The case started in 2001. I was employed by the State of New York as an investigator. May I add that I was a good employee, with a personnel file full of commendations? I was the production leader in my department and had 900 hours of sick leave (which would've been more except for both my parents dying of lingering diseases). In 1989, I fell on a construction platform and tore several ligaments attaching to my thoracic spine. I never had a pain-free day after that, and was under continuous treatment. In 2001, I was driving in an 8 inch per hour blizzard in the Adirondacks when I lost control of the car, slammed into a snow bank, fracturing my T7 vertebrae and suffering a lateral whiplash injury to my neck. Both of these accidents were accepted by my employer.
I was out of work about 3 weeks, then returned to work for a little over a year. However, I was working in severe pain. This pain was made worse by sitting over 15 minutes. The duties of my job required me to drive 7-800 miles a week, and then sit and go through piles of paperwork, often 4 to 5 hours at a time. It felt like a wild animal had bitten me in the upper right back and was holding on. I was only sleeping 2 to 4 hours a night, and was suffering the effects of sleep deprivation. Finally, regretfully because I loved my job, I had to stop working.
The hearings have been held in Menands. Here are some of the things that the judge has done wrong in my opinion:
1. As indicated in my original post, the carrier took 6 months to take any action in the case, instead of the 18 days the law requires. Section 25-2(a) Fine $300, payable to claimant. The carrier has never been fined.
2. The law requires the carrier to file a C8 form if they are going to stop payment to a medical provider. The carrier has done this 4 times, and never once filed a C8. After the second time this happened, the judge ordered the carrier to pay the provider. They delayed 2 1/2 months (the law gives them 30 days). Section 25-1(d) Fine $300, payable to claimant. The carrier has never been fined.
3. All good State employees try to build up a lot of sick leave accruals, because the accruals will pay for health insurance during retirement. The judge ordered the carrier to restore my accruals in 2004. It took the carrier four years to get around to it. This resulted in my losing my health insurance benefits entirely. I expect there could be, or at least should be, a very large fine here, but there has never been one.
4. The judge ordered the carrier to reimburse me for mileage, medication, braces, etc., also in 2004. I have never seen a penny of this reimbursement. I've heard a story that the unit handling my claim just throws stuff like this out so they don't have to do the work. This is not typical of units in this company, but considering the way they have handled my claim, I wouldn't be surprised if this particular unit did something like that. Again, I expect there should be a fine due here as well, but the situation is so unheard of that I have no idea how much it would be, or what part of the law would cover it..
5. After a totally bogus IME (my personal physician called it "medically impossible") the judge has colluded with the carrier to prevent my from getting treatment. There have been two hearings around this issue, and at both the judge has announced he was deciding in favor of the carrier without even giving me a chance to say anything. He has gone against his own Reserved Decision in making these determinations, and apparently he doesn't bother to properly review the case before the hearings.
Is this the kind of information you wanted? Anything else?
