Serious Work Injury: Third Party Claims & Maximizing Settlements

How does an injury happen? Has a third party been involved? Did a machine injure you at work? Were you injured by the motor vehicle you drive for work? There are many ways you can get outside the workers’ compensation system and be entitled to benefits. Program 1314.

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20 Comments

  1. From the moment you are being treated by workman's comp Dr. you are bring scrutinized first by your employer then the insurance company. As if we asked for the Injury to happen to us. Just fix me like I was and I will tell you when I'm finally there. Fix it or allow the workers more support and services who are injured. Instead of denying everyone at first glance.

  2. Excuse me, in regards to being a "firm believer that not for the rest of their lives" everyone A paraplegic or a chronically ill person are clients injured for the rest of their lives. For example, a veteran of war and a person from an accident who cannot longer stand up from a wheelchair or the ones suffering flashbacks from mental traumas are permanent injuries, Madame. And if the cure will be to give them a life like the rest of people who enjoy without prejudice a chance at an education and employment, that should be the main recovery concern in the legal system. Why should people suffer in silence for the rest of their lives due to issues that can be resolute with such a simple arrangement?

  3. Worked as an automotive technician in Louisville, KY. got send out to a busy Highway to recover a truck that a wheel has fell off, I refused but was threaten with my job if I didn't go, I was send out by my self no one else would go because they don't get paid for that. I fell off the side of the work van side door knock my knee into the side step and cracked the knee cap, no later than 15-20 minute returning to the shop I was fired for another reason, they was told that I may have hurt my knee prior to that termination. insurance is dragging the process, is been few months now, nothing is done for me as of todate

  4. REVOLT! Social Security Administration can report $25,000 OFFSET for years even if you didn’t receive money, so you pay $6,000 taxes each year and you cannot fight it! locked for LIFE! When it’s cleared – TOO LATE. Lost $80,000 and a JUDGE COMPELLED TO RELEASE THE OFFENDER so no personal injury or medical assistance, either. THEY’RE THE ONES WHO ARE “DOUBLE DIPPING “. What a con against Americans.

  5. Worker’s Compensation only protects the employees I’ve said Worker’s Comp. association and the doctors they use and pay for our going to side with the employees at the Worker’s Compensation offices

  6. These DRs are being paid for from worker’s compensation or work force. So what is the dr going to say. That’s right no nothing

  7. I got hurt at work over 13 months ago and I quit my job because of it because the doctor I seen said I could go back to work a week later I worked in shipping on a towmotor loading trucks and lifted a 50lb propane tank and blew out my shoulder and my boss wanted me to come back to work and as of now my doctor has my back on just how bad I am and the BWC has no choice but I live in Ohio so now with no payments at all I will go after them all.

  8. Funny how they forgot the judge was even there in; the room until he had to open his mouth to make himself known

  9. The entire system is broken. Listening to this woman state that the
    WC program can assist a person to become whole after following an injury while at work is so full of herself. I found her attitude nauseating and ignorant. . The obviously has never had any type of WC injury greater than a possible paper cut. I was injured over 20 years ago due to a manager who felt it was ok to use red tagged piece of broken equipment over buying new, resulting in a bracket breaking, allowing a 250 lb person already intubated to start falling off an operating room table. in a knee jerk reaction I grabbed her and wrestled her back onto the table, resulting in multiple herniated and ruptured disc in my neck and back. If I would have closed my case within a year or even 5 years after my injury, I would have been in a horrible spot due to the health issues that came up after these years. Neuropathy, Radiculopathy, bowel and bladder disorders caused from Quadra Equina syndrome, and to top it all….I've lost almost 80% of my hearing as a result from multiple anti inflammatories prescribed for over 20 years. WC is now trying to make me close out the case by refusing to approve ANY of the medications I have been taking continuously, some for the entire 21 years. They utilize a third party (BOUGHT) physician that quickly scans a chart and then writes the report the WC wants. I was advised by my pain management Doctor that this third party physician deserves to have a Mal practice suit brought against her for treating patients without actually physically contacting the patient. This is actually no different than those Drs being bought up on Medicare fraud for writing they have seen / treated a patient when in fact they have not. In my instance , the WC has now declined to allow any meds to be filled without any notice to me what so ever. I suppose they have not realized by now that I am not the dog that rolls over and plays dead. Though I have had a catistrauphic injury, undergone multiple surgeries, I DO continue to work full time as an orthopedic operating room nurse. The WC mindset is unclear to me….they don't want the injured worker to take time off, and yet as with people such as myself whom are the only support for their family, they want to punish the injured worker as if the incident was on purpose. WC continuously make being seen by a Dr. more difficult as well as getting approval for tests, getting approval for medications. I personally would enjoy a sit down conversation with this spokeswoman to find out just what the world looks like through her rose colored glasses. and then demand what action she has that is going to make the broken worker "whole" again. It is people like her that cause the IW to develop distain and lack of trust.

  10. *Spread Awareness! The following is just a small list of crimes that are facilitated against injured workers. Help to spread awareness of these crimes.
    1. Employers who lie in an effort to deny the injured worker the benefits / medical treatment afforded under the workers compensation law(s)
    2. Falsifying of medical & surgery reports and the minimizing of the injury to save the insurance carrier / employer money i.e. Doctors, AME’s, QME’s who falsely document / medical reports or eliminate the injured workers written descriptions of the injury and/or pain charts, sketches and letters
    3. Deceptive methods of having an injured worker sign multiple page forms wherein the first page is marked differently than the pages underneath
    4. The intentional maiming and battery of the injured workers body during medical treatments for strategic reasons i.e. “creating the look of a condition or condition(s)” that will be then be used against the injured worker for defense purposes during trial or as retaliation & mental abuse
    5. Intrusions into the injured workers home to set up video and audio and to taint or poison their food, move personal items from one area of their home to another part of the home leaving the IW to wonder how an item got from one part of their home to another aka “gaslighting” (these type of tactics are implemented to mentally abuse the IW), the removing of items from the injured workers home including their WC related documents – theft
    6. Vandalizing the injured workers personal property including their car / automobile / home
    7. Overt aggressive surveillance conducive of stalking and/or harassing of the injured worker (not to be confused with sub-rosa style surveillance)
    8. Hacking into the injured workers e-mails, social networking accounts & computers
    9. Intentional disruption / covert dropping of phone calls that may include calls the injured worker makes for emergency purposes including 911 Emergency, intercepting of phone calls including incoming and outgoing phone calls
    10. Harassment via cell phone and home phone tricks that include the appearance of the injured worker calling themselves on their own phone (false caller ID) or the appearance of the IW calling their home phone from their cell phone that is not in use (false caller ID)
    11. Interference with injured workers medical / healthcare appointments with their general practitioner “outside of workers comp”, trips to the hospital for pain or trips to an urgent care facility – all are opportunities to “design your medical reports” to favor the insurance carrier (may be utilized at trial for defense) Shockingly, the hospitals, urgent care facilities and other medical providers not associated with workers compensation often times cooperate with the defense firm’s & insurance carrier’s investigators. Healthcare providers are induced to cooperate with these corrupt individuals by virtue of false information and lies that they are provided to show the IW in a negative light.
    12. Harassment of the injured workers family members that may include harassing false collection agencies threatening to have the family member arrested & many other tactics
    13. If the injured worker does not have legal representation, it is likely that the WC Justice system will be influenced against the injured worker including at mandatory settlement conferences or at trial. Judges have been known to be “bought”. An injured worker without an attorney can be a sitting duck depending how hungry the defense firm is / lack of integrity & ethics, who the insurance carrier is and if the employer approved or encouraged the “program” i.e. the entire harassing / abusive / traumatizing procedural tactics!
    14. Malicious & unwarranted prosecution of the injured worker. Some injured workers have died defending themselves. They are called liars and treated with disbelief or a campaign to question to mental status will be implemented.
    During a conversation that I had with someone who works at the WCAB in California, I was told, "It is the attorneys!" I have no doubt. Some of these attorneys must be psychopaths to implement such horrific crimes against an injured worker, all for money and anything to keep the case open so that they, themselves, can "milk" their own clients, the employer and/or the insurance carrier.
    There are a plethora of crimes that are committed against injured workers. It doesn't matter if the injured worker is represented or not. Injured workers can be targeted due to their age, whether or not they live alone, the nature of their injury, what it may cost to remedy the WC claim, retaliation from a vengeful employer and more.
    If you file a workers compensation claim, from the very beginning, it behooves you to be on the lookout for these and other tactics. Protect yourself, carry a camera with you at all times, carry a recording device with you to be utilized at any and all medical appointments in or out of the workers compensation system and during any consults or treatments with workers compensation medical providers and with your attorney! Take pictures of all forms that you complete or sign as sometimes, IWs are denied copies! If you can, take a friend with you to act as your health advocate. You are permitted, in most cases, to have an advocate with you. If at any time you feel that someone has been in your home or apartment, you may be right! If you eat something at home that makes you sick or disrupts your body in any way or your nervous system, save the food so that you can report it to the police! Purchase home surveillance for your kitchen, bedroom, bathroom and living room. As my former attorney said to me after the fact, insurance carriers can be heartless and brutal! Take care of you!

  11. *There are several groups who are active in spreading awareness and/or advocating for injured workers;

    1.  Crimes Against Injured Workers – on Facebook
    2.  National Association of Injured & Disable Workers – on Facebook and on the web  – they have a lot of resources and forums for injured and disabled workers.
    3.  Injured Workers National Network – on Facebook and on the web
    4.  National Organization of Injured Workers – on the web – has videos and an assortment of other resources. 

    We all need to work together to get help for ourselves & other injured workers.  Spread awareness of the fraud and corruption that is inherent in the workers comp system.  That is the fraud and corruption that is facilitated by those who work in the industry including Insurance carriers, defense law firms / attorneys, medical providers, surgery centers, hospitals, medical clinics, Division of workers comp – Judges and other state workers.  Help to expose it!  Encourage whistle-blowers!  Stop the crimes against injured worker!!

  12. I completely disagree with the lady that claims that the workers compensation system can make you whole. Bulls**t! Insurance companies want to do and pay little as possible for the medical care which is mostly band-aid treatment.  I had to actually had to go on Medicaid pay for my worker's compensation injury.  You have to go through so many workers compensation industrial hearings which the hearing officers 99% of the time favor their decision towards the employer so the injured worker gets screwed. I have a lot of experience with this corrupted workers compensation system.  I only collected Temporary Total Disability for only 5 1/2 months and was forced to go on welfare. I even went back to school for a field that is way less physical than then job that I once had where I got injured at.  This lady here don't know what she's talking about.  

  13. It's halfway through the video and I haven't heard nothing about the patient's everyday struggles and how that is an important matter.

    Meanwhile, you attorneys and judges are discussing money later on down the line these workers comp companies are violating the injured party's civil rights and basic human rights!

    My case is open. I've had a IME that says I can't return to work without further treatment yet the insurance company won't simply authorize the treatment. Due to the negligence in treatment I've lost my position at my job! NOR HAVE I BEEN PAID IN OVER A MONTH! My children are hungry and I'm facing eviction! Im suffering from severe depression from being in constant pain! Being unable to work! And looking at my children go without food clothes and shelter!! My credit has been severely damaged by non payment and no one at Sedgwicks CMS give me a damn!

    WHAT ABOUT THE INJURED PERSON!?!?!!!

  14. CRIMES AGAINST & CRIMINAL MAIMING OF, INJURED WORKERS:   I am an injured worker who has been deliberately maimed and battered by the medical provider(s) in the workers compensation insurance carrier’s “network of medical providers”. After filing a workers comp claim, injured workers seek treatment. Unfortunately, some injured workers are maimed and battered by the very medical provider(s) that they are sent to.  In my case as in many other WC cases, medical forms, surgery reports are altered and/or falsified.  Documents changed over and above the injured workers signature. 
    I was forced under anesthesia for simple lumbar epidurals.  Just prior to the 2nd lumbar ESI procedure, while in pre-op, for, I objected to anesthesia.  I was told I had no choice, that it was the policy of the surgery center that all patients must undergo anesthesia.  I awakened from that with severe neck pain and slight left arm pain.   My Doctor had injected my person from my neck, down the left side of my spine and my entire left leg with some sort of chemical that tingled and popped like Alka Seltzer.  The tingling – popping sensation was also present in the frontal lobe area of my head.   The procedure that I was there for was to receive an epidural steroid injection in the lumbar area and "trigger point shots" to the left side area of my lumbar spine.  There should not have been any other injections. 
    The next epidural procedure, I made it clear I that I did not want to be placed under anesthesia not only on the phone a day prior to the procedure, but also before the procedure in pre-op.  I re-stated the same in the operating room for everyone there to hear.   I said that I was to get a local pain blocker.  (just as I had during the first lumbar epidural). Instead, my Doctor abruptly shoved the needle into my back without any pain blocker whatsoever. I could feel the needle going through the different textures of my back (not precisely in the lumbar disk area between the vertebrae). The injection was slightly to the left of the spine. My head flew up as I screamed "Wait!" or "Stop!". He would not relent! As my head went down to the operating table (where a towel and prop to lay my head was), he moved the needle inside me to the nerve in my back next to my spine and held it against the nerve! The pain was so excruciating that I bit into the towel that was for my head to rest on and screamed with the towel in my mouth. Pure agony! He would not stop! Clearly, I had no choice once again but to give into anesthesia. When I awakened, I thought to myself, Oh my God, they didn't! I could feel the injuries from being maimed throughout my back, neck, shoulders and arm, from my neck down to my tailbone. I could feel the nerves firing all over my back and next to both sides of my spine from the injections of some sort of chemical (the Alka Seltzer feeling again) that over the coming months, burned and corroded the ligaments in my spine, tendons and muscles, nerves in my back. It felt as though I was being burned from the inside out. PAIN from burning and maiming! I can now & back then could feel that some of the tissue/muscles were pushed away from my spine creating the feeling of divots or holes on both sides of my spine.  I could feel what seemed to be a muscle pushed away and hanging down on to the right mid side of my person. The ligaments that are in my neck and run up into my skull feel damaged, sore. My spine felt "chiseled" in specific areas most prominently in the top of my back and neck and the bottom near the lumbar sacrum area. For 7 months, I had positional vertigo.  The vertigo recently re-occurred for several weeks.   I now have instability in my spinal column. I can feel the vertebrae in my spinal column moving not in sync with the other vertebrae. There is much more damage that I could continue to describe but will refrain.
    In order to get treatment, I had to see the AME “agreed upon medical evaluator” (paid by the WC insurance carrier) designated for my WC case. I demanded to see him. Efforts to delay that ensued. Eventually, I was able to see him on August 12, 2013, more than 2 months after the procedure described above after my insistent efforts to move the date up from what I was originally informed was the earliest available date of September 9, 2013.  I contacted the AME's office and spoke to the appointment desk myself, I was told that there were dates available in July and August however, the insurance carrier and MY attorney agreed that I wasn't to see the AME any sooner than August 26, 2013. Odd?  My attorney’s initially moved the appointment from September 9, 2013 to August 26, 2013.  Then they finally conceded to allow me to see the AME on August 12, 2013.  After seeing the AME on 2 occasions and describing to him and his historian what happened to me verbally and via color sketches and in a 5 page written description, his report indicates, Yes, my neck was damaged during the procedure(s) however, the pain, the holes and more that I describe in my back and spine are "medically improbable”! Interestingly, the AME rendered an opinion of how my neck could have been accidently damaged. That is NOT his job! He has also diagnosed me with degenerative disk disease. However, approximately 8-9 months prior to the 3rd epidural procedure, he specifically told me there was no sign of “DDD”. 
    COOPERATION OF MEDICAL PROVIDERS:  Not only was the Ortho Surgeon involved. It was also the surgery centers and the anesthesiologists and others that have been involved. After informing my then attorney via e-mail and via several cell phone conversations, the attorney who runs the WC division in that law office, called me on the phone and begged me not to file a grievance with the California Medical Board and allow himself and the AME to handle this! Later he called me again and told me to file for permanent disability right away! My attempts to get help through other means have been stalled. What has been done to me and the continued efforts to interfere as I try to seek treatment even outside of the WC system, has been a well-orchestrated effort. Through injured workers associations, I have come to find out that what has happened to me has happened to many other patients through the years but is being ignored due to the outrageous and maliciousness of the crime. To think that a field of medical professionals would participate in the maiming and battery of patients is something out of a movie, but it does exist!  It is a strategic tactic. 
    AWARENESS IS KEY:  I'm trying to prevent what has happened to me from happening to others.  Join me and other injured workers to 1.  Create a mandated disclosure law in all workers comp cases that reveals the danger of injured workers being targeted for “battery” and “maiming”!. I should have been warned.   Injured worker should be presented with a disclosure indicating something to the effect of: “Some injured workers have reported having been harmed, maimed or battered while receiving treatment for their injury.  The injured worker is advised to report any occurrence of injury or suspected intentional harm to the proper governing authorities in the state in which their WC case is filed. I am told that only a few states have a medical battery laws.  2.  Support a Medical Battery Law so that these crimes can be reported to the police department and/or the District Attorney’s office.  3.  Injured workers should have the right to require a patient advocate to be present (NOT AN ADVOCATE FROM THE INSURANCE CARRIER'S MEDICAL PROVIDER NETWORK & WITHOUT THE APPROVAL OF THE EMPLOYER, INSURANCE CARRIER AND/OR DEFENSE ATTORNEY) should the need for anesthesia arise. I wish I had known that I had the right to remain awake during the 2nd epidural.  I have since found out that most lumbar ESI procedures are done with just the local anesthesia pain blocker, just as I had requested.  The third epidural wherein I was forced brutally to accept anesthesia, I don’t know what I could have done differently.  I couldn’t scream loud enough that he (the Doctor) would stop pressing the needle against the nerve in my back! I couldn’t get off the table with the needle in my back either. My body is prolifically maimed.  4.  A disclosure should be signed by the injured worker that indicates that “Some injured workers have reported having had documents altered / changed over and above their signature, medical reports falsified, surgery reports falsified, deceitful methods of marking documents one way on the top page, however, having documents marked differently on the flow through attached copies   5.  Injured workers should have the right to have their treatments / surgeries / procedures, consults, appointments with any Doctor or medical staff including visits with a Primary Treating Physician, QME, AME, IMR, IME or other examiner, video and/or audio taped.   At my procedures, I was asked to sign off on video and audio taping, but have since been told that no video or audio taping of the ESI was done.   I find that interesting.     
    I’m told that fraud against the injured worker has been going on for 20 plus years.  Why aren’t injured workers advised / warned in advance of the various criminal activities targeted against the injured workers.   
    NEVER ENDING PURSUIT FOR JUSTICE:  I have gone to law enforcement 5 times wanting to file a complaint against the Doctor, Anesthesiologist, surgery centers etc. I have been told that I cannot report the crimes of falsified documents and maiming & battery as there is nothing in the penal code.  All 5 instances, I was sent away without the benefit of being able to report the crimes perpetrated against me.   I have contacted the FBI several times – I am told that they cannot do anything either. The OC DAs response to the maiming and battery, falsified surgery reports, documents changed over and above my signature and much more was “Unfortunately, your case is not unique”.  This week (September 8, 2014), I was told that I can’t file charges or complaints with at the District Attorney’s office either.  I am referred to the California Medical Board to file a complaint.  Clearly, this is why crimes in the workers comp system are systematically committed against the injured worker.   
    Fraud & battery has been facilitated on the part of the defense.  “Creating the look of a condition(s).   I had demanded to see the AME because I had been forced under anesthesia, maimed and battered! The AME knew this so out of concern for himself, he had his “office manager” present during the 2 office visits after the 3rd epidural! In his final report, he does not mention that I informed all parties including his office historian, that I had been forced under anesthesia and maimed.  The “legal” staff member in his office told me that they removed the 5 page letter that I wrote to the AME which set forth some of the chain of events that had occurred since I filed the WC claim including the maiming, and more.   She said that it was removed for my benefit as it was “Ex parte”.   I believe that is was removed because the AME had an obligation to report the crimes that have been committed against me which would in turn jeopardize any future referrals to his office from this insurance carrier and / or defense attorney.   I can see that the AME was not acting as a neutral party and he certainly wasn’t acting in my favor.  His report, to me, reads biased in favor of the defense by virtue of statements that he included, that I am told is NOT his job – for example, lending an opinion for  how I was hurt, rather than stating that the applicant (me) reports that she was forced under anesthesia, and awakened with injuries and injections throughout her body.   Additionally, he indicates that my complaints of other pain, maiming, is medically improbable rather than doing the proper studies.  The insurance adjuster told me herself, that they were not allowing any further studies including an MRI of thoracic region to investigate.  Which is probably why the AME wouldn’t do one back in August 2013.   During my visit with the AME, I brought a family member with me to act as my “patient advocate” at the AME appointments, however, the AME objected and said that he would not proceed with the office visit unless my family member / patient advocate left the examination room. The partner in the law firm that represented me back then (September 2013) told me to file for permanent disability right away. So, he must know what they have done to me. During my last attempt to file charges or a complaint against the “Ortho Surgeon” and others, the police officer told me that my attorney should have reported the incidents.  I e-mailed the partner in the law firm asking if he reported the wrongdoing in my case. He said that he wasn’t present during my epidurals so he didn’t have to report it. 
    ATTEMPTS TO GET TREATMENT OUTSIDE OF THE WORKERS COMP SYSTEM:  I have tried to get help outside of WC. I have been met with bizarre situations and the Doctors through Medi-cal “doctoring” my medical record by not including the fact that I informed them of the maiming and pain throughout my body, instead, some mention only “lumbar pain”.  Why would they do that!  The most recent Doctor told me that if I accuse another Doctor of having maimed & battered me, that he will not take me as a patient!  I refused to comply with his requirement, so he said, “Then, I can’t help you.”    
    POWER / GREED:  I am amazed at the power that the defense has over medical staff, surgery centers, etc. But I’ve been told that this has been going on for years. If you are an injured worker with a back injury, you, as I am, may be a target of maiming and battery to create the look of a condition, so that later the case can be litigated and the “condition” can be added and considered as apportionment which may reduce or eliminate the employer’s and the insurance carrier’s liability.  There are likely many other strategic reasons.
     WC FRAUD:  The most prevalent fraud in the worker’s comp system is facilitated by the defense and their “minions” including corrupt attorneys, Doctors, medical staff, surgery centers, hospitals, and insurance carriers and vindictive employers.  Why isn’t this a well-known fact?  Why aren’t injured workers warned?  The insurance carrier’s often shine a light on the fraud perpetrated by injured workers, which is miniscule compared to the fraud perpetrated by the defense themselves. 
    A former defense attorney who writes about workers compensation, and is still active in the industry, wrote an article wherein he asked of the people who were attending a workers compensation conference geared towards industry professionals, “How many of you, if you were hurt at work, would file a workers comp claim?”  In response to his question, 1 person of the 400, raised their hand.  Speaks for itself, doesn’t it.      

  15. Attention; Lorie, Laurie: Or however you spell your name; At 7;40 of this video, you state, I am a firm believer, that not everyone is injured for the rest of their lives;
    I suffered multiple spinal workplace injuries, due to medical malpractice, breach of fiduciary duty, my injuries were debated, non-diagnosed, denied medical care by workers comp, who stated, a fractured coccyx, doesn't require treatment as it heals on it own. (I also suffered broken back, that went undiagnosed 2 yrs)  I received spinal injections with celestone, marcaine, depro-medrol: which caused, incurable spinal disease from injections; Adhesive Arachnoidits; I cannot work due to intractable pain flares; AA (adhesive arachnoiditis) pain like cancer without the release of DEATH; 

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