Workers' Compensation Discussion Forums

Good Morning everyone. I hope you are happy and pain free this morning.

We will be having a mediation in March (possibly). What should we expect? Husband's attorney said early on that the insurance company wanted to settle with my husband for 1 1/2 years worth of his salary without open medical.

Even though we had $4 to our name, we said no. I did not want to do this. Husband was released too early from his WC doctor (says our atty and us). She just wanted to get rid of him and probably me too.

So our atty says we will probably not get offered open medical. This is a big issue to us as my Husband does not have any other insurance to pay for his injuries and WC is not paying.

We are entitled to a second opinion though and will probably request that at the mediation if things do not go as we want them to.

Right now my Husband has bulging disks in neck and back, Deg. Disk Disease, irritation to his L5 nerve in leg (causing falls), severe carpal tunnel (although Neuro wants to check for Thoracic Outlet Syndrome). He needs appts with Rheumatology, Neurology, Ortho, is getting PT right now (killing him). We lose our state Medical the end of the month. We have been using this. We are so unsure of what all is going on. He is mentally not all here either. How can they possibly think he is fine with a MMI of only 5% on the back. He had no problems prior to the accident last year. I assume the Deg Disk Disease was underlying but it did not rear its ugly head until after the accident. Is this compensible? I think it is. So is carpal tunnel if this is truly what is going on. Am I right about all this?

Thanks for any words of wisdom you can pass along to us. We are so new at this. I am wanting to make the best decision we can.

Blessings your way.

ok please has he filed for SSDI? if not do it today you can do it online altho I prefer the face to face method it works better I believe....

filed once in July - declined

requested reconsideration - January 2008

This is such a crap shoot! I cannot believe how people treat other people.

Our boys are disabled and get SSI. When Husband settles, will this affect their Social Security and Medicaid? I am worried about them too.

Thanks!

yes it might.......please check with your lawyer......this country penilizes you for being a hard worker

Thanks for your kind words and advice!

I have two thoughts for you. The first has to do with the main cause of back problem may be from DDD, even though it did not rear its ugly head until hubby's injury. I just know from an experience, here in VA. My co worker and I were both injured at work (we both fell), about 1 month apart from each other. She was first and although never had a back problem, The Dr. said it was DDD and there was no way to tell if it was caused because of the fall or if it was about to take her down anyday, w/o the fall. They did not cover her. On the other hand, I was covered from day one and for the longest time, the two of us were trying to figure out why I was treated differently. We finally figured out that my initial Dr. found 2 (very slight) fractures in my spine as well as DDD. There was no denying the fractures came from the fall. I count it my blessing that I fractured my spine . The fractures both healed on their own, within 10 weeks, and I still have the DDD (4 yrs. later) and it is being treated. With that said, I think that they may say that there is no way for either side to prove the DDD is from the injury or not, and if they think it caused most of the other problems, that may be why they gave him a low rating. (It's not right...but be prepared that they may try to say that. Your lawyer should be willing to fight it, though.) My lawyer explained this to me at the beginning, and said she would fight it, if they did that to me.

2nd-please continue down the SSDI road, as I was denied 3 times and when I went in front of the Judge, he accepted me right away.

As far as if a settlement will affect your sons ssdi and medical-I don't know the answer for sure, but I just posted a question about if my W/C Settlement would mean that SS would take a chunk of it out. Many people have told me that it will, unless I make sure the settlement has the correct wording. I was told that the settlement needed the following:
"Utica Mohawk Clause and Utica Mohawk language, and a Medicare set aside fund". It would seem to me, that your son's SSDI and medical would likely fall under the same situation as my SSDI & medical. But that is just my thought.

Good luk and keep us updated.

the boys SS is based on the total family income(or it was for our daughter) that is how it may or may not effect it again the Utica Mohawk clause will protect them as well...this clause is very very important.....dont sign nothing in a settlement without it.....

Thanks to everyone for their response. I appreciate you all more than you will ever know.

If my husband gets soc sec dis, will our boys get something each month also? Right now, two of our 3 boys get SSI because of disabilities. I know when my Dad was disabled and I was under 18 (or over 18 and still in school) I got a check each month. I do not think my Mom got one through Dad, just me. I think it may have been $400 ish. This was quite a few years ago.

I will definitely talk to the atty about the "utica" clause before my husband signs anything.

During mediation, can I be present? My husband is a mental mess right now and cannot make a decision on anything.

Thanks again! You guys are awesome.

I was present during all hubby visits so I dont see why not.....my children get SSDI from both my honey and I its a mixture and I cannot tell you how she worked it out but my kids draw more than I do....If he is in that Bad a shape he isnt MMI and shouldnt be making any decisions about anything....this is life changing and not to be taken lightly....dont be forced into anything you believe isnt right for your husband....NO DAMN BODY CARES AS MUCH ABOUT HIM OR YOUR FAMILY AS YOU DO so dont be forced in to anything....take your time and ask for a time out to talk to your honey or lawyer in private if you need it...remember it can take as little as 2 months or years to get SSDI.....my husband and I were lucky it came quick some on here with worse injuries are still waiting years with deny deny deny......so please think everything thru

Thanks Jayne for all your heartfelt kindness and wisdom.

I would love to sometime in the future chat with you over the phone. I have so many questions and feel like the world is falling down on us. I feel like you are sort of in our situation since you have two kids with disabilities.

Blessings to you for all your kind words. If you decide to let me give you a call, you can send me your phone number through a private message. I promise, I am a Christian, homeschooling Mom and will not dare share your number.

Thanks again!