So I want to get your opinnion's for those of you who have workmen's comp. I am eight weeks out of my L5-S1 fusion. I am starting to heal and feel that I am on the way to recovering. This is my second surgery in a year, my first one was last June, I had a lami/diskectomy which failed, resulting in getting a fusion. So I am finally starting to feel improvement. Thank God. And yesterday I got a call from my lawyer saying that workmen's comp want to make a settlement with me for a lump sum and I would still receive medical with them for about 3 years. My doctor say's that he feels that this surgery is going to take and since I am so young, I should be in good shape with it. THe only problems I might have down the line is other disks, due to the fusion. And I talk to my lawyer and he explained to me that if that does happen, that they will not pay for it anyway, since it is not the same disk I injured. And chances are that if I go in for round three of surgery, they probably will fight me for it anyway. Right now I am making chump change with workmen's comp. THey are offering me a great deal of money. What are you thoughts on this????
The one question I would have for your attorney is will another insurance company consider this a pre-existing condition and not cover you down the road.
It also does not sound right that they would not cover another level.....if you never had the injury and surgery to fix the injury chances are that you PROBABLY would never have needed a fusion in your lifetime. We all know that once you have a fusion it is likely that you will need another one down the road due to the domino effect.
In my case I had a fusion in 1982 and was blessed to have made it to Feb. 1, 2007 when I had my second fusion. Since my fusion in Feb, we have learned that I have another herninated disc above the level that was fused in Feb. So I would keep an open mind and make sure everything is done in your best interests.
I too am on workers comp however, I have not missed any work in three years. My injury date was June 22, 2004. I tripped and fell and landed pretty hard on my left side. Long story short they can't pin point why I'm STILL in constant pain for the past three years. I too got an attorney. I just saw a pain management doctor a couple weeks ago for the last time. HE was no help at all. I go see my attorney's doctor at the end of September to determine my percentage of disability and hopefully settle once and for all. I'm surprised the workers comp offered to pay for medical since they hardly agree to anything at ALL. From this expereince I voewd NEVER to deal with workers comp again! Even after I settle I will still continue to work full time.
I can't agree more with Diet and others... absolutely does not sound right that your lawyer told you that they will not cover another level surgery.
I had car accident in 2003, before that i had no problems with my back: a lot of sports, worked, heals, etc. Well, i had 2 level fusion in 2006 and now another level broke, which is a common thing in our situation.
And i will need another surgery soon. This is not my fault what happens now, this is a domino effect. My insurance also said they will not cover second surgery but my lawyer said that this is BS and it will be covered, they just play games. I have to say something to you: your lawyer wants this to settle himself that is why he tells you this. They usualy don't like long cases - fast money and good buy. I fired my first lawyer for this: he told me we have to settle the case because we never win a trial. New lawyer told me that the previous one did not want to be bothered since my case is a long time going on.
Fight and go to check with someone else. Don't forget, you may get your money now, but who will pay for a long term medications, treatments, tests if you need and a possible second surgery. Based on my experiece - something does not soung right here.
Mandy--First off I'm on workers comp too . Pepper and Moldova is right , you may experience the domino effect above or below your fusion site. Sounds like your attorney is interested in your settlement. They have to pay for any problems that you may have down , that includes your levels above or below. Don't let your lawyer talk you into settling your Medical portion. Tell your attorney if you want to settle to do the loss wage portion only. You may not get as much but you will be glad you did when you need help down the road. Your attorney doesn't care about you. My attorney tried the same thing with me. I snooped around and got answers. They do have to pay. All the attorney wants is money, period. If you haven't yet apply for SSD now. I have been on w/c for 4 years now and wish I applied sooner.
Your only 8 weeks out of surgery , please give it longer. Your way to soon to give in now. Sure the money sounds great , I know . But if you settle NO insurance will cover your medical expense . Trust me I called and ask all around . If you really have your heart in settling make sure your attorney puts a set a side for your care. It's with Medicare I believe.
My attorney wants me to settle for $250,000.00 plus 2 years left on my medical. The money sounds so good , boy could I use it to pay off my bills but thinking long and hard about future care and how much surgeries are I changed my mind and applied for Social Security Disability , on top of my w/c checks I would get $800.00 more a month. Enough to help with my bills.
Not to be nosey but how much did they offer you for your injury ?
I am also on Workers Comp, have been since 2001. I so agree with you Shawley. I recently asked my lawyer, what happnens down the road..what if 10 years later a screw breaks or something (this was before my failed back issues and such). She then said I would need to consider medicare/medicade then. Things are different for me now that I have new issues, so any settlement stuff has now been put on hold. But yeah, lump sum sounds great, but you have to look in the future. On my mylogram couple weeks, it showed my L3 is buldging. Before my fusion, there was not a single thing wrong with my L3. So you have to think of stuff like that.
Again you are only 8 weeks out of surgery, need to give it sometime. I am 9 months out and not even close to settlement yet.
I should have filed WC for my 'slip' on the ice in the parking lot that started all of my back problems...however...I had dealt with WC before with a neck/wrist issue from falling in the hallway and VOWED never again to claim anything...well what I thought was just a few spasms turned into 2 laminectomies and a two level fusion...$274,900 billed (much of it written off however) to my personal insurance later, of which I have a lifetime maximum of $500,000...I'm scared if I have another few surgeries I will exhaust my benefit...thank goodness in the interim I got married and I'm now on my husbands insurance also...
Please Please Please think of the long term cost to the decision you may make...unfortunately in this day and age we can lose all of our assets to take care of our health and I'd hate to see that happen to anyone!
Also, anyone who has injured themselves be smart and report it or you may end up in a situation like me...scared to death I'm going to lose my job by exhausting my sick/FMLA benefits and the reason I'm hurt in the first place is because I went to work!
Grace that is so sad , you should have filed right away. I know how comp can be. So far comp has only been late on a few checks , and refused to pay my mileage to and from my Dr. appointments (but thats taken care of now) . Plus the IME's and IRE's they send me to alot. But my Medical Bills are payed thank the LORD.
My attorney told me not to file for SSD because it would effect my settlement , but once I realized I'm not going to get any better and not able to work I filed , I'm still waiting on SS decision...I really hope I can get it ..I worked ever since I was 17 so I guess I shouldn't feel guilty for applying.
Nikki -- My surgeon told me my levels above and below are giving out too.
I have a bulge on my L3-L4 now . These are things to worry about because my wifes insurance that I'm on will not cover my spine now. PLUS I was turned down for Suplemental income ? I'm not sure what that is ? I hope it wasn't Medicare . These bills just keep on piling up on us even when my wife works two jobs. If I was promised Healthcare in writing after a settlement I may do it ? Right now I'm just trying to get reimbursted for my mileage.
My first back injury was in 1998 at work. I had a one level discectomy in 2000. I settled at that time and left my medical, modification and review rights open. Following many years of pain, I went back to my laywer and he helped me reopen my case after seeing two M.D.s that both said that my herniation at the injured site and above were both a direct cause from the original injury. The lawyer had to prove causation of the injury. I am still at the same job as 98 and our hospital has changed work comp insurance two times. My surgery ALIF went back to the original insurance carrier. It is very well worth leaving your medical and review rights open. Also very important to have a work comp lawyer. I am now curious what my settlement may be and if they will leave my medical open. It wasn't easy, but with a good lawyer, it can be done. I could have never done this on my own.
ALIF March 27 L45/L5S1
Hi there. I work in "the" field, but we do not handle WC, so I dont know much about it legally. Your are ONLY 8 weeks out of surgery. Personally, you should not be settling your claim at this time. You still do not know the final outcome of the success of your surgery so early into this. I would ask your attorney WHY he/she feels the need to settle this now and point out you are ONLY 8 weeks post surgery. God forbid, the surgery not take. Sorry, but I don't think that is good advice from your attorney.
The offer of 3 years medical. That is great for those 3 years, but what about after? By the end of that time, If you are not working full-time with a company offering medical insurance, you are in a pickle. To get private insurance would be soooooo expensive, you could pay for your back care out of your own pocket instead. Basically, insurance carriers would boost the premium so high, you wouldn't be able to afford it, nor would it be worth to take.
If you are in major financial difficulty at this time, maybe you could work out a very minimal partial settlement regarding your lost wages to this point ONLY. That could at least help you some, but I would not settle this claim, and I would consider getting a consult with another attorney for another opinion on things, to make sure you ARE being represented properly. Which makes me wonder.
Keep us posted.
"believe in the beauty of your dreams"- E. Roosevelt
L5/S1 bulging @ 18, now 46; still there (but no pain)
Fusion at L4/L5 Apr -2006
Solidly Fused Nov-2006
A Success, but still improving!
Mandy, Could it be that your attorney is wanting the 35% of the money? I agree, this seems very quick to settle. Also, from my post earlier, BCBS would not cover anything when I first went back to the M.D. for my back issues. And, my level above the original injury was covered. You have alot to think about, I know the money sounds good. I was only offered 20,000.00 with my original injury, wonder what will happen now. Just wanted to give you my opinion.
[COLOR="DarkSlateBlue"]$20,000 ? Is that it ? No way would I settle for that..This is a back injury that they wanted to pay for right ?
My attorney can only take 20% of what I get from a settlement or if he has to go to court to fight for money...I have noticed the only thing on his mind is me settling and I'm sure thats what Mandy's attorney wants..It's a shame they act this way but thats what they go to school for ? I agree 100% not to settle your Medical portion , maybe the loss wage part if they would.[/COLOR][QUOTE=bailey07;3150088]Mandy, Could it be that your attorney is wanting the 35% of the money? I agree, this seems very quick to settle. Also, from my post earlier, BCBS would not cover anything when I first went back to the M.D. for my back issues. And, my level above the original injury was covered. You have alot to think about, I know the money sounds good. I was only offered 20,000.00 with my original injury, wonder what will happen now. Just wanted to give you my opinion.
Hello..I have been having back problems for about 3 years now due to a cyst on my spine that needs to be removed surgeically but i don't have any health insurance.
I have been on Long Term Disability for the past 2 years and Short Term Disability before that.
Well my Long Term Disability ran out back last month and i have a LTD lawyer and he is working on my LTD case to get my check for 3 more years or longer.
The insurance company has until next wed. to give my lawyer a answer as if they are gonna extend my LTD longer. If the insurance company does not hear anything by wed. then my lawyer is gonna sue the insurance company.
God knows how long that will take, but they would probably settle out of court.
Has anyone been through this before and what do you guys think will happen from here on out ?
I want to have my back surgery so i can go back to work and not have this terrible pain every day.
Thanks so much... Littlelady
Littlelady--I have no clue on how that works , I was talking to my nephew yeserday about my LT & ST disability I payed for , for 10 years. Since I was injured at work I couldn't collect it because I recieve workers comp , my question is , since I was hurt at work don't they have to keep that up for me ? You know pay the insurance my monthly cost for it. I would hate to see all that money I payed over the years wasted for nothing..I was wondering if and when I ever get off comp could I collect this disability money that I paid in for.
Shawley - In our WC law, if you settle with a perminent partial disability, $20,000 is the max the ins. co. has to pay. So it is important if you have a high whole body % to fight for the perm total dis. so that they will actually pay closer to what the disability is going to cost you in lost wages and pain. If I lose my $20 hr job, and have to try to find something that I could to (yeah right) in this depressed area min. wage is what I would have to take. You can not tell me that will only be worth 20 grand.
I am not sure about your ST & LT, but once I used up my FMLA after surgery, I am now required to pay all my ins., health, add-ons and life. I am looking at between 750 and 1000 depending on how many pay periods in the month. My WC is only 1800. If I do not pay those items, they will all be cancelled.