Need settlement advice so confused

[kate]

butterfly300 Wrote:WC & not the wc insurance is pushing to get a MMI now ( it has been 2 yrs last month since my injury)

In Florida, The maximum number of weeks for Temporary benefits (TTD and/or TPD) is 104 weeks. At that time you are considered at “statutory MMI” and the doctor is required to rate you.

440.15(3)(d) (d) After the employee has been certified by a doctor as having reached maximum medical improvement or 6 weeks before the expiration of temporary benefits, whichever occurs earlier, the certifying doctor shall evaluate the condition of the employee and assign an impairment rating, using the impairment schedule referred to in paragraph (b)…

440.15(4)(e) Such benefits shall be paid during the continuance of such disability, not to exceed a period of 104 weeks, as provided by this subsection and subsection (2). Once the injured employee reaches the maximum number of weeks, temporary disability benefits cease and the injured worker's permanent impairment must be determined

butterfly300 Wrote:The psychiatrist said he maybe treating me for months can they come to MMI while being treated by him? They never approve a psychiatrist any more & I'm sure I would not have gotten one if not talking to my adjuster,

Your MMI rating is for your physical injury and is generally done by the treating physician. Any mental injury is separate. You can only receive temporary benefits based on psychiatric restrictions for 6 months after MMI for your physical injury (unless you’ve already used up the 104 weeks). The permanent impairment for psychiatric injury is limited to 1% no matter what.

butterfly300 Wrote:also suggested a settlement & my adjuster agreed.she didnt mention being MMI first. She said give her a $ amount & she will speak to her supervisor about settling it.

The adjuster won’t always mention that right away. First they need to get approval to settle from their management then they will contact the physician to see if you are MMI. If you have an attorney, MMI is not necessary.

butterfly300 Wrote:the minute I hire a attorney I lose all contact with my adjuster & any help she has & can provide so its a catch 22. The wc nurse even agreed I have gotten further on my own than most with a attorney so you can see why its hard to grab one now. Not to mention the horror stories I have heard about the attorneys. If I hire one, dont like him later, fire him he can put a lien on my settlement!

Yes, you will lose contact with your adjuster but if your injury is 2 years old, they are going to try to close your claim by settling. This usually means they will start denying additional treatment. An attorney can be very beneficial in evaluating the worth of your claim.

If you dismiss one attorney, the new attorney negotiates any lien. There are limitations to attorney fees and the judge has to approve them.

[Regrets]

Butterfly, I'm on My 6th Year of Battling, and with everything They have tried to Throw at Me I Never would of Made it this Far! My Case is now Leaving the w/c System and going to the Commonwealth of Pa. State Appeals Board and with Luck, My Case will Expand a Current Law and Help not only Myself, but Many Injured Workers in the Future! My Case is Very Complicated and Confusing, but You can Bet if You are Near the End of Your Case, They will Equip. Themselves with Attorney's, and You May very Well have to go against Them in a Hearing Setting. I would Never want to do that Alone, I have had 16 Hearings so Far, and it's Tough Believe Me. Just a few bits of Info. in Hopes You Reconsider an Attorney to Help You through this Point in Your Case! Best of Luck!

[butterfly300]

Bad Boy Bad Boy Wrote:As the thing you wrote about an attorney.

WC is a legal system, going at a legal system, without all the knowledge, and combating an attorney working for the IC leaves you where? Yes, attorney's cost money, sometimes well worth it.

I am going to try & talk to another attorney. Everything I have read they are after the PPD & MMI $ & dont help in solving medical settlements as they can not collect on them or can they?. Not sure if it will stop me from settling on that part since Im being represented. The worse thing that could happen is to have a attorney after the MMI which I have been told will be nearly nothing & stop all communications with my adjuster and be forced into having a surgery with a doctor Im not comfortable with doing it or lose everything. My medical care has not been good so Im trying to get what I can & find my own treatment. Im not concerned with the $ the attorney wants thats not the complete issue, its having $ for my medical. I am 99% sure that MMI will not even come close to covering it. do u see how a attorney could hurt more than help? If I was happy with my medical or they refused to pay me (denied my claim) I can see where anyone would want a attorney. seems the more i read all over the internet the more confusing it becomes. but judging by the attorneys websites none of them mention settling medical. have to watch them, the adjuster, the employer, the doctors, the attorneys and filter through what they all say & benefits them. So Im here bugging you fine folks hoping for any tid bits that you have to offer bad boy. TY Im making a call again in a few minutes & hope they dont ask for my soc sec # right off the bat like the others. trying to get ur case b4 answering any questions. If I could just find that 1 attorney who really cares & not just about the $$$

[butterfly300]

Im realizing Im missing some other replies, sorry I am not ignoring anyone just getting use to the site

[butterfly300]

dmma Wrote: It may be helpful if you contact your local hospital and find out what the O.R.(operating room) would cost, anesthesia, a semi-private room, etc.. All hospitals are equipped to give patients that information when they are considered "self-pay". It may give you an idea about future costs.

butterfly300 Wrote:My husbands health insurance has been picking up the slack. For the longest time I had to use it due to wc dragging their feet so I dont imagine they would give me a hard time now. it is like pulling teeth to get doctors to give me a estimate so I know what to ask for. I do know a 1 level disc replacement & 1 or 2 level fusion is around $77,000 not counting 2 or 3 day hosp stay. have no clue what that would be & if something went wrong & I needed another surgery or pain mangement for the rest of my life. Coming to a $ amount is really hard. I do our insurance does not pay for disc replacement , they consider it to new. has anyone here had this type of surgery or a fusion?? What $ amount would you ask for with the info I have given you? again I really appreciate the help & understand you are not attorneys & just being helpful

yes I have been working on getting the cost Ty

[butterfly300]

Regrets Wrote:Butterfly, I'm on My 6th Year of Battling, and with everything They have tried to Throw at Me I Never would of Made it this Far! My Case is now Leaving the w/c System and going to the Commonwealth of Pa. State Appeals Board and with Luck, My Case will Expand a Current Law and Help not only Myself, but Many Injured Workers in the Future! My Case is Very Complicated and Confusing, but You can Bet if You are Near the End of Your Case, They will Equip. Themselves with Attorney's, and You May very Well have to go against Them in a Hearing Setting. I would Never want to do that Alone, I have had 16 Hearings so Far, and it's Tough Believe Me. Just a few bits of Info. in Hopes You Reconsider an Attorney to Help You through this Point in Your Case! Best of Luck!

Your case sounds dreadful. hope it is getting better for you. 2 yrs of pain & dealing with them feels like a lifetime I cant imagine 6 yrs. Like the old saying when u think u have it bad someone else is having it a lot worse. I do think this way & try to stay positive but even the strongest can break in all we are faced with. The pain is torture enough & makes it hard to think. Thank you for doing something that could help others & good luck !

[butterfly300]

Maybe saying it this way will shed a new light....WC insurance company has set aside a set amount of $ for my medical care, of course I dont know what that amount is. If I gather information about the costs involved & its less than they set aside & they agree..is a hearing & all that still necessary ? Wont I be saving them a ton of $ & they r rid of me then?? doesnt it make sense they would want to settle & be rid of me for life? No attorney fees, court, etc?? Is my thinking so far off???

[kate]

If you don't have an attorney, you still have to go in front of a judge to settle. And the IC still has to have their attorney draw up the paperwork. They cannot settle with you without a settlement hearing.

[Bad Boy Bad Boy]

Kate, I think the wrote back to me and said they are Represented....?

I don't see how an attorney ever makes any money on any MMI a patient gets. That isn't even sounding right, as there is no money from any MMI...

[kate]

I thought she was just going to talk to one. I may have misunderstood.

The attorney doesn't get money from the MMI. They earn fees based on benefits obtained. No benefits, no fee. Obtaining money for future benefits (in other words, a settlement) is a benefit obtained.