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Another Settlement Offer - Bummer Knees - 12-31-2009 05:52 PM

The offer came in the mail today and is for $35,000.00 with a MSA of $10,000.00, with $2,000.00 of this for Part D, (Loratab)

I do not have Part D as the pharmacy says it would not be of benefit to me since I have BCBS.

The letter says if more money is needed then they will dispute the replacement being work related.

The insurance company is wanting to close out all issues, I believe this means the future decision to be made by the judge.

My attorney & I wait the judge's decision on treatment for the right arm & back, and additional treatment of the right knee.
Had nmeniscus, pica, & chrondyl repair approved by wc of the right knee 2/07.

Add to this I am having problems with the replacement (left knee) with pain & limited range of motion.

And I fell a couple of days ago when the right knee buckled and been having pain about 7/8 in the joint and lateral area of the knee.

I do have to wonder if the insurance company is sincere in the settlement offer or are the scared on the decision the judge may make.


RE: Another Settlement Offer - Still in Limbo - 01-02-2010 12:06 PM

Bummer, Your Case has had Many Twists and Turns, and Only You and Your Attorney know what's Best for You! Me Personally, I would not even Respond to such a Low Offer, but You have to Remember My Injury is Different than Yours, as Everyone's is. I have already Turned down a Half Hearted Low 6 Figure Settlement, a Few Months ago. I am Ready and Will Settle at any Time, if We could Reach a Happy Medium, as there is No More Medically at this Point that can be Done for Me. If I had Unresolved Medical Issues, I would want Them Corrected before any Settlement Talks. I Hope You Make the Correct Decision, and Please Keep Us Informed!Wink


RE: Another Settlement Offer - bodybuilder1958 - 01-02-2010 12:18 PM

Question,
how can they dispute the replacement being work related when they already paid for it?

I'd wait it out, they can make you all the offers in the world. You my friend still need alot more done medically. But that's my advice.


RE: Another Settlement Offer - Bummer Knees - 01-02-2010 01:33 PM

Bodybuilder

The replacement was per a judge's decision and made after reviewing medical documents, but the insurance company disputes the replacement being related to the work injury because as they write in the letter they do not want to place any more then $10,000.00 in a MSA account.

And yes I do need additional medical treatment.

Still In Limbo

In my state the top dollar an injured worker can receive is $125,00.00 at settlement, this amount would be for someone totally disabled and no longer able to walk according to my attorney, and few qualify for this amount.

Also in Kansas TTD already paid is deducted from settlement dollars if you go before a judge in reaching a settlement. If an IW settles with the insurance company without going before the judge TTD already paid is not deducted from the settlement amount.

Injured workers in Kansas receive the lowest amount of TTD and settlement dollars paid in the nation.

I do have lots of questions to answer before I amke a decision and Bad Boy and others on this forum have been a great help in sharing information.


RE: Another Settlement Offer - Bad Boy Bad Boy - 01-02-2010 03:08 PM

It don't matter what the Judge/Hearing Officer say's. It all matters to what is in your medical reports. So if the medical reports states, such and such body parts are in relation to the said work injury, then CMS is going to have those reports when you go up for Review of SSD/SSDI, as they are allowed access to your medical. This is why I also said you will qualify for the Reval of SSD/SSDI.

So, if said body parts don't get accpeted by Judge/Hearing Officer, you will then see why in the past, I said let-em go the other direction, because now, it is too late to change the medical reports. Medical reports now say work relation, or work related, meaning they must be part of the MSA to CMS now. This is another reason to why I warned you in the past. All of this can come back and back-fire on you at a latter date.

This is why, I didn't add my Knee to my injury, even though, it blew out in a FCE, I did not allow it to be reported as any relation to my work comp claim.

Future medical expenses will need to be determined on a case-by-case basis by the claimant's treating physician or other medical professional. Unlike the indemnity and attorney's fee allocations, determination of future medical expenses will require detailed analysis of the claimant's specific circumstances. Medical expense projections will be unique to each case.


RE: Another Settlement Offer - Still in Limbo - 01-02-2010 03:16 PM

Bummer, from Your Lat Statement on Your Post it seems that Bad Boy and the Others May be able to Help You Better than Me, at Least that's the Way it sounds. So I Understand, and will Make Sure and Stay Clear of the Discussion, as I don't want to give You any Wrong Info.! I Wish You the Best, and Hope All Goes Well for You!!Wink


RE: Another Settlement Offer - red1030 - 01-02-2010 09:11 PM

Good luck bummer...I know nothing about this either so I can't help you, but will keep my fingers crossed and my prayers going up for you...Red