Sacramento, CADiane resides in California and used to work for the federal government. She suffered a severe injury on a private company's property and the company successfully filed her injury under their workers' compensation insurance. However, Diane wants to be removed from the claim but she says the California labor law is set up to protect business and she cannot sue the company. Diane is now a parapalegic.
"This claim was filed without my knowledge so this business—a yoga retreat--could limit their liability," Diane explains. "In other words, I have no recourse."
The accident occurred on September 16, 2006. According to Diane, she was "messing around" in a field (the retreat comprises 400 acres) with some construction workers, jumping back and forth between logs and the prongs of a forklift. Someone inadvertently started the forklift while she was standing on one of its prongs and she was hurtled into the air. Next thing Diane remembered was waking up in the intensive care unit. She had multiple broken bones, including a broken back, and a collapsed lung.
"I was in hospital for one month and convalescence for six months," says Diane. "The retreat's business rep called the hospital two days after I was admitted and had them change my insurance policy from my federal health insurance to their workers' compensation insurance. I was later terminated from my federal job for 'medical inability to perform."
So why doesn't Diane just accept workers' compensation?
"Once I am off this claim, I can receive social security benefits until my federal disability kicks in," she says. "The first year is 60 percent of my salary and after that it would be 40 percent for the rest of my life. And I could still work; there is no exemption. But with workers' compensation, it only lasts two years.
And I sporadically receive workers' comp checks, usually $3,300 per month (my salary was considerably higher than their allowable maximum amount). But some months the checks don't come at all: once I didn't receive a payment for 12 weeks. If I do not meet their criteria, I get cut off. Because all the paperwork from the workers' compensation board was sent to this yoga retreat, I didn't get the rules and regulations. I have been trying to get "the examiner's case file" and I have been denied access.
Why did workers' comp deny payment for three months? Diane says that she had to leave the country to obtain medical care. "I have paid $32,000 out of pocket so far for my medical care," she says. There are so many questions left unanswered in this convoluted case.
Apparently, workers' compensation didn't cover all her injuries. "In the state of California, I am not allowed to receive medical care from any physician if there is an open workers' comp claim that hasn't been approved," she says. "The yoga center has minimized the amount of damage to my body to make my injuries sound less severe. They said that I had a cracked vertebra, a broken rib and my lung was collapsed. But they didn't mention that I am a parapelegic.
I just pulled the money out my retirement funds and left the country and received care in Cape Town. Because my injuries are so severe I was approved for social security, but social security will not pay me while there is an open workers' compensation claim—whatever agency pays the greater amount."
Meanwhile Diane is desperately trying to get rid of the workers' comp claim so she can access her federal benefits. "I need a lawyer to get rid of this claim because I have no idea how to do so," Diane says. "Workers' comp attorneys are not allowed to give me advice--their attorneys get paid through open claims such as mine so they definitely are not on my side.
I have spoken with my federal department's OPM (office of personnel management). They told me the same thing: I am guaranteed benefits. But it confuses them—they want to know why I am covered by the state's workers' compensation insurance. I contacted federal lawyers but they don't step into state laws—I haven't found a federal attorney who wants to take on a California court."