Judge

WORKERS COMPENSATION APPEALS BOARD  – State of California

3737 N. Main Street, 3rd floor

Riverside, CA 92501

RE:          ADDENDUM TO DOR AND OBJECTION TO PETITION TO COMPEL ATTENDANCE  (sent yesterday)

Dear Judge Hill:

I pray the Court will finally intervene on my behalf, and on behalf of all American Injured Workers subjected to such abuses by the insurance industries and their goon squads.

Senator Fuller suggested that I take my concerns to the DIR, and the FBI suggested I take my concerns to the DOI.  Been there, done that.  There will be a special blog soon on how and which State Officials and Agencies and Legal Communities also fail injured American Workers, in this case and in others.

As I am preparing for your Court and re-filing all the medical/legal papers in my possession, in reviewing the Medical  Index in use by the Defense, I noticed yet another omitted report dated February 6, 2015 from Dr. Hilda Chalgujian regarding these very subjects.  It is a 2 page summary after a series of “discouraging” CorVel communications.   DR HILDA CHALGUJIAN 2 6 2015 FAX_20150217_1424143081_1 (1)

I ask that you include this in your reconsideration of your order to compel me to see an Ear Nose and Throat doctor as well as yet another set of neuro-psych tests for a very well documented brain injury of 1/9/12, treated by defense primarily with a few chiropractic sessions, a few clinical psychologists in 2012, 2013 had some physical therapy, 2014 finally saw to some speech therapy, occupational therapy and more physical therapy and sessions with neuro-psychologist and a few acupuncture sessions.  That’s hardly compliance with ACOEM, MTUS or even common sense.

Dr. Chalgujian’s initial report is approximately 40 pages, which includes her testing results and her comprehensive review of all medical records up to April 2014, when she agreed to begin to treat me.  Defense had no neuro-psychologists and I had to make many calls to find a local brain injury expert, and Dr. Chalgujian’s name was constantly recommended.  As a result, she agreed to treat me, then defense wanted her to do another evaluation, which she agreed to and provided.

Please note that the difference between Dr. Chalgujian’s reports and those of QME/AME doctors — Dr. Chalgujian does the testing herself, and writes the reports herself, and reviews all the medical records herself.  I know of no doctor in the WorkComp system that does so — in fact, a few have admitted that their “well trained” (non-medical staff) write the expensive reports that that doctors just sign.  I suspect most don’t even even review them, or if they do, I would have to further suspect how they made it through medical school.

I don’t know if Dr. Chalgujian has been paid for her reports or all therapy visits; I know that Defense has refused to reimburse me for even those medical miles (90 miles, round trip; weekly for a while; gas at approximately $4.00/gallon.  I hope to meet with Dr. Hilda to discuss resuming treatment with her, either via my alleged Workers Compensation Insurance coverage, or via my Medicare policy, awarded through recent total disability designation by the Social Security Administration.

If CNA continues to refuse to provide estimated Permanent Disability funds (they have breached the Law repeatedly on refusals to pay TTD as well, so there is no reason for me to expect right action or legal compliance at this stage either) , with penalties, and if WCAB allows them to continue all these atrocities, then I will be unable to continue at the Coastline Acquired Brain Injury program in Newport Beach — the lodging, travel and meals out are too expensive and I don’t know how I am to survive on the SSA award income.

Without completing the Coastline program, and dealing with the vision and auditory processing issues,  speech and vestibular issues and other yet unknown issues (EEG scheduled for next month, self-procured, because CNA doesn’t apparently think they are valid for brain injury diagnosis, nor have they provided MRI’s)  I don’t know how I will ever be ready for a trial return to work.

If I am unable to return to Coastline 8/24/15, my entire support system will break down, leaving me somewhat defenseless and could cause a loss of all the progress I have made in learning compensatory strategies.

Neuro-vision evaluations and vision therapy, acupuncture, Brain MRI’s (2012, 2014) as well as scientifically based functional neurology treatments have been self-procured since carrier’s callous disregard for law and life is indisputable; in October 2014, a State run program, the Coastline Acquired Brain Injury Program at Coastline Community College, best in the nation for people with disabilities and more, has also been self-procured.

How is this and EXCLUSIVE REMEDY when doctors are simply paid to write reports with recommendations for treatments that are ignored, then the select few doctors write clearly false reports at the beckoning of the defense, and the defense churns the file for billable hours, shifting cost burdens to injured workers, State & Federal Tax payers?

With the thousands and thousands and thousands of dollars the defense has paid for reports – false and otherwise – a fraction of those monies spent on medically necessary care might have helped me heal, and perhaps returned to work at any point along the way.  I have SPENT more than $43,000 to-date to survive these atrocities.

How many thousands of dollars has the defense laundered through how many unclean hands to cause such harm to me, and Injured Workers like me?  “Follow the money.  Always follow the money.”

 

“Compel” the defense to identify what TREATMENTS they have provided; I CAN PROVIDE A LIST OF ALL RECOMMENDED TREATMENTS THAT THEY FAILED & REFUSED TO PROVIDE SINCE DATE OF INJURY.  

COMPEL THIS!  WorkComp Defense to provide medically necessary treatments as part of Exclusive Remedy

Is it time for more serious discussion about THE DEMOLITION OF WORKERS’ COMP?   ProPublica peeps have just discussed the tip of the iceberg….Write on Michael Grabell and Howard Berkes!  Keep involving the industry experts…..shatter their delusions.

cognitive dissonance

Let’s do something good for America, your Honor.

Hold these insurance companies and their defense firms accountable for their actions, and do what you can for some house cleaning at 3737 North Main Street.

Thank you for your consideration and an expedited hearing.  Mediation might be a good idea to save the Court some bother, wouldn’t you agree?  It would be great if a representative from the Corporate Fraud Unit of the Office of the District Attorney could be invited to observe and review.

Sincerely,

Linda Ayres, In Pro Per

Wyndham Worldwide Shareholder, Injured Worker

#WorkComp & #BrainInjury Survivor

PO Box 835

Yucca Valley CA 92286

ADJ8181903

760 368 7236

Attachment:   DR HILDA CHALGUJIAN 2 6 2015 FAX_20150217_1424143081_1 (1)

WE ARE THE    MEDIA NOW

PS   Ask About Your Radiation This Week – Dodge the Rads! It’s Dangerous Out There….

Tired of Fighting #Workcompsters– Will you take it from here for a while?

Honorable Judge Robin Woolsey

Divison of Workers’ Compensation
Workers’s Compensation Appeals Board
RIV – ADJ
3737 Main Street #300
Riverside, CA 92501
Re:  Request for ADA Accommodations and Change of Date of Hearing
Dear Judge Woolsey:
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In an attempt to minimize the continuing harm caused to me by many unclean hands in this WorkComp case, I am respectfully submitting ADA Accommodations for the upcoming Status Conference Hearing in your Court, scheduled for my birthday, April 8, 2015 at 8:30 am.
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Will you kindly move the date to a Friday, or a Thursday, to minimize the continuous harm to this injured worker, and will you kindly ensure that the requested ADA accommodations are honored.
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I have never been heard by a Judge regarding my violated rights to immediate, reasonable and appropriate medical care. Date of head injury, 1/9/12.
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I have an untreated Brain Injury and I am surviving Workers Comp to the best of my abilities and I believe Congress needs to initiate #Domestic Torture Reports for the conduct of those running WorkComp in America.  By copy, I am asking for help on these complicated matters from Senator Jean Fuller, Deputy District Attorney Jennifer Lentz Snyder, the Employer Fraud Task Force, and the investigative journalists at ProPublica, and the world at large.
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“Over the Counter Analgesics” recommended by WorkComp doctors for Traumatic Brain Injury? Defense repeatedly omits approximately 300 pages of medical records with intent and success to deny medical care, without consequences to anybody but injured worker, and to the profit if the defense firm and industry doctors? Another doctor alleges there was no witnessed slip and fall, and if there had been, of course, medical treatment must be provided, but it was probably epilepsy.
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Three industry doctors falsely stated the date of injury in their reports as “1/9/1 3“, and used medical evidence of 201 2 to support pre-existing conditions.  When brought to their attention, they simply changed the date of injury reference, and made no changes to false conclusions, all with intent and success in denying medically necessary treatment for over three years.
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How is that any good in America?  Super lawyers have told me my case is not unusual, it happens all the time. Upon confirmed diagnosis of brain injury, TTD benefits were terminated in April 2012,  State disability was paid, and when I sought assistance from I & A, Ms. James asked if I was stupid, and why wouldn’t I want the greater income provided by the State.  I showed her the Court order and she said, “well, it says ‘if necessary'” it would be reinstated… I was still TTD, so that was another violation and direct harm from the WCAB.  In May of last year, CNA reimbursed the State of California what they paid, less approximately $18,000.  I appealed that, and that Judge said it wasn’t my money (so I assumed they just gave the $18K to CNA from California taxpayers, and I had to go to the Salvation Army during that charade, to get help to keep my utilities on and find food.  Monsterous.)
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They (Defense and my then-counsel) attempted to coerce me to accept a $100,000 settlement, less attorney fees, in November 2012, without the requested evaluations and treatment that first year, less attorney fees, and required resignation from my job, and a promise to not file for social security disability for at least 3 years.   The representing attorney told me, “Work Comp is a very small community, everybody knows everybody.  If you don’t take this, you’ll get nothing.  Nobody will believe you have a brain injury.”  I told him that’s because he didn’t get me to any of the recommended doctors, nor get me any of the recommended treatments, and that I am injured, not stupid.
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Defense and I & A Officer reiterate that “it’s a small community, everybody knows everybody”.  What does that sound like to you?  I think the DOJ should find it of interest, don’t you?
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Investigative journalists have said, ‘too bad, happens all the time, best you can hope for is SSI and an early death’.  How about the insurance company call in Fall 2014, in response to pleas for help to get medical care after 2.5 years, who asked, “…so tell me, Linda, when ARE you going to die?”   
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CNA Brain Injury Treatment Kit

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Your honor, I think there should be some investigations and arrests regarding my case, don’t you?
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BACKGROUND:
While Valerie James, Riverside I & A officer, not known for compliance with ADA law, advised me on the phone today that requesting a change of date so that I do not miss time from the State run Acquired Brain Injury Program at Coastline Community College “is not an ADA request” I will seek further counsel there.
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It seems to fall under the category of reasonable requests, particularly since I have to travel over 100 miles to get to the program, pay for a hotel room, and eat meals out in order to obtain help for compensatory strategies to deal with the untreated brain injury of 1/9/12 and consequent second impact trauma of 2/4/12 and a more recent injury, related to the initial injury, of 12/3/14.
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In order to be present for further Defense file churning and use of Court time, I will have to miss a full day of compensatory strategies by leading brain experts, I will have to repack from a Newport Beach Hotel and find a Riverside hotel, unpack, pack again, show up at Court, listen to Defense continued chicaneries, then drive back to Newport Beach for the final day of the program, on a Thursday.  While to someone without a brain injury, that sounds like “no big deal”….. for someone with cognitive impairments, slow processing, auditory and visual impairments, it is close to a devasting demand.
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It took me two years to get in front of a Judge at WCAB to be heard for my right to medical care, denied now more than 3 years, with the help of the Information and Assistance Officer.  At one hearing, when I requested auditory aids, not only did she deny them, she confiscated my cell phone and the recording devices I had brought to make it an easy request.  At the last hearing, in July of 2013, it was an extended continued hearing, and when I arrived, there were none of the accommodations requested.
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In fact, I had to be addressed by the Judge, in a Court room of lawyers, with all my paperwork sitting in my briefcase, behind the Judge’s chair.  I was not allowed access to the papers and I don’t even recall much other than the horrors of such a violation.  The Judge told me that issues of fraud are not addressed in his Court and that if I had such allegations, I was required to verbalize my concerns.
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I HAVE A BRAIN INJURY, WITH SPEECH, VISION AND AUDITORY IMPAIRMENTS.
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I asked then for a postponement so that I could find a government agency to help me address my concerns of felony fraud that permeate my case, and I assured the Judge I had no intention of returning to his Court until such time.  Sadly, I have learned that Fraud is a non-prosecuted pattern and practice in the world of Workers Comp.
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I have been denied disability benefits, medical benefits, and I have been harassed, discriminated against, bullied and more since this injury, and much of it has happened with WCAB Riverside knowledge, and in some instances, participation.
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Does it make sense to have an Orthopedic Surgeon, who fully admits he has no knowledge of brain injuries, as the designated primary treating physician since 2/15/13, and to have every one of his requests for specialty evaluations and treatments denied denied denied?
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Originally, when he was designated, Ms. Mall of the defense, and Ms. James of your offices, assured me that I could not have a Phsyiatrist or Neurologist of Neuro-psychologist as the treating doctor, but the orthopedic surgeon could as for such.  After months and months of denials, defense firm said the requests were denied since the orthopedic surgeon had no brain injury expertise.  What a “Grand WorkComp Fraud” I have been victimized by.
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Now, they want yet another battery of Neuro-psych tests…. although they ignored the results and failed to provide requests for treatment by doctors since 2012 — Dr. DeGoede – Clinical Psychologist referred by EAP, Dr. Eileen Kang – Neuro-psychologist, referred by Dr. DeGoede since CNA had no neurologists or neuro-psychologists to refer to, then a Dr. Marcel Ponton – QME, Neuro-psychologist, Dr. Lynn Lowell, Neuro-Optometrist, Dr.Eric Ikeda, Neuro-Optomestrist, Dr. Michael Lobatz, neurologist, , ScRIPPs Brain Injury Rehabilitation Center and approximatley 34 doctors, all paid for expensive evaluations, while I have been denied medically necessary treatments since date of Injury.  I have spent more than $30,000 out of pocket to survive work comp, and this recent phone call with Ms. James tells me nothing has changed. She is not an impartial Information and Assistance Officer.
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While Stewart Reubens, Esq. advised you that “Ms. Ayres has been evaluated by a psychiatric Agreed Medical Evaluation, Dr. O’Brien, an orthopedic QME, Dr. Holmes, and a neurologic QME, Dr. Kent.  Currently Ms. Ayres is treating with Dr. Chalgujian, a neuropsychologist.  She is also treating with Dr. Darren Bergey.”  What he didn’t tell you is that Dr. Darren Bergey is an Orthopedic Surgeon, with no knowledge of Brain Injuries, who requested valiantly medically necessary evaluations and treatments while he was the PTP, February 14, 2013 thorough December 2014.  Over the course, he obtained authorization for an MRI of my right shoulder, and upon diagnosis of a severe tear and injury, he was told to change his records to indicate that the right should was non-industrial.  His MMI for orthopedic supported that lie.
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Apparently, the carrier or defense had threatened his office financially, by threatening to terminate referrals if he a) continued to request brain injury treatment and b) did not change the right shoulder to non-industrial.  He cancelled my December 2014 appointment, and said I am MMI – orthopedically, and still 100% TTD from the brain injury.  Mr. Reubens also neglected to mention to you that the O’Brien, and Kent reports were an expensive disorganized mess, due to his collegue, Kim Mall, and her little pattern of practice to omit medical records (hundreds of pages!) with clear intent to deny medical care.
 linda ayres says JOIN ME ON TWITTER
Those three doctors seems to have been working directly for Ms. Mall, and when it was brought to their attention that they had mis-stated the date of injury as 2013, and that they were using 2012 medical records as false evidence to deny medical care, they simply changed the date in their supplemental reports, but NOT the conclusions.
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That does seem to meet the DIR defintions of felony fraud, but alas, this is WorkComp…. with secret medical records (yes, Ms. Mall attempted to continue to use the Dr Obrien report and asked evaluating doctors to consider but  NOT summarize it.  I’m not a lawyer, but that seems to be a breach of Article… XIV of the California Constitution, and the 14th Amendment of the US Constitution. Alas, it’s work comp….. nobody seems to have jurisdiction over such wrong doings.
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Stewart Reubens, in further acts of ADA and EEOC violations, even suggested that I should consider a Conservator, since I am unable to protect myself from the WorkComp chicanery.
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I have repeatedly requested electronic communications due to my brain impairments, and Kim Mall and Stewart Reubens have repeatedly abused deadlines by sending things regular mail.
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Perseverance and tangential communications are part of the brain injury, and I am working very hard on learning compensatory skills to hopeful build a life again, after these monsters refused to provide medical care for over 3 years, and the first two years, I could not even leave the house except to get to their demanded evaluations.
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CONCLUSION:
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I would appreciate a change of date for the hearing, and I would also ask you to kindly ask the Defense exactly WHAT TREATMENTS WERE PROVIDED SINCE THE DATE OF INJURY, and were they in compliance with ACOEM guidelines.  
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If you are unable or unwilling to change the hearing date, kindly ensure that my ADA accommodations are honored.   I will bring the nearly 1,500 pages of medical evidence, and CorVel denials that appear to have supplemented CNA hand-washing.
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With all due respect, I have been terrorized by this system far too long and I will seek intervention from the Fraud Unit at the District Attorney’s office, and hope that they will sent a witness to accompany me to the Workers Comp offices for the hearing, on whatever date you demand.  This letter will also be a part of my social media records.
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I would hope that you would encourage investigation of this case, from top all the way to Sacramento.  It appears to be real dirty.  Perhaps the investigative journalists at ProPublica and NPR could take a look and provide some direction. Several work comp expert bloggers have written about my case, with concerns.
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My blog, if you have an interest, is ASK ABOUT WORKERS COMPENSATION GRAVY TRAINS https://askaboutworkerscompgravytrains.com/  …. all the grim details are there….. it’s a crying shame that such things happen in America, in “roughly 80% of work comp cases”.
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Thank you for your patience and consideration.
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Linda Ayres, REPRESENTING MYSELF
ADJ8181903
PO BOX 835
YUCCA VALLEY CA 92286
f:  760 418 8383
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Attachments (2):  Accommodations Requests for Persons with Disabilities  1 of 1 – Change date of hearing; 2 of 2 Reasonable accommodations including quiet room, large table, recording, laptop, support chair and breaks at least every 50 minutes.
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Distribution:  I CERTIFY, UNDER PENALTY OF PERJURY, THAT THE FOLLOWING DISTRIBUTIONS TOOK PLACE ON 3/23/15, IN YUCCA VALLEY, CALIFORNIA 92286     LINDA AYRES
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Senator Jean Fuller  FAX:  16613230446
Jennifer Lentz Snyder – LA DA JSnyder@da.lacounty.gov
Employer Fraud Task Force – fax: 714 637 3350
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Nicollette Zumaya – WCAB Disability Accommodations Coordinator fax 951 782 4114
Fred Sachs – CNA Claims Plus  fred.sachs@cna.com
Shane Riedman – CNA Fraud Unit shane.riedman@cna.com
Michael Dougherty -Wyndham Risk Manager  michael.dougherty@wyn.com
Mary Falvey – Wyndham EVP  mary.falvey@wyn.com
Tina.Jordan – Wyndham Regional HR Manager  tina.jordan@wyn.com
Jerrell Stark – Wyndham Regional Recruiter jerrell.stark@wyn.com
WVO Leave Support Center  – wvoleavesupportcenter@wyn.com
Kim Mall – Grancell kmall@grancell-law.com
Stewart Reubens – Grancell  sreubens@grancell-law.com
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Life with TBI is so

PS  Anybody else wonder why federally mandated, grant funded DISABILITY RIGHTS CALIFORNIA’s PATBI PROGRAM, Protection & Advocacy for Individuals with Traumatic Brain Injury program EXCLUDES INJURED WORKERS?

www.disabiltyrightsca.org 

CAAA looks the other way.  So far, the offices of the DA have the looked the other way.  DIR and EEOC refer back and forth to one another… My My….. Ain’t it a crying shame.

Is that more of the #GrandWorkCompFraud and Exclusive Remedies deal?

must find accurate news source  media

WE ARE THE MEDIA NOW