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Timothy Belt

As has been pointed out by many other posts, every state is different. PA, where I live, is a wage loss state. Settlements are used to resolve future entitlement to wage loss and medical benefits and upon occasion to resolve past due benefits that are in dispute. If you have already received the wage loss benefit, there is no deduction from the settlement for this payment. TTD is used to designate temporary total disability benefit which is paid when you are out of work entirely with no retained earning power. In PA TTD can potentially be received for the injured workers entire life. TPD is used to designate temporary partial disability benefits which is paid when you have returned to work at less then your time of injury average weekly wage, when a judge has found a residual earning power, or when you have undergone an impairment rating evaluation with less then 50% impairment. TPD is capped at 500 weeks. The injured workers remaining entitlement to TTD and TPD is used to calculate a fair settlement value to resolve future entitlement to wage loss benefits.
1171 Wrote:after 100+ posts you should put your location in your profile.
thankx
Still in Limbo Wrote:Hi RHolmes, I hope you are well Today. Let's take this one step at a time. If I understand you correctly, you are asking if the payments you are getting now are a part of your settlement, should you get one. So you are asking if they settle, just using figures only, for $25,000, they will deduct what you have been paid so far? Is that your question? If so, the rule of thumb is no. When you settle for an amount, they don't deduct what you have already been paid, that's the amount you get, minus Attorney Fees and anything else you agreed to in your Contingency Agreement with your Attorney. Now, if you settle, and it's going to take let's say for conversation, 2 months for everything to be done, and your check be sent to you. At that time you have the option to stop getting your weekly payments, and wait for the check, or you can continue to get weekly or bi-weekly checks, however you are getting paid now until your settlement check arrives. NOW THIS IS IMPORTANT: If you decide to continue getting paid until your settlement check arrives, they WILL deduct the two months that you were paid while you were waiting, but only for the waiting period time only, not ALL of the checks you have received. That's the usual norm at settlement time. I hope this Helps, and Have a Great Day!!Wink

Hi Still in Limbo. I was told the same thing by the paralegal. I thought this was strange too.
It may very well be star, I gave the info. of settlements as a rule of thumb, that Most States follow, but it's always good to check as you did! Best of Luck!!Wink
Still in Limbo Wrote:It may very well be star, I gave the info. of settlements as a rule of thumb, that Most States follow, but it's always good to check as you did! Best of Luck!!Wink

Thanks
The way things are in California is really not too complicated in this regards as I understand them. First off you have to differentiate between the payments you receive. Initially when you are off work you are being paid TTD which can last up to 104 weeks at least under the new rules. At some point, could be prior to exhausting the TTD or long after, you will be declared P&S and receive your impairment rating. At this point if you were still on TTD it will cease. The insurer will now begin paying either PPD or PTD based on that rating. More than likely PPD since PTD is becoming a rarity. These payments are usually much smaller than your TTD. These are payments being made on account so to speak. What they are doing is beginning your settlement payout based on the projected amount you will be entitled to according to your impairment rating. At some point during this time they will negotiate an actual settlement either in an MSC or before WCAB. This settlement can be in one of two forms. The first is a stipulation with future medical. This is the smaller settlement and is what the initial projection was based on. The second form is a Compromise and Release. They do not have to offer this but if it is offered it is a higher dollar amount however you give up all future medical. Now with either settlement the PPD or PTD payments you have already received are deducted from what your actual final payout is since those were considered advance payments. If you have an attorney their fees which are capped at 15% and will be determined by the WCAB will also be withheld. The amount of the settlement will also be affected by whether you are given an offer to return to work by your employer. That is if you have not already returned. This offer must take into consideration any work limitation that have been placed upon you in the P&S report. If this offer is made whether it is accepted or not your settlement will be decreased by 15%. If no offer is made then the settlement is increased by 15%. I think I have covered the basics and hopefully not confused anyone too much.

**star** Wrote:
Still in Limbo Wrote:Hi RHolmes, I hope you are well Today. Let's take this one step at a time. If I understand you correctly, you are asking if the payments you are getting now are a part of your settlement, should you get one. So you are asking if they settle, just using figures only, for $25,000, they will deduct what you have been paid so far? Is that your question? If so, the rule of thumb is no. When you settle for an amount, they don't deduct what you have already been paid, that's the amount you get, minus Attorney Fees and anything else you agreed to in your Contingency Agreement with your Attorney. Now, if you settle, and it's going to take let's say for conversation, 2 months for everything to be done, and your check be sent to you. At that time you have the option to stop getting your weekly payments, and wait for the check, or you can continue to get weekly or bi-weekly checks, however you are getting paid now until your settlement check arrives. NOW THIS IS IMPORTANT: If you decide to continue getting paid until your settlement check arrives, they WILL deduct the two months that you were paid while you were waiting, but only for the waiting period time only, not ALL of the checks you have received. That's the usual norm at settlement time. I hope this Helps, and Have a Great Day!!Wink

Hi Still in Limbo. I am in CA and was told the same thing by the paralegal. I thought this was strange too. I is it different for CA?
[quote=frustratediw]
The way things are in California is really not too complicated in this regards as I understand them. First off you have to differentiate between the payments you receive. Initially when you are off work you are being paid TTD which can last up to 104 weeks at least under the new rules. At some point, could be prior to exhausting the TTD or long after, you will be declared P&S and receive your impairment rating. At this point if you were still on TTD it will cease. The insurer will now begin paying either PPD or PTD based on that rating. More than likely PPD since PTD is becoming a rarity. These payments are usually much smaller than your TTD. These are payments being made on account so to speak. What they are doing is beginning your settlement payout based on the projected amount you will be entitled to according to your impairment rating. At some point during this time they will negotiate an actual settlement either in an MSC or before WCAB. This settlement can be in one of two forms. The first is a stipulation with future medical. This is the smaller settlement and is what the initial projection was based on. The second form is a Compromise and Release. They do not have to offer this but if it is offered it is a higher dollar amount however you give up all future medical. Now with either settlement the PPD or PTD payments you have already received are deducted from what your actual final payout is since those were considered advance payments. If you have an attorney their fees which are capped at 15% and will be determined by the WCAB will also be withheld. The amount of the settlement will also be affected by whether you are given an offer to return to work by your employer. That is if you have not already returned. This offer must take into consideration any work limitation that have been placed upon you in the P&S report. If this offer is made whether it is accepted or not your settlement will be decreased by 15%. If no offer is made then the settlement is increased by 15%. I think I have covered the basics and hopefully not confused anyone too much.

WOW that really helps.
Not exactly. It is your percentage of disability rating that determines how much you will receive. That is where the attorney will usually have the dispute and push for a higher rating. Now theoretically that has been calculated to include some loss of earnings. For instance as of 2005 the maximum weekly dollar amount of PTD is $230 (that is without the +/-15% for job offer). A 10% disability rating is calculated at something like 30.25 weeks. That would make the settlement worth roughly $6958.00 with future medical treatment if it is determined to be necessary. Now they can offer a C&R for a much higher dollar figure and you give up future medical. I don't know that there is any exact formula for what you may or may not be offered in that regards. The concept with such a settlement is that you are given the larger dollar amount and you will save it and use it toward paying your own medical. Now I know some attorneys will push for this type of award for obvious reasons. If you have good coverage under private insurance they may tell you to take the money and obtain your medical care through them. This is where things might be quesionable in my opinion however I am not well versed on all the aspects of this. I have been given conflicting answers in this regards and therefore do not want to pass along misinformation or my own personal opinion. One other aspect to consider under the California system is whether your condition may worsen. With the stipulated award you have 5 years from the date of injury to request to reopen your case. If your condition has worsened it may be possible to then have the rating increased. This deadline is very important. If your accept a C&R you do not have this ability.

**star** Wrote:[quote=frustratediw]
The way things are in California is really not too complicated in this regards as I understand them. First off you have to differentiate between the payments you receive. Initially when you are off work you are being paid TTD which can last up to 104 weeks at least under the new rules. At some point, could be prior to exhausting the TTD or long after, you will be declared P&S and receive your impairment rating. At this point if you were still on TTD it will cease. The insurer will now begin paying either PPD or PTD based on that rating. More than likely PPD since PTD is becoming a rarity. These payments are usually much smaller than your TTD. These are payments being made on account so to speak. What they are doing is beginning your settlement payout based on the projected amount you will be entitled to according to your impairment rating. At some point during this time they will negotiate an actual settlement either in an MSC or before WCAB. This settlement can be in one of two forms. The first is a stipulation with future medical. This is the smaller settlement and is what the initial projection was based on. The second form is a Compromise and Release. They do not have to offer this but if it is offered it is a higher dollar amount however you give up all future medical. Now with either settlement the PPD or PTD payments you have already received are deducted from what your actual final payout is since those were considered advance payments. If you have an attorney their fees which are capped at 15% and will be determined by the WCAB will also be withheld. The amount of the settlement will also be affected by whether you are given an offer to return to work by your employer. That is if you have not already returned. This offer must take into consideration any work limitation that have been placed upon you in the P&S report. If this offer is made whether it is accepted or not your settlement will be decreased by 15%. If no offer is made then the settlement is increased by 15%. I think I have covered the basics and hopefully not confused anyone too much.

WOW that really helps. I have another question if you don't mind. I am off of work as of Nov 06, treating doctor says P&S 5% whole body disabled, needs future surgery (declined surgery for now), and awaiting AME appointment. Isn't the settlement based partially on lost future earnings? If so I usually make around $85K annually. Do they take that 5% and multiply it over a lifetime of future earnings (assuming 60 years old retirment)? I researched the formula and calculated around $80K (before anyone takes their share) settlement based on what I earn, % of disbaility, etc. Seems high but if it's based on the new formula, then that's what I came up with.
[quote=frustratediw]
Not exactly. It is your percentage of disability rating that determines how much you will receive. That is where the attorney will usually have the dispute and push for a higher rating. Now theoretically that has been calculated to include some loss of earnings. For instance as of 2005 the maximum weekly dollar amount of PTD is $230 (that is without the +/-15% for job offer). A 10% disability rating is calculated at something like 30.25 weeks. That would make the settlement worth roughly $6958.00 with future medical treatment if it is determined to be necessary. Now they can offer a C&R for a much higher dollar figure and you give up future medical. I don't know that there is any exact formula for what you may or may not be offered in that regards. The concept with such a settlement is that you are given the larger dollar amount and you will save it and use it toward paying your own medical. Now I know some attorneys will push for this type of award for obvious reasons. If you have good coverage under private insurance they may tell you to take the money and obtain your medical care through them. This is where things might be quesionable in my opinion however I am not well versed on all the aspects of this. I have been given conflicting answers in this regards and therefore do not want to pass along misinformation or my own personal opinion. One other aspect to consider under the California system is whether your condition may worsen. With the stipulated award you have 5 years from the date of injury to request to reopen your case. If your condition has worsened it may be possible to then have the rating increased. This deadline is very important. If your accept a C&R you do not have this ability.




Thanks for taking the time to explain all that. Helps a lot. I know they have vocrehab but this helps you attend a trade school and those type of professions (most of the time) pay a third of what I usually receive. This is terrible!!!
Here i
First a question: When was your mother in laws injury? This is important because things have changed dramatically in the last few years.

Yes that is correct insofar as the calculations for disability percentage rating. The settlement is based on that final percentage. Like I said theoretically it has accounted for loss of future earnings. It does not necessarily take into account actual loss of earnings. You may for instance be rated with a fairly small percentage and still be virtually unemployable at least in your field. You may possibly be able to do something else but does not actually account for that difference on an individual basis. The easy way to look at it is each percentage is valued according to number of weeks you will receive payment for. There is a maximum dollar amount that is paid on a weekly basis. Like I said in the previous example 10% eguals something like 30.25 weeks (I'm not positive but close since I'm winging it here from my bad memory). If you are a max earner that would be calculated at $230 per week for 30.25 weeks. That is whether you are able to return to work or not. That is why I said theoretically. For instance you could have a 10% rating and have job restrictions placed upon you that clearly do not permit you to return to your job or any similar job within that pay scale. The AME report will address this and may consider you a Qualified Injured Worker (QIW). That would make you eligible for the Supplemental Job Displacement Voucher (SJDV) which is also based on that final disability percentage rating. This is a major change and difference from the old Vocational Rehabilitation. It ranges from up to $4,000.00 for a rating under 15% to a maximum of $10,000.00 for ratings from 50% and up. Since this is a voucher it is not paid directly to you but is money available to be paid toward schooling. In my examples I am referring to Permanent Partial Disabilites (ppd) as opposed to Permanent Total Disabilities (PTD) these cases are different and not as prevalent. So hopefully you can see how it does not necessarily in all cases compensate the IW for loss of future earnings. Each situation and case is very different though. What we all have to understand is that Worker's Compensation System is not designed to compensate the IW for all losses. It is just a bit of a safety net for when you are injured. It works well for relative minor injuries when you simply get medical and totally heal and go back to doing what you were doing. Higher wage earners don't do as well under it as lower wage earners. It was never intended to fully compensate the employee. For the most part it is there to protect the employer and in so doing has given the employee some protection and rights.

**star** Wrote:Here is the link to California disability formula. Page two talks about the the differetn factors for settlements in CA.


http://www.dir.ca.gov/dwc/PDR.pdf
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