gaiassoul1@yahoo.com
Senior Member
Posts: 2155
Joined: Feb 2004
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Sunday December 21, 2008 4:09 PM
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again, you have ceded a position that is not in the intent of the thread....this is not personal and you take it that way, falls into the category of your personal issue.
if you advocate anything, you have to be prepared to back it up. There were no comments as to you as a person, only as to your technical position. So if you choose to take it any other way, again your choice.
I did not put words in your mouth and I have not received any emails so no words were put in any emails either. I never pretended to walk a mile in your moccasins, life experiences and learning curves are unique to each individual.
These are YOUR words, not mine..
" still hold to the fact that if a case has not Stipulated (S&A) or had a Finding and or Order of Award, there is still a one year extension for new and further. I know that the BROAD extension of "BENEFITS" also pertains to "medical treatment..." HOWEVER, this is not what I've learned or practiced over 22 years as a C/A. My interpretation is from ONE YEAR from an provision of an AWARD for P.D. Of course, I could be wrong-but after all this time, it's been the routine procedure. "
This is the position I disagree with .... so I did not make up the words....I debated the position. The rest of the words were mine....all mine and I have the broad shoulders to take responsibility for any position I advocate. I advocate strongly, passionately and zealously and the people who have met me appreciate the candor and brutal honesty, as well as a sheer understanding and deep compassion for the risks they face and the jeopardy an injury puts into someones life
The technical errors in this statement are blatant. Medical is for lifetime, you don't have to file for new and further. Compensable consequence is also limited to five years from date of injury as well as TD and PD benefits, there is NO one year extension once an award has issued as to compensable consequence or any type of TD or PD and until you read an en banc decision to the contrary, I continue to contend the position is risky as risky as it comes. IT is not the routine procedure at any insurance company to not fight a petition for new and further disability if it is five years from the date of injury.
12 years as a claims examiner with much time spent as a temp, never saw one insurance company fail to fight the issue, five years as a defense paralegal under a certified workers compensation specialist attorney, never saw us not fight one of these and never saw the defense attorneys trained otherwise, five years consulting - auditing for employers, training examiners, working for applicant and defense attorneys as a hearing representative -- -again never saw an ins. co fail this issue on an audit, never had a claim manager or ins. co auditor take the opposite position. Attend CAAA as many times as I can afford, read all appeal decisions every week, research obscure legal issues all the time and I cannot find this position? So I have walked my own path and share only my own experience, education and the results of my legal research here -- a technical debate, nothing to do with who you are as a person, again a huge misinterpretation
The reason insurance companies settle, settle, settle is that medical inflation is 200% every five years, most people who leave medical open do not just fade to black, but rather are frequent users of medical care on a regular basis. So the reason to settle goes to two claim adages -- "the only good claim is a closed claim" and "claims never get better they only get worse".....this going to the point as people age, the degeneration of the body becomes your issue as the medical care is not apportionable.
I have never advocated a position here without the ability to back it up with evidence and yes every day no matter who you are I will demand you do the same.
Take a look back at other threads, where other people told this forum that LC 4650 self-imposed increases no longer existed....I did the reasearch, advocated for the injured worker, asked around from people I felt were knowledgeable and reported my findings -- it was never repealed, it still exists and that person would have caused irrevocable harm. It was interesting there was no rebuttal to the position.
Not sure why this suddenly did not call for what every question here calls for --- an ability to support it with codes, regulations and case law -- not that it initially needs to be provided at first, becaused most people just want to be able to advocate a correct position to their attorney or I&A officer, but if it arises, that the person find the actual evidence required to support the position.
Comp is not about nice or mean, comp is not about where you are at unless you are continuing evolving. Comp is about legal entitlements as supported by codes, regulations, case law and legal theory that is sound and leads to cases of first impression - knowing when to take a case up and when it will make bad law and should not be taken up.
Case is a benefit delivery system no more no less.
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Ginger
To know how to say what others only know how to think is what makes men poets or sages; and to dare to say what others only dare to think makes men martyrs or
reformers - or both. Elizabeth Charles
Edited: Sunday December 21, 2008 at 4:34 PM by gaiassoul1@yahoo.com
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