San Francisco Bay Area Workers' Compensation Law Blog

Frustrated with Medical Provider Networks (MPN) and getting an appointment to see a treating physician or specialist? Try asking the MPN and/or insurance carrier to assign a Medical Access Assistant (MAA) to your case.

The Department of Industrial Relations’ (DIR) website has a list of every approved MPN. That list can be found here:

https://www.dir.ca.gov/dwc/mpn/ListApprovedMPN_Alpha.pdf

The DIR requires each MPN to post a roster of every approved MPN doctor on the MPN’s website. The roster is supposed to be updated quarterly, and must contain information on how to contact the doctors as well as the MPN’s Medical Access Assistant.

A Medical Access Assistant (MAA) is a person assigned to help the injured employee find an available MPN doctor of the employee’s choice. They must be available from 7 AM to 8 PM Pacific Standard Time, Monday through Saturday. It is their duty to contact the doctor’s offices during regular business hours and schedule appointments. (See Labor Code §4616(a)(5) and Title 8, California Code of Regulations §§9767.1(a)(16) and 9767.5(h).)

An initial non-emergency care appointment must be scheduled within 3 business days and a non-emergency specialists care be scheduled within 20 business days. (See Title 8, California Code of Regulations §9767.5(f) and (g).) “If an MPN medical access Assistant is unable to schedule a timely medical appointment with an appropriate specialist within 10 business days of an employee’s request, the employer shall permit the employee to obtain necessary treatment with an appropriate specialist outside of the MPN.” Title 8, California Code of Regulations §9767.5(g).

Once you have located the MPN website information, search the list of doctors for an appropriate doctor or specialist, and select. Try to find the MAA’s contact information on the MPN website, and if you can find it, notify the MAA that treatment is needed, provide the name of the doctor selected, and request that they schedule an appointment. If you cannot find the MAA’s contact information on the MPN website, write to the carrier with a demand that the MAA from their MPN schedule an appointment within the time limits provided by the Regulations. If the MAA does not respond, consider filing a Request for Expedited Hearing with the WCAB with a demand that treatment with a doctor of your choice be authorized outside of the MPN.

If you encounter problems with an MPN, you have the option of filing a Medical Provider Network Complaint, which can be found here:

https://www.dir.ca.gov/dwc/DWCPropRegs/MPNRegulations/MPN-Final-%20Regulations/FORMS/MPNComplaintForm9767.16.5.Strikeout.pdf

The Shoemaker Law Offices, a leading workers’ compensation law firm that serves clients throughout Northern California from office locations in Vallejo and San Francisco, is pleased to announce Elizabeth A. Common has joined the firm as a partner, effective August 1, 2018. The addition strengthens the firm’s core practice area of workers’ compensation, and with over 26 years of experience in the area of Worker's Compensation and litigation, she has the knowledge and experience to fight for hard-working Northern California residents.

Elizabeth graduated from the University of San Francisco School of Law in 1992, and is one of a select few attorneys recognized as a workers’ compensation certified specialist from the State Bar of California. If you would like to learn more, visit her attorney profile page, or contact us directly to schedule a consultation.

About the Shoemaker Law Offices

At the Shoemaker Law Offices, we use our experience to get compensation for injured workers in the Northern California, Bay Area. Regardless the type of work-related injury you have suffered, we will work hard to get the workers' compensation benefits you deserve.

Many of California’s injured workers say they don’t have a fighting chance to recover under a workers’ compensation claim. The Investigative Unit is digging into a system that many patients and doctors say unfairly denies medical care, and examining an appeals process critics claim rubber-stamps denials of critical treatment. NBC Bay Area learned that nearly 90 percent of the time, anonymous reviewers agree injured workers don’t need the medical treatment their doctors have requested to get them back on the job. Sometimes it can lead to devastating consequences. Liz Wagner reports in a story that aired on Aug. 24, 2016. (Published Wednesday, Aug. 24, 2016)

Source: Injured Workers Face Stacked Deck During Workers’ Comp Appeals Process, Critics Say | NBC Bay Area | Full story here

Some California’s injured workers say the system that is supposed to get them back to work is actually making their recoveries longer and more complicated. A California Highway Patrol officer injured in a collision with a drunk driver says the problem is too big to ignore. The Investigative Unit’s Liz Wagner reports in a story that aired on August 22, 2016. (Published Monday, Aug. 22, 2016)

Source: Workers' Comp Drags Out Medical Care, Injured Workers and their Doctors Say | NBC Bay Area | Full story here

A San Jose fire captain nearly died after a building collapsed on him, but the workers’ compensation system denied the medical treatments his doctor says he needed. The Investigative Unit learned his injury was captured on camera. Now he’s asking, if he can’t get treatment for an on the job injury – who can? Liz Wagner reports in a story that aired on August 13, 2016. (Published Sunday, Aug. 14, 2016). This story is the first part of an NBC Bay Area investigation into California’s workers’ compensation system. Check back on Aug. 22nd for Part II.

Source: Dozens of Injured San Jose Firefighters Denied Workers' Comp Treatment | NBC Bay Area | Full story here

It is recommended you file DWC-1 form within 30 days of your injury, but if you missed that deadline, here are the rules on when your claim may be denied for being past the “statute of limitations.”

• You have one year from the date of death to officially file your claim, if you are attempting to collect benefits on behalf of a relative who died due to a job-related injury.
• You have one year from the date of injury to officially file your claim, if the insurance company either denied or ignored your request for benefits, or report of injury.
• You will have five years from the date of injury to officially file your claim , If your employer’s insurance company provided benefits after the injury was reported (e.g., paid for your medical treatment or paid you for time off work).

You should contact a San Francisco Bay area workers’ compensation lawyer If you did not file a worker’s comp claim within the above time frames. An experienced lawyer can potentially discover if there are circumstances in which you can be excused for missing the statutes of limitations deadline, such as if your employer didn’t post the proper notices, or properly advise you of your right to file a workers’ comp claim.

There are specific forms that must be filed if you wish to file a workers’ compensation claim in California. While you may file on your own, you also have the option of having a qualified workers’ compensation lawyer file on your behalf at no cost to you. There are many attorneys in the San Francisco Bay Area who can help you. They get paid once there is an award. If there isn’t an award, then you pay nothing. Attorney Scot Shoemaker, in San Francisco, California, has over 2 decades of experience fighting for hard-working Northern California employees. He is among a select few attorneys recognized as a workers’ compensation certified specialist from the State Bar of California. To speak with Attorney Shoemaker about your specific claim, call (415) 463-5310 today.

You have a right to benefits under California’s Workers’ Compensation Act if you live in California and have suffered a job-related injury. By law, the employer is required to pay workers’ compensation benefits, including medical treatment, to any employee who has been injured on the job.

What do I do after I was injured on the job?

The first thing you should do after a work-related injury is to get medical treatment right away. In an emergency situation, the injured employee is not limited, and may go anywhere to receive treatment, and the employer must pay for medical services. The employee should let the doctor or hospital know that the injury happened at work.

The Department of Industrial Relations (www.dir.ca.gov) has announced the launching of the Return-to-Work Supplement Program for injured workers. As part of Senate Bill 863, a 120 million dollar fund was created to assist eligible injured workers. It is a quick way to receive an additional $5,000 for injured workers who have been unable to return to their job. The program was announced on 4/13/15.

Qualifying is easy. The Applicant must have a date of injury after 1/1/13 and have received a Supplemental Job Displacement Benefit (SJDB) voucher for their injury.

Applying for the $5,000 is easy too.  The application is completely done online and detailed instructions can be found at: Return-to-Work Supplement Program (RTWSP)

Serving Clients in the San Francisco Bay Area - Free Initial Consultation

At the Law Offices of Scot D. Shoemaker, we are glad to bring you this information so that you can quickly access these benefits. You should act immediately. The 120 Million is the total statewide amount and we imagine that injured workers across the state will be filing their applications early. If you have questions, please contact our San Francisco workers' compensation lawyer for a free initial consultation today by calling (415) 463-5310 or fill out our online form today.

As we say goodbye to 2014 and we welcome 2015, we need to keep in mind that with the new year we have new laws relating to workers' compensation in California. A summary of the new laws can be found at the following Department of Industrial Relations website link:
 
http://www.dir.ca.gov/OPRL/Leg_Digest2014.pdf
 
With respect to workers' compensation, The Governor signed AB 1035 which extends the time period for public safety employees (firefighters or peace officers) to file a case to collect death benefits from 240 weeks to 420 weeks but no more than one year after the date of death subject to certain conditions.

The Law Offices of Scot D. Shoemaker opened a new location in San Francisco to better assist our clients located throughout the Bay Area. After successfully practicing Workers’ Compensation law in Vallejo since 1992 and establishing the premier Workers’ Compensation law firm in the Northbay, we discovered that the need for competent, approachable legal representation existed for Applicants in proximity to San Francisco as well. Since the Oakland Workers’ Compensation Appeals Board location is convenient for our Vallejo location, we wanted a location that would be convenient for access to the San Francisco Workers’ Compensation Appeals Board.

Fortunately, we discovered our San Francisco Location at 4630 Geary Boulevard #302 in a professional building owned and operated by the long established real estate firm, Cournale & Co. The building has ADA access as well as an elevator up to our third floor office.

Over 22 Years of Legal Representation to Thousands of Clients in Northern California

At our new office, clients can expect the same personal service and professional legal representation that we have been providing for over 22 years to thousands of clients.

As part of our expanded efforts, we have re-designed and improved our website at: shoemakerlawoffices.com. We have provided loads of information about workers’ compensation. We have updated our FAQ’s. We have provided links to valuable resources.

Workers’ Compensation Law is constantly evolving. As new legal developments arise, we will provide updates through our Blog and share the latest developments. In the meantime, if you need representation for your workers’ compensation case, you should call our office at (707) 552-1000 or (415) 463-5310 early on in the course of the case. There are important time considerations to think about and strategies to employ. If you wait too long to consult with an attorney, some important legal rights can be lost forever.