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

Is Wyndham Worldwide Committing Workers’ Compensation Fraud in California?? ASK AN INJURED WORKER TODAY!

DRAFT TWO:  TO WHOM IT MAY CONCERN

Just the Facts, Jack and Jill!

“A WITNESSED SLIP AND FALL WITH LOSS OF CONSCIOUSNESS AT WORK….”

#WorkComp NEGLIGENCE BAD FAITH AND REFUSAL OF WYNDHAM WORLDWIDE TO PROVIDE NECESSARY MEDICAL TREATMENTS TO INJURED WORKER SINCE 1/9/2012

Forensic Psychiatrist:  “Treatment should only be provided industrially if the Finder-of-Fact finds some evidence of an industrially-related concussion injury.”  April 2013

wc workers-comp-fraud  if your company lies

OFF WORK NEARLY 1,000 DAYS…EVALUATION AFTER EVALUATION, RECOMMENDATIONS FOR TREATMENT REPEATEDLY BY MULTIPLE EVALUATING DOCTORS…IGNORED OR DENIED…NOT AUTHORIZED.

Wyndham Worldwide #WorkComp BAD FAITH DENIALS;  JUST THE FACTS!  USA SOS!!!

STILL ON THE ‘REST AND WAIT PROGRAM’, WITH REQUESTS BY DEFENSE FOR YET ANOTHER ORTHOPEDIC EVALUATION, WITH A REQUEST FOR AN ORDER TO COMPEL…. in order for defense to ‘defend’ against the demand for medically necessary treatments, denied since date of injuries.  #USA SOS!!!

Liberty face palm

Wyndham Worldwide:  http://www.wyndhamworldwide.com/  

http://www.wyndhamworldwide.com/about-wyndham-worldwide/mission-culture

~~~~~~~~~~~~~~~~~~~~~~~~~~

draft 1  – June 16 2014; sent to Grancell Stander Reubens, et al,  CNA Insurance/American Casualty and Corvel Corp-Utilization Review Department, as well as Dr. Darren Bergey, Orthopedic Surgeon PTP  and Dr. Hilda Chalgujian, Neuropsycholgist.

draft 2 – June 29, 2014  …herewith:

LINDA AYRES VS. WYNDHAM WORLDWIDE   ADJ8181903    NEGLIGENCE, BAD FAITH AND REFUSAL OF EMPLOYER TO PROVIDE IMMEDIATE REASONABLE AND APPROPRIATE MEDICAL CARE, SINCE DATE OF INJURY, JANUARY 9, 2012, WITH FURTHE BAD FAITH ACTIONS CAUSING IRREPARABLE HARM TO INJURED WORKER.

[a friend, A RETIRE NURSE, helped organize these facts, without the emotional ‘charge’ around them.]

No head injury is too severe to despair of,
nor too trivial to ignore
-Hippocrates 400 BCE

Date of Injury:  January 9, 2012, approximately 8 a.m.

Injured Worker: Linda Ayres, TimeShare Sales Executive –

Vacation Ownership Sales, Real Estate Broker

Claim #: CNA e3269102     WC #:  ADJ8181903

 

A witnessed slip and fall with loss of consciousness at work.  Able to stand with assistance.  Complained of feeling “dazed and confused”.  Also, c/o headache and pain in back of head, neck, back and right ankle.  Was neither advised nor offered a ride to seek medical treatment by sales manager who had witnessed the fall and assisted with getting up off the snow covered ground.

 One unfortunate event led to another unfortunate event, which led to a series of unfortunate events with wrong dates, doctors, omitted records and misinformation and inconsistencies with misrepresentations.  The harm caused to the injured worker by these unfortunate events is irreparable.

She continued with “usual work” (sales meeting followed by sales presentation) with above symptoms, including severe confusion, until approximately 10 am, when administrative manager approached with work comp form stating “you can see any doctor that takes work comp insurance”even though the form had no insurance information on it.  Again, she was not offered a ride to the Emergency Room nor was she advised to seek immediate medical treatment.  She continued with above S/S, including confusion and dizziness.  She left work at approximately 2 pm, (approximately 6 hours post fall) with her manager’s knowledge of an approximate 1 hour drive home – 20 miles down steep snowy mountain road, 40 miles of flat desert road.

 

She continued with headache, confusion, dizziness, head, neck back and right ankle pain.  She drove directly to the chiropractor who had been seeing her periodically (every 1-2 months) for maintenance.  Upon arrival, the office staff commented on her state of confusion and general “dazed” appearance.  She informed the chiropractor about the slip and fall at work, her LOC and immediate and persistent pain, headache, confusion and dizziness.

 

The doctor’s office attempted to contact her employer for needed information regarding a work comp claim.  Messages were left but employer did not return calls.  (See email from Dr. Whitlock to Daniel Elliott dated Tuesday, 2-28-12, CNA Adjuster, and return email authorizing more chiropractic visits #14)

 

1-11-12 injured worker presented self to Avalon Urgent Care due to increase in confusion  and pain and headaches.  (See 1st Report of Occupational Injury).

 

Injured worker was not contacted by employer for follow up.  Not given a list of MPN authorized providers.

Was given an incomplete Work Comp form filled out by employer.  Personal health insurance (CIGNA) billed for Work Comp by Avalon Urgent care due to lack of infomration on Work Comp DWC-1 form.  Attempted authorization by Urgent Care.  No response from emkployer or Work Comp Insurance.  Injured worker had to pay out of pocket for co-pay and medical tests including Xrays (request for MRI).  This office was not a member of alleged MPN at the teime, but apparently later became a member.

 

On 1-11-12 injured worker contacted EAP provided by employer due to continued confusion and concern thereof.  Continued lack of support by employer.  She continued to update employer  No authorization for medical treatment.

On 1-13-12, Injured worker was seen by Dr. Daniel DeGoede, Clinical Psychologist,  referred by employer EAP (Employee Assistance Program).  See handwritten referral dated 1/13/12 from Dr. DeGoede  to Dr. Esmael Sebti, Neurologist for scheduled appointment on 2/7/12.  Was refused evaluation and referral when appearing for appointment by Dr. Sepbti due to non acceptance of work comp patients.  It was later discovered that this doctor’s two offices were a part of the alleged MPN network.

 

On 1-21-12 Retained attorney due to lack of medical treatment and appropriate authorizatin for treatment of head injury and was scheduled for an appointment on the next day by the law office with an Orthopedic Surgeon. Dismissed law firm with cause shortly thereafter, at the recommendation of a retired Judge, and worked directly, in-pro-per,  with Adjuster to coordinate a team of providers, with Dr. DeGoede, Clinical Psychologist as lead doctor and designated PTP.

 

On 2-4-12, sustained further injuries after two falls at home from LOC due to head injury on 1-9-12 with undetermined periods of loss of consciousness, suspected to be less than 30 minutes each, but unknown.  (See attached Hi-Desert Hospital ER report of Dr. Lambros, NO EEG DONE.

On 2-6-12  MRI Brain (one month post initial injury, 2 days post subsequent 2-4-12 injuries).  MRI not authorized by WorkComp Carrier even though it was recommended by 1st treating doctor in Urgent Care prior to subsequent fall on 2-4-12.   The MRI WAS authorized by employee health care provider, CIGNA, with a large co-pay due at time of MRI.

On 2-22-12, Authorized referral (non-MPN) to Dr. Eileen Kang, Neuropsychologist, by Dr. Daniel DeGoede, Clinical Psychologist (EAP referral, and ultimately authorized (non-MPN) at PTP.  Dr. Kang performed a battery of neuro-psychological tests and recommendations for further treatment were ignored by insurance carrier.

On 3-6-12, was referred by office of Dr. Kang  to Dr. Stephen Waldman, Neurologist  (2 hour drive from home; non-MPN provider, no TBI expertise; field of expertise epilepsy and fybromyalgia)  after several failed attempts to find a neurologist on the alleged MPN list.   Without medical evidence, Dr. Waldman recommended ‘precautionary epilepsy medications with mood elevator’ and attempted to have driver’s license revoked for decline of offer of unfounded medications.  A second neurologist was requested, but denied by carrier.

 

In March 2012, was referred to another  attorney, who was retained until November 2012 .

On 4-23-12, was then referred, again by another attorney, to a clinical psychologist, Dr. Marcel Ponton, in Pasadena (3 hours from home) who’s colleague, Dr. Gunn, re-administered a similar battery of neuro-psychological tests and recommendations for further treatment and evaluations were ignored by insurance carrier and in fact, TTD benefits were terminated on 4/30/12 in bad-faith action by carrier.

Dr. Marcel Ponton then referred injured worker to a second Orthopedic Surgeon, Dr. Kahlid Ahmed for a second consultation, and to a physiatrist, Dr. David Patterson, Medical Director at Casa Colina Rehabilitation Centers, for DMV eval to disprove Dr. Waldman request to revoke driver’s license.    Recommendations for further treatment and evaluations were ignored by insurance carrier.

 

Diagnosis through March 2014

850.1 Concussion w/brief loss consciousness, 338.11 acute pain due to trauma, 847. 0 Cervical Sprain/Strain, 839.08 Disloc mult. cerv vert clos, 728.85 spasm muscle, 839.21 Disloc thoracic vert close, 739.3 Nonallopathic lesions lumbar nec,  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 Sydrome, 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, 850.9 Head Concussion, 854.0 Closed head injury, 784.0 Headaches, 294.9 Cognitive DisorderNOS, 310.20 Post Concussion syndrome, 850.9 Head Concussion, 378.42 Exophoria, 378.43 Vertical Heterophoria, 368.33 Fusion with Defective Stereopsis, 368.13 Visual Discomfort. Neck Pain 723.1, Mid-back pain 724.1, [Note: “A Vision rehabilitation program is medically necessary to improve Linda’s deficient visual skills, as noted…(March 22, 2014, Dr. Lynn Lowell, Neuro-Optometrist, Ketchum Eye University 2014, as also indicated by Dr. Eric Ikeda, Casa Colina, Neuro-Optometrist]  Closed Head Injury 854.0, 784.0 Headaches, 294.9 Cognitive Disorder NOS, 310.20 Post concussive syndrome, 850.9 Head Concussion.

.einstein concussion

 

Dr. Hilda Chalgujian, Forensic Neuropsychologist: May 2014 –

‘…recommend this patient be monitored neurologically in light of the above-noted cognitive issues; patient will benefit from a neurologist with experience int he treatment of traumatic brain injury; … recommend patient continue with individual therapy to help develop better insight into her functioning and increase her coping skills, and minimize external stressor;… supportive individual psychotherapy will help her develop strategies to help her…;  recommend she receive speech therapy to directly address her current difficulties with communication, including verbal fluency, as well as attentional issues…; recommend she is evaluated and monitored by a neuro-ophthalmologist to assess her ongoing and longstanding complaints of impaired vision, and explore vision therapy…; she may also benefit from occupational therapy to address ongoing visual concerns; this treatment should also address how to best compensate for situations that would be most relevant for her return to work in the future; …defer to her treating physician for her physical therapies; she should be re-evaluated in six months following her treatment regimen to assess her permanent and stationary status….’

 

ALL IN ALL, TO DATE, SHE HAS SEEN:

 

34 specialists, and has had 2 MRI of the head, one of the Cervical Neck, and one of the Right Shoulder.  Several of the doctors were referred by attorneys, her legal representation or by treating doctors.

 

She has been seen by neurologists, psychologists, psychiatrist, neuro-optometrists, neuropsychologists, physiatrist, 4 orthopedic surgeons, multiple therapies, including speech, physical for neck, acupuncture, vision and cognitive rehabilitation evaluation (please refer to attached list)

 

Retained and dismissed 4 attorneys due to incompatible goals; Injured worker has been represented approximately 14 months out of the 2 years 5 months since date of injury.   Each attorney did increasingly greater harm compounded by further failures to facilitate medical treatment than prior representatives.

 

The most care/evaluations were authorized when injured worker was in-pro-per after dismissing law firm #1. (Treatment with Dr. DeGoede, Dr. Kang and Dr. Whitlock Jan-Apr, 2012)

 

Due to brain injuries, and consequent communication and cognitive deficits, injured worker has been unsuccessful in retaining competent legal representation, knowledgeable about proper handling of a brain injury claim and necessary treatments and treating team, in accord with ACOEM guidelines. ADA requests for accommodations at WCAB – Riverside have been repeatedly violated.

 

1) <30 days (1/21/12);      Castillo & Associates

2) >9 months (Mar 2012 – Nov 2012)   Mike Durich, Esq. 

3) < 3 months  (Jan 2013 – Apr 2013)  David Lynch & Associates

4) < 1 month  (mid-Dec 2013 to mid-Jan 2014)  Clayton Perry, Esq.

 

Treatments of chiropractic, acupuncture, neuro-optometry, neurology, functional neurology, speech therapy evaluation, on-line brain-training, EEG, and Brain MRI’s were medically necessary, as requested by multiple doctors, and in light of the medical necessity, and continuous bad-faith actions of employer and it’s insurance company and defense counsel, have been self-procured and more than approximately $23,500 in outstanding medical costs remain unreimbursed since 2012.

 

To date, authorized treatments have only included:

2012 – 14 chiropractic, 17 psychotherapy

2013 –  6 physical therapy

2014 –  6 chiropractic, 12 acupuncture (right shoulder only for first 6, second set of acupunture requested as “959.01, 784.01 Multiple Head Injury, Multiple Neck Injury, Multiple Upper Extremities, Upper Back Area” and was modified by non-doctor to “959.01, 784.0 Multiple Neck Injury, Upper Back Area”  

[All urgent medically necessary treatments have not been authorized, many denied by non-physicians, and in 2013, Corvel became involved in further denials, primarily not-authorized by their Orthopedic Surgeons denying further evaluations and treatment by specialists in Traumatic Brain Injury.  Distortions by QME/AME doctors, compounded by Defense pattern and practice of omission of medical records have further contributed to the lack of medically necessary treatments. The 38 page April 2014 evaluation by Forensic Neuropsychologist has been objected to by Defense, apparently in order to further delay treatment and cause further harm.]

 

 

THEREFORE:  

#1  Wyndham Worldwide and it’s agents neglected to provide medical treatment and proper evaluations since date of injury.  Managers at Wyndham Worldwide resort – WorldMark by Wyndham at Big Bear – were negligent and apparently untrained in proper handling of an industrial injury, particularly one including a head injury.  The failure to have transported the injured worker to the closest Emergency Room or advise injured worker to seek immediate medical treatment to avoid further injury is extreme negligence.

#2 Not given proper Workers Comp info on MPN Providers and List of Providers and 1st report insurance information was lacking, causing need for use of  employee CIGNA insurance through February 2012.

#3 Allowed to “drive self home” six hours after Wyndham managers saw her fall and lose consciousness.  Allowed her to continue working even though she complained immediately of confusion, pain in her head, back and neck and right ankle.

#4  No immediate treatment authorized for head injury / MRI / EEG.

#5  Continuous negligence from lack of authorized treatments sent on a path of self-procured medical treatments (requested by multiple providers, ignored by carrier).  Out of pocket expenses for doctors, appointments, treatments and equipment needed for prognosis and ongoing care of brain injury and rehabilitation, and orthopedic injuries.

 

SEEKING IMMEDIATE RESOLUTIONS

A) Monetary reimbursements of medical mileage, treatments, and equipment.

B) Lump Sump Settlement for life-time medical treatments including certified Brain Injury Rehabilitation including but not limited to cognitive rehabilitation for high level Loss of Executive Function of Hi-IQ TBI survivor, vision therapy, vestibular therapy, speech therapy, vocational rehabilitation and retraining, with compensation for extreme loss of future earning capacity,

 

EXHIBITS:

(to be listed)

(Unreimbursed medical expenses and miles since 2012 exceed $23,500, submitted repeatedly and complaints filed with WorkComp Audit Unit for further investigations and penalties.)

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

LIST OF DOCTORS INVOLVED SINCE 1/9/2012…

Dr. Khalid Ahmed MD, Orthopedic Surgeon
Dr. Darren Bergey MD, Orthopedic Surgeon
Dr. Hilda Chalgujian Phd, Neuropsychologist
. Crystal Crites MPT, Clinical Director
Dr. Daniel DeGoede Phd, Clinical Psychologist   $
. Jennifer Diemart MA, CCC-LSLP    $
Dr. Ernesto Gallegos DC   $
Dr. Christopher Hancock MD, Neuroradiologist
Dr. Tiffany Hoang OD   $
Dr. Eric Ikeda Neuro-Optometrist   $
Dr. Gilbert Jaudy DC, FACFN, FABVR, CCST   $
Dr. Eileen Kang Phd, Neuropsychologist
Dr. Ronald Kent ** MD, Phd, Neurologist
Dr. John Lambros MD, ER
Dr. Michael Lobatz MD, Diplomate, American Board of Psychiatry & Neurology   $
Dr. Lynn Lowell OD, FAAO, FCOVD  $
Dr. David McCollum DC
Dr. Joseph Nguyen OD   $
Dr. Brandon Nielsen OD   $
Dr. James O’Brien ** MD, Forensic Psychiatrist
. Debra Ouellette MS, OTR/L  $
Dr. David Patterson MD, Physiatrist, Medical Director of Rehabilitation  $
Dr. Marcel Ponton Phd, QME, Clinical Director
Dr. Jacob Rabinovich MD, Orthopedic Surgeon
. Don Risser Licensed Acupuncturist   $
Dr. Jay Sanvictores MD, Family Practice   $
Dr. Esmaeil Sebti MD, Neurologist
Dr. Julie Simmons MA, PSY.D
Dr. Gurvinder Sunny Uppal MD, Orthopedic Surgeon
Dr. Stephen Waldman MD, Phd, Neurologist
. Diane Wallace Licensed Acupuncturist   $
Dr. Lynda Wells PhD, EEG Neurofeedback Practitioner   $
Dr. Jaime Whitlock DC   $
Dr. Bijan Zardouz ** MD, Neurologist

 $  “Paid for by Injured Worker or/and co-pay with CIGNA Health Insurance, referred by EAP Provider

 

**  All but three doctors (Kent, O’Brien & Zardouz) recommended further medically necessary treatments and evaluations for #TBI/Closed Head Injuries and orthopedic injuries; only a few chiropractic, a few clinical psychologists, and 6 physical therapy sessions were authorized the first two years.  The fight continues for medically necessary brain injury rehabilitation as well as for orthopedic injuries; clearly documented; Wyndham’s agents have continuously refused to and failed to authorize.  

 

If the ‘injuries are so minimal’…. does it make sense that this injured worker would be off work for nearly 1,000 days… ‘for a headache and poor anger management skills when subject to intimidation, terrorism, and systematic bad faith and negligence?”

Capture WYN COUNT ON ME PROGRAM

How can the defense continue to refuse to authorize medically necessary treatments, and how can the defense further allege that these injuries, exacerbated by refusal to deny medical treatments since date of injuries, were somehow ‘pre-existing’…..???  Mr. Reubens, any further questions??

MAKE SENSE??

 

brain concussion tbi

If you’re like me, you want to know: What can YOU do Today?

 

(1) Well, BE AWARE OF THE HORRIFIC CRIMES AGAINST INJURED AMERICAN WORKERS BY FELLOW AMERICANS IN COLLUSION WITH THE BILLION DOLLAR INSURANCE INDUSTRY.

(2) Share this blog with someone…………by email, fB post, tweet, snail mail, etc.  BE CREATIVE.

(3) Share YOUR #WorkComp story and resources as comments on this blog or and http://www.NAIDW.org, National Association of Injured & Disabled Workers “NO WORKER LEFT BEHIND”  888.788.naidw (6243)

(4) Send your letter of support to  wynLINDA@gmail.com with encouragements to continue to FIGHT THE GOOD FIGHT; The SuperLawyers and Other Legal Experts and Government Officials interviewed have indicated that THIS STORY IS NOT UNUSUAL…. and that it has a ‘too bad, how sad’ ending, always.

(5) TELL YOUR FRIENDS AND NEIGHBORS; YOUR GOVERNMENTS ALREADY KNOW.

WC WorkCompFraud and Money

REMEMBER REMEMBER:  WE ARE THE MEDIA NOW.

ONE PERCENT  99 PERCENT

WE DO NOT…FORGET.

BUT IF WE DO FORGET DUE TO #TBI, FRIENDS DON’T LET FRIENDS STAY IGNORANT!

 SMALL ACTIONS BIG CHANGE

THINK LOCALLY.

ACT GLOBALLY.

OCCUPY VIRTUALLY!

EXPECT US!