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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: California Employment Law
Satisfied Customers: 111503
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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I hope this is the right category. I have a California

Customer Question

Hi, I hope this is the right category. I have a California Workers Compensation question.I was injured on the job as a RN at an Adventist managed hospital in 2008. I have an open WC case for this condition and have been given a permanent and stationary status as of 2013 (PR4 report) and given disability benefits by WC and benefits for future medical care. As of yet, I have not been able to used these benefits. I have since moved out of state (to rural Nebraska). I am basically uninsurable for my condition and continue to suffer greatly from my injury. I was told by Adventist health claims personal "good luck finding a care provider in my new state that either they (new provider) will accept payment for CA WC claims or that CA will approve to continue care and medication for my condition." To-date they have been correct but I have not exhausted my search and have been paying for my care personally as I am able.The hospital claims department kept harassing me right from the start trying to get me to sign a "compromise and release" that I was told by WC that I didn't have to do. So I did not. Since this time the Defendant (the Hospital) has now contacted me via their attorney and I really don't understand what's going on. The first letter they sent me notified me that they were hired by the hospital to file an "application of adjudication of claim" (what ever that means). The latest letter to me is now notifying me that within "30 days of this letter" they plan on filing a Petition to Dismiss unless I "diligently prosecute" and "show, in writing, some good reason for not dismissing this case".I'm really confused and my question is: What does this all mean, where is their process heading and what is the process that I need to do (i.e. some good reason for not dismissing this case??) to assure that I do not loose my WC awards and benefits? Is there some resources available in finding providers in Nebraska that will accept California WC benefits. I need future medical care and help paying for it.Thank you
Submitted: 6 months ago.
Category: California Employment Law
Expert:  Law Educator, Esq. replied 6 months ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
What they are telling you is that you need a local attorney in CA and you need to now file suit in workers compensation against your employer and the insurer both. You need to seek a court order for them to pay for proper insurance or provide proper coverage in the state where you are now residing OR for the court to set a reasonable lump sum payment award to you that would allow you to pay the costs of any care that you would require as a result of your injury.
The employer/insurer is filing now to force you to take them to court to pursue a court judgment in the case to award you lump sum payment to be used for future medical care and also for your permanent injury damages and inability to work.
You need to move quickly to get a local workers compensation attorney to file this matter in court and you can get one from the same sites used by other attorneys, http://www.hg.org or http://www.lexmundi.com
Customer: replied 6 months ago.
Thank you for your prompt response. Please respond to the part of the question about me having to "show some good reason for not dismissing the case" with some examples of what would be acceptable for this. And what would happen if they get the case dismissed.I'm still not sure I understand why I have to sue them?? This will take some time and effort to prepare and find CA counsel from Nebraska so I can get the benefits due to me. The current letter from their attorney says I have a deadline to respond to the CW court (stated in the April 29th letter as 30 days from the date of their letter) which is this week. How is the fastest and simplest accepted way to present this "good reason" and how stringent are the timelines for this or are they just harassing me again.Thank you.
Expert:  Law Educator, Esq. replied 6 months ago.
Thank you for your reply.
You have to show why you have not taken action on settling the case with them. So you have to present proof that you are not settling with him for some good reason. The time lines set are pretty strict, if you are late in responding the court does not have to accept your reply.
You need to explain why you have not moved the case to settlement, meaning that you need to explain that you are living in a new state and the workers compensation insurer refuses to approve any doctor in your area who is even willing to take the workers compensation payment and it is the fault of your insurer and not you. Together with that you need to submit proof of the doctors you contacted and either would not take the insurance or whom the insurer would not approve.
You really should have a CA attorney representing you on this if you are out of state, because it really is hard enough being pro se in state and being out of state makes it even harder many times.

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