Worker's comp 104 week cap?

My husband injured his left hand on the job and had to have part of his left index finger amputated. This happened two years ago and we got a letter from State Comp Fund yesterday that he reached the cap of 104 weeks for payments and they will be ending. We received a letter about 2 weeks ago that said "benefits may be extended to 240 weeks aggregate within the first 5 years after the date of injury for the following injuries: acute and chronic hepatitis B, acute and chronic hepatitis C, amputations, severe burns, human immunodeficiency virus (HIV), high-velocity eye injuries, chemical burns to the..." It states very clearly that amputations extend the payments- how do we get them to resume payments- any suggestions? We have a lawyer and all they are doing is calling our adjuster who isn't calling back- nice, huh? (BTW- it's taken THIS long already because State Comp Fund is SLOW!!! Can't get appts., etc. NIGHTMARE!!)

There is a 104-week cap in California, but amputations are an exception to this law. Be sure that day one of this 104 week periods is the date the first check was issued, not the first date of your disability.

You'll need to file for disability benefits from EDD as a back up.

If SCIF does proceed with stoping your TD benefits, your attorney needs to do more than make phone calls. Your attorney needs to file a Declaration of Readiness to Proceed requesting an Expedited Hearing on this issue. The Judge will then schedule a hearing and determine if you are in fact entitled to further TD benefits. The Judge won't schedule this hearing until your attorney files that DOR.

Filing a DOR to get issues in front of a judge is a basic tool for both attorneys and adjusters. If you want to test how hard your atty is working for you, don't ask about this DOR until they've stopped paying TD. After that point, ask your attorney what can be done. Their next step is to file the DOR. If they don't suggest that, find a new attorney (yes you can do that).