Pat is correct. We see clients at all stages of these cases, but the longer you wait, the harder it becomes to achieve the correct outcome for you. You may wish to set up an appt with Pat's office ASAP.
This scenario is pretty common. You may use your doctor as a shield against inappropriate repetetive light duties. Many employers and case managers can be more determined and manipulative than an injured worker. If your Doc hangs in there, and you are clear, the employer may decide they don't have "light duty" at this time. I also like your idea of having the doctor pull you out until your hand improves or the employer actually respects your limitations.
It is usually pretty hard to get a closed claim reopened. You would need to show objective worsening of the industrial injury and a need for further curative treatment. If your doc sees a need for another surgery and there is a recent MRI showing worsening, you'd have a shot at it. Attorneys would charge you 30% of new benefits they helped you obtain, and probably a lesser percent on any new time loss, or pension award. However, it may be tough to get an attorney interested because you...
She is probably covered by L&I even if she was working under the table. The employer will probably get in big trouble for not paying premiums or min wage. There may be some back wages if they can be documented and medically certified. Treatment would be available, and possibly some PPD for skin impairment (not 4 scarring).
Go to a doctor and file an "Application to Reopen" form. Reopening is possible within 7 years of the first final closure of the claim. He must need additional curative treatment for the industrial injury, and show Objective signs of worsening (like a worse x-ray or MRI). If L&I denies reopening he will have 60 days to protest or appeal that in writing.
Probably. Self Insured employers are even more aggressive than L&I in controlling claim costs. Even though this is a no-fault system, you wouldn't know it sometimes. Surgeons (and their PAC's) often understate the degree of impairment post-surgery - after all, they "fixed" you.
Usually we can steer around these unrelated medical needs. If the recovery from GERD surgery interferes with light duty or (possibly) retraining, we sometimes see L&I or a self insured employer try to leverage that to mess with your benefits. I have some counter-measures for when that happens but it is very case specific.
Certainly possible to retrieve both policy limits if your new/superimposed injury is properly medically documented. Your attorney knows more about the facts and evidence in your case and you should trust her/him unless you have some good reason to not. Most of our PI attorneys in Puget Sound region know what they're doing.
TPD is a monthly benefit awarded when a worker has reached "maximum medical improvement" and cannot be employed or retrained. The system looks at your age, education, work experience and the residuals of your industrial injury. The TPD amount is essentially the same as your time loss rate; just that it's permanent instead of temporary. TPD is in lieu of PPD (perm partial disability, often called "settlement").
Cannot sue the TPA (third party administrator) The best you can do is pursue your claim vigorously and beat them with the facts. Opinion of an attending physician is entitled to "Special Consideration under Washington Law so you should win the appeal. You should get a lawyer, unless L&I is defending its own order in your favor.