Legal Question in Workers Comp in California

I was sent away by an ER physician who was supposed to treat my injury to my primary MD. My MD sent me back to the ER doc who at that point had to amputate my finger because of time waisted. Is there some kind of work comp law that she broke by sending me away?


Asked on 3/01/12, 7:14 pm

2 Answers from Attorneys

David Lupoff Law Offices of David B. Lupoff

Maybe - maybe not. Without knowing any more information than what you provided, it is impossible to give you an answer. Please feel free to contact me at 1.877.505.INJURY, and/or go to my website at www.lupofflaw.com.

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Answered on 3/01/12, 7:26 pm
Nancy Wallace Nancy Wallace Atty at Law

Is there a WORKERS COMP law? No.

Is there a possible MEDICAL MALPRACTICE action against the ER doc? Maybe. But no Workers Comp judge has the power to judge or award any medical malpractice.

Is there a wORKERS COMP PENALTY against the Insurer because the Insurer failed to OK the ER doc to treat you (resulting in the ER doc sending you away), THERE MAY BE A PENALTY DUE, 10% of the fees and costs of the amputation (and maybe even Labor Codd 5814 sanctions for tactics designed solely to delay and harass).

The ER Doctor is NOT supposed to treat work injuries. The "Medical Provider Network" doctor is supposed to treat work injuries.

Sometimes the situation is a true emergency and the emergency physician is supposed to just 'stablilze' the medical condition.

AN ATTORNEY might be able to get records from the emergency room showing staff tried to get an adjuster to authorize the ER Doc to take care of the finger but was ignored or refused.

Trouble is, the ER Staff never calls the right adjuster and never has the claim info and never saves the fax transmission report and never writes down which nurse spoke to which adjuster (or which nurse left two voice mails on an absent adjuster's voice machine with answers back).

Sorry this happened. Adjusters ignore calls on fingers daily. Fingers don't cost the insurance company very much. Adjusters are more worried about $20,000 ER Bill than paying you just $6,000 for the amputated finger... they save money by ignoring the Emergency Room calls and letting you lose your finger.

Focus all energy on finding out who at the hospital phoned the adjuster and would that person be wiling to come testify at a Workers Comp hearing that they tried to get the adjuster to OK the ER Doc to treat but were ignored.

Hope that helped some.

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Answered on 3/02/12, 12:59 pm


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