settelment w/c or Ins.

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successtory

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Hi All :wave:

Patsy is right about the Rehab $16,000 (up to the last point)...well, according to my vocational rehabilitation counselor. My counselor told me that W/C will either pay for retraining OR to start up a business...but not both. The decision must be made up-front. When I say "start up a business"...what I mean here is say you want to be a masseuse, and you are already certified. The rehab money can purchase you a portable massage table, the towels, massage products, computers, etc. The $16 grand will NEVER go into your pocket in order to purchase something. You must purchase it FIRST...THEN get paid back. And don't forget, the fees for the Rehab Vocational people comes out of this fund too! So do as much of your own research as you possibly can...it'll save you money in the end!

Your attorney's 15% fee is deducted from any supplemental payments you receive. So in CA...the maximum W/C benefit you can get is $490/week. "The day" you are termed P&S, there are 2 weeks where you get only $140 a week (so your $980 check is all of a sudden $280). This is ONLY for 2 weeks....IF you signed the Rehab Request Form from W/C. On that form is a box you check stating you want the supplemental income payments in addition to rehab payments. At the $490/week level...rehab checks will be $244 a week. The supplemental is the same with the exception that your attorney's 15% is taken out of each supplemental check...which leaves you with a supplement of $216 a week. These 2 checks that come every other week will amount to around $920. Every penney of the supplement is taken from the $16k fund, and let me tell you.....it goes REALLY FAST!

W/C checks do continue "for life" OR until you are claimed P&S by your doctor. Their doc can put you as P&S and W/C will work as though your own doc termed you P&S...they will continue this way until YOUR doc either agrees/disagrees with their doc's P&S statement. You are the loser in that scenario, as they won't make up for "lost benefits" in those instances.

I hope this helps you guys out some. And PATSY...Good Luck to you on Monday! All will be well.
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successtory
Oct 2000: Repetitive Stress Injury-Inverted Hernia
Feb 2001: MRI. Shows only slight bulge at L4-L5
Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.
 
I am getting ready to settle my case, I feel like I really dont know what to do or ask for I was hurt 5 years have had 2 serg, first time rated 25% now I am reinjured Drs. have rated me 100% disabled I have a laywer, but I dont know ,I now recieve SSD its better than nothing but my family now are broke you know living pay check to paycheck,I owe so much medical bills ,The DR now wants to preform a serg. called a 360% in St Louis I can hardly walk now, In so much pain 2 pain killers every 4 hours (oxy&flexerail) any advice???? olabolla
 
Yes
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that makes sence, so that is true , you cannot collect W-C after P&S?
It seems that the longer you can stay out of work the longer you can collect benefits? What I don't get is how do those people that collect W/C for years get their doctors to keep them from going P&S ?
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Are they just milking the system some how? Cause you cannot collect any settlement money until you are P&S. I truely think think that these people make us, the ones that are really hurting look bad. :mad:

Why don't we all just decide on a business that we can do together and put in all our $16,000 (add that up it's a lot!) and be happy being our own boss!! :bouncing:
Don't we wish that, but this is the real world!

Thanks for all your useful information! I'll have my daughter post here on how I'm doing after my surgery, So please ask how I am and she can get back to you, that way I can still get my message board fix!! You guys are the ones helping me through this all!
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Patsy
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[This message has been edited by PatnOscar (edited 01-23-2003).]

[This message has been edited by PatnOscar (edited 01-23-2003).]
 
Shedevil thanks for answering, I cant believe it! your story is mine.Thank you for the info. I to cant pay the bills,Its like who will I pay first this month(just to keep them off our back)its my son who suffers the most you know no dad and all,I just cant do what I used to.My attorney is not w/c he is a good one but really busy,we are wating to hear from the w/c to do a phone conference.For the final hearing.If they settle with us now who pays for the 360% in St.Louis Iam sorry for all the questions but we feel like we are in the dark, thanks again and write back, olabolla
 
Hi Patsy,

That is correct...you can no longer collect W/C once you have been termed P&S. Hopefully, you have signed the Vocational Rehabilitation Request form W/C sent you. This is your (hehe) "guarantee" of keeping those checks coming. If that hasn't been signed, their doc says P&S...and boom, you get nothing (until the form is signed). They keep this signed doc on file (their files) until the day you ARE P&S'd...the day they stop your W/C benies is the same day you will begin your "Rehab" benies (after the 2-week 'transition period'--or whatever they call it).

And how can one stay on W/C for so many years? Bad therapies...bad surgeries...or tried and failed surgeries...etc. The ones that have ruined it for all of us in true pain by milking the system, are (usually) not the ones who have had surgery (cause we all know they are really hurt to have back surgery!). I hate to say this (and I mean NOTHING personal if someone here happens to fall into this category) but the majority of the people who are faking symptoms just so they can get money for not working -- are the ones who are under 30 YO. In fact...I met one. I'm not even going to go into THAT story it makes me soooo MAAAD
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My comment there is for those who are milking the system claiming "a bad back"...not those "milkers" who pretend to fall and hurt themselves in a store, or claim whiplash in a car accident, or something phony like that. But it's the "younguns" that have figured a way to get free money without working! Us "old timers" (especially those in the technical/computer generation) are trying desperately NOT to get (or be) out of work. One good note on this however....it is not STANDARD practice to be followed and video-taped if claiming W/C...so I am hoping this added "inconvenience" will deter the fakers from ruining it any more for us. When my lawyer told me to "be careful when outside, you may be taped"...I laughed. I said "bring 'em on! Can I invite them into my house so they can see for themselves what I must go through (in pain) to live? I WANT THEM TO SEE me as I am now!" (this was a pre-surgery comment). Anyway...I HAVE been P&S'd and have been "guaranteed" a bi-weekly check (at least) until my Rehab money goes dry...after that...I'm not sure. But I hope I'd still get the $488 bi-weekly until I am finished with Rehab (or until the case is settled). Good luck at your appointment. Did I read right, your surgery is scheduled for Feb 6th? Or was it this Monday? If Monday...GOOD LUCK and get plenty of rest the day before. If Feb 6th...I'll be talkin' to you before then probably.



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successtory
Oct 2000: Repetitive Stress Injury-Inverted Hernia
Feb 2001: MRI. Shows only slight bulge at L4-L5
Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.
 
Hi Olabolla and welcome! :wave:

I can most certainly help you out. But there is a lot of info and (alas)...I must leave right now to pick up my son from school. I'll come back in a bit with some very helpful tips and information for you. I take it your lawyer is a W/C lawyer? Anyway...gotta go. Will be back in a bit. Hang tight!



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successtory
Oct 2000: Repetitive Stress Injury-Inverted Hernia
Feb 2001: MRI. Shows only slight bulge at L4-L5
Dec 2001: Discogram/CT scan shows Inverted Hernia at L5-S1. L4-L5 & L5-S1 ruptured in all 4 quadrants. Unable to walk.
Feb 2002: IDET, Nucleoplasty, Intra-Discal Injections
Sept 2002: Rated in the top 10% for successful patients. Retraining for new career.
 
Hi obo :wave:
I cant answer your question about settlements per work comp but I am real interested in knowing what you find out, my husband ( as well as myself) got hurt at work and he was deemed 100% disabled by ssd and his neuro, and we have a work comp attorney thats as far as we got, work comp has made no offers yet, but his attorney has petioned the court for a hearing date, his attorney said that work comp usually will make an offer just before the hearing, I hope our attorney plans on including the cost of what my husband would have made (loss of future earnings) I know where your coming from, we can hardley pay our utilities much less alot of other expenses. It really burns me up to think that most work comp companys think of the cost that they have to pay and never what it cost the employee who lost his livley hood, future, and pleasures of playing ball with the kiRAB just ruining not just one life but a whole family and I dont mind telling you that THEY ARE GONNA PAY DEARLY , I hope the judge is one that makes his decision for the injured worker so I will be watching your replies, successtory said she will answer you she is very knowledgeable if anyone knows the answer its her, so be patient she will tell you like it is, good luck and welcome aboard
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laminectomy 1999
discectomy 2001
spinal fusion L5S1 2002
partial hardware removal
2002
 
Yes, my surgery is this month the 27th. Can I ask what are you retraining for? I recieve 80% of my salary, I actually recieve more money then when I was on the job! because of the taxes I'm sure. My check gets direct deposited every 2 weeks just as if I was working, so far I get about $988 every 2 weeks, and whats weird is I even get holiday pay!! Really I would rather be working, I miss my coworkers and I would rather be with no pain, don't we all?!!
Also I checked into the LTD and STD, offered through the union, they don't pay on work related injuries because you are already getting benefits. But i tried!!

[This message has been edited by PatnOscar (edited 01-23-2003).]
 
One point on W/C I would like to make. I too had my case reopened. It's called a new and further, it has to be done with 5 years of your first injury. If you were rated higher, you are entitled to the difference in compensaton. If you were paid the first time @ 25% disabled, which in the state of Ca. is $12,000, if you took the settlement with future medical. You will be paid the difference minus the $12,000. In Ca, the percentage rate is paid by a scale, like 25% is the $12,000 and I know that 49% is about $50,000 and so forth. This percentage rate is determined by your doctor. The payscale is the same for anyone. I believe you can find that on the web, not sure where.

The idea of geting an attorney is to use your attorney's own doctors to get you the highest rating possible. The higher then rating the more money you get, your attorney gets 15% when the case settles.

If you don't have an attorney, which I didn't the first time, the doctor that rates you is from your work's W/C insurance. At that time if you don't agree with that rating you can dispute it, by getting an attorney and trying to get a higher rating. But, and most importment! If you decide to dispute it, lets say you rating is 25%, then your new doctor rates you higher then thats great! But if you get a lower rating, then you get less money. Make sence? Your taking a chance when you dispute the first rating. Just be careful.

From what I understand, per my attorney, the vocational rehab money of $16,000, cannot be used to start your own business, because you do not get that money up front. You could do Real Estate, lets say, and they will pay for the class, and you tell them you need money to start up your office, they will probably give you the difference. That is the only way you can get some of that money in your pocket.

Look into forced medical retirement from your work, I think you need an attorney for sure. Don't screw yourself, it's not your fault you got hurt!

Also! Were you paid the settlement the first time in a lump sum or in payments? If you took the medical then you would have gotten the payment plan, 2nd time around you will get a lump sum payment.
You should be recieving W/Comp payments right now, there is no limit on how long you can recieve payments as long as you are out of work. It only stops when they close your case! Hope all this help, I've been of work for 5 months now and have been getting paid just as if I was working, 85% of my pay without taxes. Make sure you have a W/Comp attorney, they specailize in it and are the best at knowing the law.
I too am having my fusion on Monday an am scared to death! So lots of luck and like I said don't let anyone take advantage of you. There is no reason that you should be suffering right now, without pay. They may own you backpay in W/C benefits. Good Luck! Patsy
 
Hello everyone-I know you don't know me yet, it has been over a year since I have been on the boarRAB. But I came looking for some information and fell on this thread...and found it very interesting, even though it is old;).

I am one of those who will not be settleing (although I have asked to do so, on a few occassions, since I have sold everything I have to sell.) However, after 2 lurabar fusions that failed and made my back worse than it was going in, a spinal stimulator that also failed and each of these have cause a great amount of scar tissue. I have permanent nerve damage in my legs, which cause me to fall at any given time, as I walk and my knees will just buckle and I am down. I once was crossing the parking lot of the grocery store and fell in the middle of the lot. I had recently had my 2nd fusion and I could not get myself up. Talk about humiliating! Anyway, since then, I have always used a cane or walker. My condition just keeps deteriorating and I have had to get someone to come in weekly to help me with both cleaning and more recently, to help me with bathing items. Even more humiliating! I have lost my bladder control as well, so I have to do a self-Cath. daily (although W/C does not accept that issue. Now, my knees are very painful and swell up when I walk for more than 5 minutes. They believe I have rh. arthritis or gout.

I listed all my disabilities, just to explain how there are a few cases that are on W/C long term...in VA it is 10 years. After that time, if you are found to have permanent injuries, meaning that you wont be able to go back to work ever again, W/C has to pay you for your future years of not working. So, the younger you are, the more they pay you. They also have to cont. to take care of my medical, no matter what. I talked to my lawyer a week ago and she explained all of this to me. I had asked her where we were with a settlement because I was having to file for bankruptcy. She explained that although it doesn't happen too often, every now and then, a person is found to be permanently injured and she had just won a case with a gentleman about a month ago and she said that I am worse off than he is. So, she explained what I just typed and said that I could ask for a settlement now, and I would get the equivelant of my bi-weekly checks multiplied by the no. of months that I have left, of my 10 year period. For me, I have four yrs. more to go (48mo.) That would be the settlement amount today. So, I'd probably get about 32,000.00 after the lawyers fees etc. Then my lawyer said that before I make up my mind, if there is anyway that I can wait the 4 years (which I don't know how I am going to do that...but I am definatly going to try), she believes that since I am not able to walk anymore, that I will be found permanently disabled. Then they will owe me 20 years worth of my old pay. (well, 66.5% of my old income.) I have been injured since 2003, and at no point, even once I was put at MMI, did the W/C case worker ever suggest vocation/rehab or ask me to find work. My lawyer said it was becasue they knew or suspected that I was perm. injured, from the very beginning. I always thought that was odd...I'd expect them to at least try to get me back to work. However, when I went to court and appealled my SSA, there was a Voc. /rehab worker there. The jusge asked him if after he heard my case, could hefind me a job? He said that there was nothing he could do to help me and he did not think I would ever be able to find a job, unless it was through the ADA.

I am so sorry for the legnth of this post, I hope it helps someone with something:).

LAF:angel:
 
Hi, everyone, and especially wonderful Patsy!
This is such fantastic information. It just doesn't seem to be readily available anywhere except from those who have actually experienced it.
I've decided to be brave and try and do this with no atty. I spoke with my case manager (my employer's self-funded wc co. today) and everything here checks out with her. She is much nicer than the stupid atty. I spoke to yesterday, and seems willing to make all the possibilities discussed here available to me. I think at my level (1st time wc claim) the benefits are pretty much a given, provided for by California law. My case worker did mention to me that at this point, she can pretty much guarantee I'll be offered lifetime medical care for my back. She said all the settlement stuff is way down the line, and it won't depend at all on the willingness of my new employer to re-hire me. which is interesting. I think when an employer chooses to self-fund wc cases as mine does, cases can be decided more amenably and in my case more favorably. The state of CA oversees it all, but this self-funded company administers everything. A lawyer would be a mistake right now I think.
Patsy - you have been such an amazing help. It is so great to know what to expect. I can't believe that with your surgery so near, you are kind enough to take the time out to help us all here. We'll all be rooting for you for great success with your fusion on Mon. morning! You have such a wonderful attitude, I know you're going to come out of this a million times better. Just think of a life with so much less pain. It's a big step, but absolutely the right one. Keep posting. You are such a hero for me!
 
Thanks Di!
It was great talking to you! It's nice to know I'm not alone out there. I got back from the hospital and had my blood work and chest xray done. The hospital is so nice, I will get a private room to be in pain in.(YAHOO!??)
If I had a choice I wouldn't do it, but I'm tired of taking and living off pain killers. I want to get back to a normal life! This baord has been great, ther are a lot of nice people here, willing to share their experiences, which helps us all in the long run! Thanks to all od you! Hang in there Di, we will all be just fine!! Patsy
 
Hi olabolla ;)
Isent it amazing what you can find on this site? alot of people sure are knowledgeable. I went to therapy today and she is bent on me starting back to work next week after I see doc, I am getting so sick of this crap, everyone seems to think they know what level of pain is acceptable to work with, someday I hope they are faced with having to try to live on w/c and see how they feel and have someone else tell them that they should just try to live with the pain and try to work through it yeah right
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so I was sopossed to get an afo (brace) for my right foot and leg drop foot, so now w/c says oh she had drop foot before she got hurt gimme a break anything so they dont have to pay, man I cant beleive some people and I feel for you about what bills should I pay first and what ones have to wait, my phone is being threatend of being shut off now, man i am soooo ANGRY sometimes I get so bummed out I cry all day, I really feel sorry for you too and everyone here who has problems, I will keep checking back to see how your case is going, my prayers are with you and your son, love to all
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laminectomy 1999
discectomy 2001
spinal fusion L5S1 2002
partial hardware removal
2002
 
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