To Settle With Workers Comp Or Not - Disabilities Message Board

shawley · 12-15-2006, 07:07 AM

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

ICC · 12-16-2006, 03:47 AM

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.

ICC

patty3204 · 12-16-2006, 06:43 AM

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.

charliecat31 · 12-18-2006, 12:11 PM

Shawley:
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

shawley · 12-18-2006, 01:00 PM

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 .

Thank you so much