[Kath]

Injured my back while on the job - Doctor said 3 buldges in lower spine and torn left shoulder rotator cuff. I hired a W.C. Attorney. Went on Disability 3/2/06 via SSI via a W.C. Doctor. Visited SSI doctor as requested by the State of CA in May/06. The supposed Doctor just measured my legs/arms and circumference of thighs/arms. Had me stand and move and that was it. They came back with a determination that I was able to go back to work and denied my claim. I appealed and did not know what to do. My Lawyer sent me the medical documentation to take with me to the Appeal... I thought Lawyers were suppose to attend these things with their client as I am/was not knowledgeable about these matters. During my appeal, the SSI Judge (?) If that is what she was?? Said they acknowledge the torn rotator cuff, it was the back that they wanted to know about. I gave her the medical file and she refused to look at it.. She said, "the state doesn't go by 'other' medical records/documents, the State had their own. I thought I had lost it totally, but I won the appeal. However, W.C. said they would take over my benefits, so I mailed the back payment check I received from SSI Disability to the state with full documentation and told them my then circumstances of W.C. taking over. I received a letter stating my claim had been 'Denied'... Confusing as that terminology just didn't fit??

I've been getting my benefit from W.C. Meanwhile, W.C. wanted me to see another examining Doctor (8/1/06). He also took thorough X-rays, MRI, EMG's. He also stated that I have two bone spurs - L4, L5.

My Lawyer said that the Doctor I saw 8/1 stated I was a condidate for Rotator Cuff surgery on my left shoulder, which would be an option for me if I chose to do so. (In 1996, I had Rotator cuff surgery to my right shoulder.. It was a severe tear. I opted for this surgery as I could barely move my right arm and it was necessary, so therefore proceeded. It was an excrutiating experience and very difficult as I live alone and had no help.) I don't every want to go through that again!

In addition, my Lawyer said the Doctor believed I would benefit with injections into my spine. I objected to both. I stated that I am taking care of my shoulder, exercises, etc. and being extremely careful not to injure it further. If it gets bad enough, I will then opt for the surgery. As far as injections... Absolutely, NO.. This is only a temporary treatment and other injections would be required for temporary relief. These injections can also result in potentially serious side effects or cause other risks. I didn't want that STUFF in my body.

My Lawyer stated that they would be contacting the claims representative to arrange for a re evaluation with the second Doctor (the one that wanted to do these things). Upon, receipt of his final report we can initiate settlement negotiations and set the case for hearing. He also stated, "since you have been disabled for more than 1 year. (Note, I was put on Disability on 3/2/06), it has not been quite 1 year).. he recommends that I file for Social Security Disability Insurance in which a decision takes about 60 days.. I may include all medical and psychological conditions.

I have only one set of records which by now are outdated. I have not received any records from the Psychiatrist I also saw because of severe depression.

Sorry, this is so long.. I tried to edit it as much as possible.

Does this seem right? Shouldn't my Lawyer attend these SSI appeals, etc. with me and help produce the required information?

What do you think...

I'm so lost here... I cry all the time.

Thank you.

[deadlock]

When you asked your atty about attending, what was his/her response? You are aware that an atty & office staff charge for doing the leg work of gathering information, so it might be financially better that you obtain the paperwork from your medical providers. If you cannot obtain records that support your case, ask your attorney to write a request. At an appeal you will be present but it isn't like you need to prepare a case other than submitting reports.

The terminology of "denied" means "not eligible" according to established criteria. So according to their criteria you aren't eligible for SSDI and WC.

Do you have a case manager at BWC? That person may be able to help you understand the process and terminology.

So far what you have described sounds right. If you are having difficulty with depressed mood you do need to make sure your psych doc is aware.

[Kath]

I am sorry, it seems I did not make my point as intended.

As I do not know what a W.C. Attorney is suppose to do or not suppose to do. I did not ask him to attend the appeal with me and he never stated anything about it. Although I won the appeal, I just wanted to know if this was one of the tribulations the W.C. Attorney should have attended with me?

After my appeal was won, the W.C. Insurance company said they would take over my disability payments and have done so since.

Why would my Lawyer state I was on disability over 1 year and that I should apply for Social Security Disability???? It will not be a year until 3/2/07... And at this time I'm on W.C

I will write to the Doctor's and Psychiatrist for information on my disabilities, that isn't a problem. But, my attorney to enable him to do the right thing as he has been hired to do, should have those records already in his possession.. wouldn't you think?

[seniorjudge]

...Why would my Lawyer state I was on disability over 1 year and that I should apply for Social Security Disability?....

Why don't you ask your attorney?

[deadlock]

I am sorry, it seems I did not make my point as intended.

As I do not know what a W.C. Attorney is suppose to do or not suppose to do. I did not ask him to attend the appeal with me and he never stated anything about it. Although I won the appeal, I just wanted to know if this was one of the tribulations the W.C. Attorney should have attended with me?

After my appeal was won, the W.C. Insurance company said they would take over my disability payments and have done so since.

Why would my Lawyer state I was on disability over 1 year and that I should apply for Social Security Disability???? It will not be a year until 3/2/07... And at this time I'm on W.C

I will write to the Doctor's and Psychiatrist for information on my disabilities, that isn't a problem. But, my attorney to enable him to do the right thing as he has been hired to do, should have those records already in his possession.. wouldn't you think?

Kath,

You will be able to find out more information if you call the BWC. You can also do a search to obtain information available on the WC disability vs. SSDI and SSD.

Other questions about what your atty did or does or didn't do is between you and the atty. If you got billed for something and it wasn't done that's different.