Mediation, Workers Comp & Settlements - Disabilities Message Board

Redswan · 08-16-2007, 07:47 PM

I'm confused a little bit, but I need some help. I am newbie, but have reading posts for a long time and trying to research. I was hurt at work 2 years ago, followed thru with all of the workers comp drs who diagnosed me with a RSD. My endurance has involved sympathetic blocks, a trial SCS, numerous medications, PT, MRI, Bone Scans, etc, etc,etc. I was able to get SSDI with 4 months of applying. Personally, this was a shock! I expected a fight for three years since others tried numerous times. Workers Comp was able to classify me as Perm Disable, but that was a fight. Now here is the thing, Workers Comp wants to settle with me. I am under no obligation to do it, but my case is worth lots of $$$. They are going to offer me just a little $ according to them and my attorney. I have never gone thru this before, but what can I expect from the mediation? My attorney states that I have to do all the talking he'll just sit there and listen. My concerns are about my medical. What % do they normally put aside for Medicare? I am so scared that I might be placing myself into a deeper hole because my attorney isn't going to keep what is in the best interest for me. What to do? What to do?

ICC · 08-17-2007, 06:23 AM

Morning Redswan..I'll try to clear some things up for you as best I can. Keep in mind all states are different so what I tell you might seem cut and dry but maybe isn't in your state.

Mediation: This is to see is both sides CAN agree to a $$$$ amount. If both can't there will be no settlement at that time. Case will remain open and games will continue. As far as open medical or a medicare set aside( which is the best way to go) it depends on your medical bills on a yearly basis. Let's say you spend $5000 on your injuries. They will times that by the years left in your expected lifespan and that's how they come up with the set aside. The money goes into an account in your name and you can name a beneficiary. you will begin to pay for your own medical from this money for anything pertaining to your WC injuries. I personally would not settle for anything less with having RSD. I am sorry you have this. I don't, but hear it's very painful .
Since WC has accepted your RSD you're on better footing. As far as what your case is worth no one can answer that. Just make sure your attorney has YOUR best interest in mind and doesn't just want to get paid. I found with my husband's case that the $$$$ mentioned by his attorney in medication was almost what they settled at 2 years later. Keep me posted.

ICC

Sunnycal · 08-18-2007, 10:38 AM

Redswan,
My husband is in your situation exactly. He got RSD from an auto accident on company time. He applied for and is receiving SSDI and Medicare. We are negotiating now for a settlement. The Medicare set aside account is a certain sum of money that they think you will need for your future WC medical care. When it is gone, then Medicare will pick up the tab. It is actually a requirement of Medicare for anyone who receives Medicare as a result of a WC injury. Medicare wants to make sure that the employer is paying out money so that they don't have to. I figured out the future costs of his medications and they are astronomical.
In my husband's case, the amount for his injury is set by a table according to the degree of disability and date of injury. I don't understand how yours is negotiable. Since his injury was many years ago, the dollar amount is very low, which really irritates my husband, since RSD has ruined his career.
Good luck,
Sunny

Redswan · 08-18-2007, 12:30 PM

Thank you for your personal input. Wow he has RSD too! What I have found is that there really isn't too many people out there on WC with RSD. Most of them who have developed this has had it happen to them outside the workplace. All of this so new to me and I wish there was a book titled "Settlements of WC for Dummies"! LOl I feel like when I ask a question I am truly stupid and naive. I am a highly educated person who has been taken away from a great life of fun, family and work. In actuality, I have been told a figure, but then it comes down 8% from everything else being taken away. Thus leaving me a figure of about 1/3 of the price. Now I know you are going to start asking me more detailed questions, but I preferred not to give any figures out. Once we add the figures with what medical portion is allowed I am not walking away with much. This is what is so bothersome. I still have 50 years of my life expectancy and this is not going away soon. I could be destined to be in wheelchair or use other kinds of walking aids. Who knows what my future holds! WC is playing a game now and they want me to go to another dr to be examined. I have seen 7 drs so far and they all agree as to my condition. What is WC looking for? For someone to say I don't have this? I am lieing? When I go to the mediation I have been told that I need to brace myself for a personal beating. Great!! I do wonder if this is some kind of conspiracy to make me just settle for anythning and get away quickly. Uhm? I guess I have to wait and see.

I appreciate all who can give me insight and thank you so much.
Red

Sunnycal · 08-18-2007, 12:51 PM

Of course I don't mean to pry and I don't want to know any figures. I was just wondering if you were told yours was negotiable, as opposed to a certain rating formula, the way it is in California. It never will be what a person could make in their lifetime. I guess we have been lucky in that we have only been told to go to an IME once. WC seems to accept the RSD diagnosis without a problem. They are having trouble realizing that it is lifelong and doesn't get better so that you can decrease medications and see doctors less frequently. They put together a life care plan that decreases everything over time so that they have to pay out less money. That is the part we are negotiating. We have not been to mediation yet. What state are you in? I know there are several people on the RSD board who have had problems with worker's comp, but they haven't posted in awhile. You can do a search on the RSD board for WC and look at the old posts. We have not had trouble with WC denying treatment, but a lot of other people have.
Sunny