Hi , I have this terrible problem I'm not sure how to deal with.
Back in 2003 I injured my L4-L5-S1 I had a laminectomy and fusion in 2004.
In 2005 of April , I broke a pedical screw during my work hardening program , my therapist had me lift a 65 lb wood pallet , my Dr. had to go back in and remove and replace all my hardware because I was not fused.
( no bone growth).
April , 2006 I had another sugery , my Dr. wanted to put a sleeve like material around my dura to protect from scar tissue build up , and remove my hardware if fused ( my IME Dr. said he seen no sign of fusion at all) he didn't remove any hardware , just put some bone and protein around my hardware.
Still I have severe pain , and workers comp wants me to settle my claim in full. My attorney is trying to scare me into taking a small amount so he can get some $$. I don't want to settle my Medical because I know I have another surgery down the road. I'm not fusing. I told my attorney the ONLY way I would settle if I recieved a large sum of money. He said I wouldn't get as much as I told him , I said ok then I won't settle. Now he's telling me comp will have my Medical taken away...NO WAY ! I have rods /screws and cages back there , their not going to find me ok. But he still say's they will. I told my attorney If he comes up with this amount PLUS 2 years left on my medical I may consider settling. So it's been a month and I haven't heard a word from comp yet.
The Big question is , If I can't ever work again will I have to pay my settlement money to SS if I have to go on it ? I don't want to settle but if the price is right why not ? And will my health insurance pay for my spine problems down the road if I settle ? I had my insurance before my accident at work. I'm not looking to rip anyone off. I just have to look after me and my family first.
Thanks for replies
shawley----anyone who has dealt with the WC system knows you're not trying to rip anyone off. it is a horrrible corrupt system. out of all WC claims only about 2% are fraudunlant and yet all are treated as if they are. that being said i will try toanswer some of your questions.
1) injury is work related. if you settle your personal insurance will not pay for anything to do with it in the future.
2) everyone goes in with a large $$$$$$. if you trust your attorney you need to listen when he says times up. sometimes the IC will make a couple of offers and if IW continues to turn them down the offers get lower.
3) my husband spent 3 years fighting them. he won. by the time they paid all his medical back, all fees, what they owed him for 3 years and 6 months of bi-weekly checks plus settling his case within 6 months after he won it was actually the $$$$$$$ amount he wanted in the first place. when he settled his medical was kept open for life. that an change in years to come if wither party wants to totally close the case . at which poin he will get apart of what they kept out for medical that wasn't used.
4) as far as SSD goes your settlement papers have to be written in a specific way to protect you from SSD taking any of it or not giving you a lump sum from what they owe you. your attorney should know the proper wording to safe guard you.
5) remember SSD and SSI are 2 totally different things. if/when you settle the judge will make it clear that if your medical is open it will only pay for your original injury. once you are paid on that injury your personal IC will not pay for anything pertaining to it and i don't believe medicare will either. usually when a WC case is settled a dr. has put the patient at MMI (maximum medical improvement) doesn't sound as if you're there yet so i would definitely discuss all of this with your attorney. some attoreny want a case settled for whatever so they get paid. most if they believe they can push it and get more for their client will go for it as it puts more in thier pocket also.
Did I help any? let me know.
Ive been on work comp for 8 years now and am getting ssd also. My attonery as advised me all these years to not sell out my medical. You have a cap of 125,000 with work comp payments. Like I said Ive been getting weekly checks from work comp for 8 years now and still have my medical paid for. My attorney is actually one that fights for us hurt people and is not there for the money. They have tried many times to get me to settle but have never made any kind of offer because I beleive they know my attorney knows the laws. So do not settle because they wont Im sure give you an amount to take care of the rest of your surgerys. I would find another attorney that really cares about your well being, hopefully you might be able to find one like mine. I hope the best for you and family. Merry Christmas and hopefully a better New Year.
First let me start by saying how sorry I am that you are in pain and are having to deal with the WC system. Like Patty I have been dealing with WC for a long time (7 years for me). It is a miserable thing to deal with and I agree with ICC that we are all treated as if we are trying to cheat the system. The stories I could tell you from the past 7 years... I am also receiving WC perm. total disablity benefits bi-weekly, WC pays my medical and I am on SSD and have Medicare. I am fortunate to have an excellent attorney who fights for injured workers rights. She has given me outstanding advice over the years and fought hard for me.
As far as deciding to settle or not goes, please think long and hard about this decision. I was shocked at how it works when the time came to discuss this w/ my attorney. We talked about keeping my medical open for life, but settleing my wages and how it was explained to me might help you out. They do not pay you what you would earn in your estimated life time, they pay you what it would cost for WC to put aside enough money NOW to pay you for your lifetime. I don't know if this is how it works in all states, but that's how it works where I am.
Settling the medical side is also very tricky. For me it wasn't in my best interest considering I have a morphine pump that will need refilling every 2 months for the rest of my, God willing, long life. The up side to settling the medical is that you can get out of the WC system and choose what doctor you want to see.
It's a tough decision and everyone's case is so different. I have to agree with Patty that it sounds like you need a different attorney. Read over the contract you signed with him and find out if there is a clause about letting him go - sometimes they have a fee you will need to pay if you fire your attorney, so check into that. You need an attorney that is fighting for YOUR best interest. I was lucky that the firm I deal with has a Social Security lawyer as well that was able to help with my SSD claim.
I wish you the best with all of this. I know how difficult all of this is. You're in pain and then you have to deal with all of this on top of that - it's enough to drive us all into the looney bin. Good luck and if there's anything I can do to help or a question I can try to answer, I'll do my best to help!
Take care and have a very Merry Christmas! Hopefully 2007 will be a great year for you
Thank you all for the information you all gave , everyone has answered my question in some sort . I am truly thankful for this website , the people here are so friendly and wanting to help. I want to shout out a Very Merry X-mass to you all and your families, and pray for our troops who are far from home and their families this holiday .
I unfortunately settled with wc due to the fact they were trying to starve me out and as a single parent I did it to be able to provide for my son. 14 months later still not help, even LTd turned me down even though I have 4 specialists that have written that I am completely disabled. The goal of all insurance companies is to get out of paying, especially if you have a complicated case as I do/did with brain injury, soft tissue complications, and loss of short term memory. Stand strong and go with your gut. My lawyer told me it would be risky to go to court, but in hindsight I think he just wanted to be done with it. He had no background in brain injury, and I believe he just does not get it. I am not going to use him most likely for my SSD appeal even though he has all my records. I think it would be better to find someone else and let them pull the records. Good luck to you, I know how hard it is and WC is a crock in SC.
mimgregg---starve us out? yep that's exactley what they try to do.
charliecat-----you are 100% right in how they "pay for life" it is not even close to what you would have made if not injured.
to all----- this is my 5th WC claim with same employer. 2 involved my back and knee. i healed totally and went back to work full duty so all medical was paid and I also had no problem getting paid. one injury was aconcussion that i worked with for 2-3 months. one was a slight ankle sprain and i worked through it with a boot on. this one has efffected 5 body parts. neck, back, shoulder, knee and ankle. case ws denied even though i have MRI's to back all injuries up and even their dr. has said they are consistant with the job i was doing. My opinion is that sometimes the IC looks at the injuries and the age of the employee and knows that they will be putting alot of money out and they're the cases they fight in hopes that they can "starve you out" and you'll give up and drop it. I have seen this happen numerous times. they make your life unbearable in refusing treatment and yet they want you well and working, they take your livelyhood away so you have nothing. it is a corrupt system in that IME's are paid to lie and find nothing wrong with the IW. in my husbands case , it took 3 years for him to win, i used to ask him whose MRI he brought to the IME. obvously this dr. at first missed the 4 herniated lumbar disks and then a year later missed the fact that 2 of them were missing.LOL all states are very different but one thing remains the same . it is a horrible system to enter into. you work hard all your life and then make the "mistake" of being injured and you are guilty until proven innocent. what makes them think anyone would go through this if they weren't really injured? that being said i'll stop because i could go on allday about the corrupt unfair WC system in most states.
Right after my back injury , I was walking down our stairway and my left leg gave out and I fell down the stairs , see my leg would get these jolts the whole way to my feet and my muscle would just give out , well I ripped all my ligaments in my ankle , my ankle swelled up like a softball , I had my spine Dr. visit the next day he looked at my ankle and said what did you do to your ankle it looks like you broke it...I just said please fix my back Im not worried about my ankle ,he wanted to x-ray it but I wasn't worried about it.
After my spine surgery I decided to get it looked at , 2 weeks later I had surgery to repair my ligaments , so I have screws and junk everywhere , plus I didn't turn it in to comp , just my insurance.
To be honest with you all , workers comp hasn't been to bad on me , a couple late checks , lied to . But they seem to pay everything for me. There the ones who want to settle all this. I just havent heard anything for about a month on the settlement , I just had my MRI today to figure out where my pain is comming from and if my bone is fusing or not. I have my fingers crossed.
I don't mean to pry , but has anyone settled for their back injury , medical and all and what did you get $$ I have a friend who settled for $350,000.00 for 3 ruptured disc hurt at work in NY. Thats where I got my idea for a settlement price and my spine is even worse than his. Of course I didn't ask for that much , but sort of close with 2 years left on my medical.
I guess no news is good news so far huh ?
Hope your all well today , it's chilly here but beautiful .