Legal Question in Workers Comp in California

I was terminated when I brought the dr note for modified duty. I never talked to my employer and only email the adjuster that my employer never offered any modified work and they terminated me instead.

I filed for unemployment because I didn’t know what workers compensation benefits were. It was 3-4 months until I was advise that I should be on sdi. I applied and I was approved and it was backdate to date of injury. Although the start date was to backdated, the benefits was not, I had to wait a few weeks that receive any benefits.

The carrier is telling my I don’t get ttd for the months I collected unemployment. But edd sdi said they will put a lien and replace the money and then the rest will be sent to me. I spoke with unemployment and they said that I owe that money. The carrier said I certified I was able to work and I told them I was able to work because my restrictions was 10-20lb. I couldn’t find work and there was no work to return to.

My doctor currently has me as ttd but qme has me at mmi. However, the qme report was sent in 4 months late, he didnt review all the medical reports.

What period am I entitled for ttd? The claim is still currently denied but the adjuster wants to start negotiating but I can’t counter because I don’t what dates I am entitled for ttd. The carrier wants to pay the lein but I just found out that they only pay .50 cent to the dollar and that is not much at all.


Asked on 9/30/18, 2:40 pm

1 Answer from Attorneys

Nancy Wallace Nancy Wallace Atty at Law

You are entitled to Temporary Disability payments LESS THE UNEMPLOYMENT payments from the date the employer terminated you until a physician declares you able to return to full duty with no restrictions (or at Maximum Medical Improvement). You MAY NOT cash an Unemployment check then demand another check for the same dates. YOU NEED AN ATTORNEY immediately, you needed one the date you were terminated and you needed one before you picked the horrendous QME you picked. The insurer need not pay you any more TTD because it has a QME report that says you can work at something somewhere, you are at Maximum Medical Improvement and so no longer temporarily totally disabled. you should have objected to the QME findings when there was no report 60 days after the appointment, but you 'crossed your fingers' so see what he might say...and it's probably too late to object to his findings as being late. But an experienced certified specialist attorney in workers comp MIGHT be able to get the matter on calendar and get a judge to strike the report as non-admissible because it's late, BUT YOU NEED TO GET THAT DONE IMMEDIATELY. So when interviewing attorneys, make certain the one with whom you sign will get the claim on calendar immediately to get the QME report struck...the 'radio' and 'TV; guys have secretaries administering claims and they don't fight QME findings, so if you are not meeting the attorney handling your claim face-to-face and the attorney does not tell you when she's going to get the claim on calendar to get the QME report stricken and TTD payments ordered, go find another attorney.

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Answered on 10/01/18, 11:44 am

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