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Old 05-10-2006, 11:28 AM   #1
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RSD hopeless HB User
question for those on Workers Comp and has RSD

Thank you for taking time to read my post...

My question is... If your on workers comp, and you have no outside medical insurance, will workers comp continue to help you?

My RSD started right after I had Carpal Tunnel surgery. RSD, developed right away in my right arm. Now I have it full body this has been confirmed by 6 doctors.

I had applied for SSI or SSD and I didnt qualify for either of it. (have'nt worked long enough) I do have a lawyer working on it and I've been lurking on different boards about people setteling there cases with Workers Comp.

Workers Comp, so far has done everything all my doctors requested. I'm heading toward my 2 yr mark with Workers Comp. Has there been anyone, that you know of that doesnt have medical insurance, that Workers Comp, close there case.

Also, if Workers Comp Settle someone's case... is it enough money to help them though the rest of there lives. Sorry if my questions seem confusing.

Thank you!

 
Old 05-10-2006, 10:07 PM   #2
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Re: question for those on Workers Comp and has RSD

Dear hopeless--Welcome to the boards! It's a great site and no question is too stupid to ask. About settling your work comp case, with no medical insurance, make sure you have medicare first. RSD is a permanent disability, and it might take 3 times, but you will get it>>when it takes forever, or it so it seems. Once social security deems you disabled, you will have medical insurance. You sound kinda young, because you haven't worked that long. Whatever you do don't close your case until, you have some for mof medical insurance. Medicare now covers prescription drugs, and if you are low income, they are free. You have to understand having RSD and especially full body, you are going to have a big med expense. How did your injury happen? Where did it start?

Before you close your case, make sure you first get ss disability, and figure out how much you need to llive on, (rent, cabs, etc) before signing anything! Do you live by yourself? Do you have any family member that can help you? If they are your caregivers, and you are disabled, they can get paid for taking care of you. I guess more info is needed before leading you in the right direction.

Again welcome to the boards. Aloha Skooze

 
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Old 05-11-2006, 05:47 AM   #3
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Re: question for those on Workers Comp and has RSD

dear rsd hopeless, i am also a wc case. i have been on wc since 2000 but not due to rsd. it was due to cervical spine problems. had 4 surgey's the last being in nov 0f 05, that was when i awoke with the worst pain ever in my hands, could'nt even get them to work for awile then just plain old awful pain. i am lucky because my hubby has insurance. i want to settle my wc case and have recently applied to ss. the very nice guy from ss informed me although he was reluctant that u always get rejected the 1st couple of times so, it hppens to almost everyone, but a skooze says, keep fighting them. i will settle if the amount that wc is willing to pay me is what i want. needs to cover my expenses and my med. even if u have insurance, ,ost companies have a life time cap and i'm sure with all the meds, pt, psy help, doc visits ect i will blow thru that quickly so i will make sure my lawyer takes all that into consideration... lots of luck and welcome to this great, supportive web sight..., patti

 
Old 05-11-2006, 05:58 AM   #4
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Question Re: question for those on Workers Comp and has RSD

Hi and thank you Skooze,

My RSD started right when I had Carpal Tunnel surgery,on my right hand. Still have carpal tunnel in my left hand... which they will not do the surgery on. I'm 18 months into having RSD and about 8 months of having it full body.

Im not too young 44 yrs old.. (wish I was younger again) I didnt work outside the home till about 4 yrs ago. Worked in a resturant, then started working in a machine shop running CNC machine. This is were I started getting the carpal tunnel. Didnt realize my hands hurting, and the sleepless nights were signs of carpal tunnel. Kept pushing myself to continue working.

As soon as I had the surgery I knew something was wrong with my hand... It burned from the very beginning after the surgery. Hard time moving my fingers and could'nt even touch the stitches. This continues for 6 months and I had hand theraphy, then aqua theraphy..etc.

I was told to get a lawyer which I did, also go apply for SS. I was denined this the first day... so I figured the lawyer will do the rest. I had a phyc- envaluation(sp), also. W/C has done everything so far without a fuss...
My concerns are if W/C, decides it's time to get her off.... and they want to settle. Do they give you enough to sign off of W/C or how do you get medical benefits if you dont qualifiy for medicare or other benefits.

I'm married and my kids are grown and are there own. I'm home by myself and never leave the house anymore till my husband comes home. I got approved from W/C, to do the trail of a back stimulator... I have to have a doctor check me first, then I can go and have it done.

My main concern is that when W/C wants to start settleling your case and you have full body RSD.. do they give you enough money to help you though out the rest of your life. What if W/C offers you a settlement and you dont feel it's enough.. can you refuse it. I guess these are questions I should ask my lawyer, but I thought I would ask to see if anyone else has.

Thanks

Hopeless

Last edited by RSD hopeless; 05-11-2006 at 05:59 AM.

 
Old 05-11-2006, 08:28 AM   #5
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Re: question for those on Workers Comp and has RSD

Hi Hopeless, Skooze, and Pattihabs. Hopeless, your concerns are valid ones and a lawyer familiar with your case could definitely help you better than I can, but no, you don't have to accept wc's offer on a settlement. In fact, you never have to accept anyone's off on a settlement. That's why it's an offer for a settlement and not a settlement. I would think that most people wouldn'taccept it because I'm sure wc is going to try to get out of your case as cheaply as possible even though I know that they know what RSD is and that they are aware of how your life has changed, and not for the better. It's like when I was in the auto accident that caused my RSD. 2 weeks after the accident the insurance company called me and offered me a $5,000 settlement. I told her that I wasn't going to accept *any* settlement at that because the accident had just happened and it was too soon to tell if I might develop complications or something. At the time they offered me the settlement no one had any idea that I would develop RSD, but the insurance company knew that is I did accept it that they would no longer be responsible for anything related to my case, and they wanted me to get them off the hook should something develop. $5,000 is a lot of money to most people and they were counting on the fact that I'd be excited about getting a check from them, and so soon especially. Thank god I didn't say settle! Later on, when it was time to discuss a settlement again, they made sure I was aware of just how much they had paid out for me already and they did increase their lump sum check I would get but it was no where near the cap on what I could collect per accident. I told her no again and she asked me what I would settle for and I told her that I wanted the whole amount because I had this condition for life and even if I did get the entire amount it still wouldn't be anywhere mear enough. A couple days later she called me back and told me that I could collect the cap (minus what they had already paid out of course). Was it enough to last me my lfetime? Hardly. and I seriously doubt what wc offers you will be either. From what I've read on the boards and heard from people here, you can keep your medical open, although I don't know if there's a cap on what they'll pay out over a lifetime or not.

I'm thrilled for you that you haven't gotten the usual static and feet dragging from wc in regards to your treatment. One day the people who are responsible for the decision making for wc cases and insurance companies will realize that covering the costs of treatments/procedures in a timely fashion will actually save them money in the long run because not near as many people would suffer such long term and severe consequences if the proper treatment plans ordered by doctors were allowed to be carried out. How many people would have had their RSD curbed some or who might have been sent into remission had the insurance companies not dictated what procedures they could have and when and how often they could have them? And that's just one condition. I better get before I start getting really ticked, Argh!
Cathy

 
Old 05-11-2006, 08:54 AM   #6
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Re: question for those on Workers Comp and has RSD

RSD hopeless... have you tried to get state assistance? Food stamps, medical, cash assistance? It can't hurt to apply.
Cathy

 
Old 05-11-2006, 12:31 PM   #7
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Re: question for those on Workers Comp and has RSD

Horsie nutt, love the name by the way.

I just sold all my horses because of this diease. I quit showing my dogs also. I never applied for anything except SS, my husband works so we wouldnt qualify for anything. I just want to be able to continue getting medical though W/C, if this is going to be a life time problem.

Thank you, for explaining how W/C works... They havent asked if I was ready to settle (Or maybe they dont) maybe I should say, I havent heard anything yet about a settlement. I'm only 18 months into this RSD.. I guess my concerns are more like.. How long can you stay on W/C.

If SS or SSI or SSD, says no to you once.. Do you go back and reapply each time they denine you? Or is once good enough. So sorry Im just confused to the whole thing. I just worry about not having any type of medical if W/C drops me.

Thanks so much!

 
Old 05-12-2006, 02:04 AM   #8
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Re: question for those on Workers Comp and has RSD

My husband's auto accident was in 1992. His worker's comp case has been open since then. WC has paid for about 30 surgeries and procedures since then. (And we have not had much trouble getting things approved.) He has been on total temporary disability since 1998, and was diagnosed with RSD in 2002. So, you see, it can last a long time. Your doctor would need to declare you "permanent and stationary" before the insurance company would be talking about settling. As long as they are actively trying different treatments, they probably wouldn't be using that term yet. My husband was declared permanent and stationary in November 2004. We rejected their first two offers without a lawyer and now have a lawyer working on it. They have to keep paying for everything until you settle. If you can get SSDI, you automatically get Medicare, so you would be covered medically. You can ask for your medical to be kept open through worker's comp for life, so that your medical bills would always get paid. The only drawback in California is that you have to go to a doctor in your insurance company's medical provider network.
Hope this helps.
Sunny

 
Old 05-12-2006, 06:14 AM   #9
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Re: question for those on Workers Comp and has RSD

Great ... yes it did help me alot. I was concerned that you can only stay on W/C for a limited time frame. I got scared thinking I was going to be left out in the cold without medical.

Thank you so much.

 
Old 05-12-2006, 07:06 PM   #10
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Re: question for those on Workers Comp and has RSD

Hi Hopeless! I also might add from Sunny's post that if you leave your medical open you will get a very reduced settlement. And you would be subjected to them approving or denying you treatment. And constant independent medical exams by their doctors who love to twist things around!
I would hold out until you get ssdi, and then when no more can be done for you, meaning they tried every treatment to help you, then you are considered disabled and stable. Stress plays such a big part in RSD, as does depression. I settled for $180K before attorney fees, which netted me $150 and change. I have medicare as my insurance and my meds are free now, although I did pay $400 a month until the new drug plan kicked in this year. Cathy also made some very good points too for everyone. Hope this helps. Aloha Skooze

 
Old 05-12-2006, 07:15 PM   #11
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Re: question for those on Workers Comp and has RSD

Skooze, you are right. I re-read my post and realized that I may have made it sound easy to leave your medical portion open. I know WC has been a mess for a lot of people, although we have not had a problem getting things approved. So each situation would be different. The reason we got a lawyer now was that they offered him $20,000 and $170 a month in addition to the Medicare set aside portion. Good that you were able to get a decent amount.
Sunny

 
Old 05-12-2006, 07:34 PM   #12
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Re: question for those on Workers Comp and has RSD

Hi Sunny!
They are only offering you 20K! Is this before your attorney's share. Here it's 10% plus some expenses like faxes and postage. Is the $170 to cover the doctor visits or why that amount? Can you guys live off of that? Also do you have alot of debt from your hubby not working? My attorney approaced them like this. Look at how much they were paying a month in taxi's ($1200), meds, physical therapy, and all of the other doctor's Ive seen. One year alone my medical was $148,000. Take that times 5 years, and you want to settle for how much?? Also I just remembered a good point for all. When your attorney does the settlement papers, they need to write it in such a way that they take the $$ amount, divided by the remaining years of your life expectency, to give you what it would average out to for a month. For example as in my case, It stated my date of birth, and WHEREAS, according to the IRS life expectancy Table, claimant has a current life expectancy of 39.6 years (remaining) and the lump sum payment after attorney fees the monthly rate will be less than $378.78 per month. Why they chose the IRS table I have no clue. But I remember my attorney saying that this is very crucial to social security, because when you report to social security that you closed your work comp case, this puts this into perspective for them Hope this helps all. I had to pull out my settlement papers to look at that, and everytime I do I get a kick out of every sentence beginning with WHEREAS>>TeeHee Cracks me up. Aloha Skooze

 
Old 05-14-2006, 01:12 PM   #13
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Re: question for those on Workers Comp and has RSD

I have RSD caused by a work related injury, W/C pays only for work related injuries nothing more, also if you win your W/C case you only get 70% of your base pay if you are labeled 100% disabled W/C will take care of your work related injuries and pay you 70% of base pay for the rest of your life. ONLY IF YOU ARE 100% DISABLED if not they pay you so much for which part of your body is injured there is a price tag on different parts of your body, your attorney should be able to tell you that. I was 100% disabled and that is what I received and I also receive Social security. I hope that I was able to help answer some of your questions. Lynn

 
Old 05-14-2006, 01:21 PM   #14
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Re: question for those on Workers Comp and has RSD

Quote:
Originally Posted by Lynn O.
I have RSD caused by a work related injury, W/C pays only for work related injuries nothing more, also if you win your W/C case you only get 70% of your base pay if you are labeled 100% disabled W/C will take care of your work related injuries and pay you 70% of base pay for the rest of your life. ONLY IF YOU ARE 100% DISABLED if not they pay you so much for which part of your body is injured there is a price tag on different parts of your body, your attorney should be able to tell you that. I was 100% disabled and that is what I received and I also receive Social security. I hope that I was able to help answer some of your questions. Lynn

 
Old 05-14-2006, 10:44 PM   #15
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Re: question for those on Workers Comp and has RSD

I also just settled my WC case..Here whre I live you have to have a permanent impairment reading (thats from a workers comp doctor who decides how much RSD impairs the rest of your life and how disabled you are) Its VERY VERY hard to get a total disablility out of workers comp...although I was lucky I did. For instance..where I live..with RSD in my arm..you had to have SUBSTANTIAL obvious PERMANENT nerve damage to 2of the 3 main nerves in your periphial nerves in your arm. Sounds easy right? After all I went through...I barely squeaked by. With RSD also...its tough in my state to get workers comp to keep your medical open...after all..thats why they wanted me to settle. I was tooooo expensive. I got a decent settlement..was it as much as I would have made if I could have worked? NO WAY!! I settled now because I have health insurance that will cover me..and I have a strong malpractice suit I didnt want comps hands into (so I got a waiver) thats getting close to the end as well to. Everyone has their reasons for settling..if its for money..and you have no insurance (and they wont cover medical..think long and hard about that!!...hope this helps...C

 
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