Your Riverside WCAB office is scheduling EXPEDITED HEARINGS really fast these days, like in 4-5 weeks from filing the Declaration of Readiness to Proceed.
The attorney could serve the DOR Monday, file it Tuesday, and you'd likely be on calendar to beg the WCAB Judge for both TTD and Surgery Approval by the end of February.
Zurich CANNOT STOP EDD payments... only EDD stops State Disability Insurance payments. If you are without income, apply or re-apply for SDI payments immediately to have some income.
Typically when the Insurer terminates TTD and refuses to authorize further treatment, The Insurer has a medical report that says the injured worker has reached Maximum Medical Improvement, won't improve with any further treatment procedures, and is Permanent &b Stationary.
If Zurich's doctor did write your husband is Permanent & Stationary, DIRECT YOUR ATTORNEY TO DEMAND PERMANENT DISABILITY ADVANCE PAYMENTS issue immediately. If Zurich has evidence of permanent disability and fails to make any timely Permanent disability advance payments, you're due penalties on each late payment.
"Is this ethical?" No, but workers compensation laws approved by your state senator and assemblyman permit unethical activities throughout workers comp proceedings.
"Do We Have REcourse" - the EXPEDITED HEARING. if your attorney hasn't filed the DOR for that Expedited Hearing, find out why... sometimes I couldn't because the physician's report requesting surgery never mentioned the ACOEM Guidelines or how the worker would improve by surgery, so I know we'd lose... if you need a report 'fixed' RUSH TO THE DOC AND THE THE DEFECTIVE DOC REPORT FIXED ASAP.
Just looking at the State of California website, it appears EDD state disability is paid if you are unable to work because of a "non-industrial injury". I do not practice in California, but sounds to me like Zurich is saying your husband's injury is not work related. I would immediately contact the attorney you hired and have him / her explain what is going on.
This response is given solely as a general response to the question and does not create an attorney / client relationship between the questioner and responder.
Tell Bubba to make an Appointment with his Attorney, and fax his written questions to Attorney a couple days before the Appointmnet. If you do that, he should know/share the answers and your Appointment should only take 15 minutes. Then leave. It is hard to get an appointment because everyone thinks they can talk forever.
We offer general concepts, but you should give ALL your facts to a licensed Attorney in your state before you RELY upon any legal advice.
It seems they are stating husband is p&s. This has to be supported by med evidence. If this report does not exist your attorney needs to file a DOR for an expedited to address benefits owed. Good luck!