Legal Question in Workers Comp in California

I experienced right and left arm and leg weakness after a mandated flu vaccine at work. It eventually also led to left shoulder pain. Because I waited several months to report it, the doctor said it doesn't make sense. He is choosing to only focus on the left shoulder pain and disregarding the remaining weakness in my left leg, shoulder.

Doctor denied my request for physical therapy and has ordered an MRI. The only treatment I have received the past month or more is ibuprofen which hasn't done anything.

The insurance company hasn't decided if they will cover my case or not. I am hesitant to schedule the MRI until I know it will be covered by workers comp.

Also I am hesitant to have invasive therapies such as being injected by the contrast dye used in MRIs. It's also why I requested conservative treatment such as physical therapy.

Can I postpone the MRI until I hear from the work comp insurance company regarding coverage?

Thank you.

Asked on 9/13/21, 1:25 pm

3 Answers from Attorneys

David Lupoff Law Offices of David B. Lupoff

You can do anything you want. However, the goal is to get to the bottom of what your injury is, and how you injured yourself. Please feel free to contact me at 1-877-505-INJURY

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Answered on 9/13/21, 1:36 pm
Ronald Mahurin Law Offices of Ronald Glenn Mahurin

If you file a claim for WC benefits and get an MRI, the carrier will be responsible for payment unless the denial issues before the MRI. So do not let the lack of a denial stop you from moving forward. As for the injury, it is unfortunately not covered by one of the Covid presumptions which relate to how you were exposed to Covid, so you will need a treating doctor to opine that the injury you claim is work related, or alternatively go to a Panel QME and get such an opinion. With a PTP the carrier will likely object to any reporting supporting a work related injury, so the Panel process is likely the fastest way to move forward and the best way to force the carrier to make a decision. Remember, if you file the DWC-1, the carrier must deny the claim within 90 days or there is a presumption of injury. DWC-1 can be found at the DIR/WC forms page..

In other words, file the claim. You can then ponder if you need an attorney when you get more information.

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Answered on 9/13/21, 4:01 pm
Nancy Wallace Nancy Wallace Atty at Law

There is $10,000 on the table for treatment and diagnostic studies -- like MRIs -- until the Insurer issues a Denial or Acceptance letter.

The trouble is the MRI company won't do the study without a promise in writing as to who will pay.

If you are seeing a doctor who is writing that your claims of weakness make no sense, it's time to get a new doctor. You'll need to find a doctor familiar with getting paid from the $10000 available during a "DELAY" phase of the claim.

If you do not know how to research the doctors on the insurer's MPN list, it is time to get an attorney.

You want the doctor you see looking at VAERS Data about other vax recipients have this type of weakness. If you are the only one out of 75 million (well, 25 million for each drug manufacturer) who had this weakness, the doctor will have a really tough time writing that your weakness the the result of the vaccination.

If I had a rough reaction to a vaccine, I'd be on the VAERS data lists for that drug manufacturer combing through the 10,000s of entries seeing what happened to people my age who took that brand in the arm, then printing and showing that data to my doctors.

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Answered on 9/13/21, 4:15 pm

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