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NJ Workers Comp Question
#11
(12-03-2017, 08:37 PM)bugmann Wrote: [quote pid='166224' dateline='1511790237']
[i]Hi MCATS,[/i]
TO take a break from the seriousness of this discussion please visit 

http://www.snotr.com/video/528/The__quot_wake_up_quot__cat 
 

for a smile as Im sure you can appreciate this cats adventurous take on getting fed ASAP in the AM along with some loving. I've been a kitty guy all my life, sadly I just lost my 19 yr old Russian Blue who was a gift to me when I learned I woul be disabled for a long while. I have never had a kitty so dedicated to being with me than "ACHOO" I miss him very much. I have a rescued Russian Blue from a house fire. The people whose house was totaled just picked up and left. "GARTH VADER" aka "BOB" was living on garbage for several weeks until I found him, and got him to my Vet to be sure he would not get my British short hair "Blue" sick. So I now have 2 BLUE'S but both are rescues and have been through many terrible events and will take much love to get them back in the saddle, and Chumly has been to 5 homes in his 1st four years of his life and the old lady whom I got him from kept him locked in the bathroom as she preferred her dog more. But my wife was helping her with some private issues and one day, her kitty came right to me and he laid on my chest and when they were done I told the old lady I would take himnif she ever needed to find him a good home. At that time I new Achoo was on borrowed time but was assured he was not suffering. Dont you know it about 3 weeks passed and we got call to come get him. He has been a great addition to  my home and he knows when I am upset over some thing as he comes and lays on my chest and puts me to sleep and I wake feeling better?. He is Alfa male now that Achoo is gone.
Well I'd love to hear your kitty story, if you want to share.
OK now lets get to the point on your Hubby's pending WC case
1) No Union contract on point is bad luck and poor economy and the aftershock of Reaganomics by breaking the Cal Air Traffic Control Union agreement, as this set the ball rolling to destroy most of the powerful unions ( Steelworkers, mine workers, auto workers etc... Having a contract on point would have set the rules in black and white with no grey area as in NJWC Law/  Rules. Then it wouldn't be so bad dealing with the carrier.  
 2) These IME's where most likely at the carriers request so they can pick and chose from each report what thy will use as evidence in the final hearing ( should it go that far) Most JUDGES of WC Court encourage settlements over trial, but like anything every profession has their good and bad employees, I imagine this includes JUDGES. Certainly  the expert Drs are all paid millions of $$ each year to minimize the liability of the carrier, these Drs are WELL EDUCATED, top of their class and field, of expertise.  Its shocking to read their written reports when you know how hurt your Hubby is and how he was prior to this injury. The only expert Drs you have are the ones you had to pay for in advance b4 your exam. Also any FCE exams, that display no inappropriate illness behavior that is in line with your Dr reports will be very valueable            
3) The 9538.00 of Temporary Disability monies receives must be from the State Temporary Fund it is set up for non work injuries  but  must be paid back to avoid whats called double dipping. Which means Hubby was paid by 2 insurances for the same time period and same injury, because when when the smoke clears NJM will have also paid Hubby for the same time period in which he got NJ State Temp Disability. Nj is 1 of less then 10 states with such a benefit!! For this reason there is a lien on your award for repayment of this amount. I doubt the ins co will be repaying this lien as you received it and the ins co will be liable for all payments owed to you of your ACE amount ( the amount equal to the TTD benefits you received in the very beginning)  the ins will pick up from the day after you where deemed MMI. With this said you will have been paid 2x for same injury and time period and thats double dipping and is a NoNo in Nj ☹.  I cant imagine what your lawyer was thinking to say that, unless you miss understood his words which is easy as everyone is trying hard to absorb what is being said and your both "pumped up"
Its more likely your lawyer was referring to his service fees as it is common for Judges to make carrier's pay all or most of your lawyers fees?? 
Should your Husband be found totally disabled not 100% impaired as he would need to be a vegetable for a 100% impairment. The employer will only be responsible for the impairment rating due to the injury sustained at work.
In order to get SIF it is imperative that you be open and honest with your lawyer about Hubbys past medical issues, including mental disorders like anxiety, depression, personality orders etc as this is the easily tied together with failed back syndrome.
I dont have any information of Hubby's back condition but if he has limited prolong sit/stand/walking & no pushing pulling or climbing then I would say his work injury is a major contribute  to his total disability. Nor do I have his medical history where I may evaluate how his past conditions effect his back today?? 
Honestly your lawyer has been seeing the carriers lawyer and the JUDGE about every 3-4 weeks as this case has been in rotation since MMI. Rotation is the cycle of which every pending WC claim goes through so the JUDGE knows where the case is going and insists on settlement over trials.
Any payments ordered are only until your hubby can return to work not for te rest of his life. He will have reveiws from SSDI and it tells you on the Award Letter when to expect this review. SSA's reviews go from 2- 7 yrs depending on the likely hood of improvement. Also the ins co is permitted to give hubby exams whenever they feel one is going to show improvement. They can do this yearly if they want to be a pain in your a___.
My best advice is to move out of nj IF ITS POSSIBLE. I say this because once in a different State that States rules applies.  I moved to PA where  IW are protected from jerks like in NJ who send you to job training because your Dr didnt write you are permanently and totally disabled in his requested report. Many Drs dont like to predict the future by stating in writing permanently and totally as some claimants think because they moved no one is watching them, this is UNTRUE!! Then the investigator gets the IW on video moving a piano and take the tape to the dr who then feels like he has been taken. IT         HAPPENS TO ALL Dr's for IW. So when you get the request for an exam the form you give 2 the Dr has all required information the ins co wants. So when it comes to are your totally and permanently disabled ask him to put at this time you conclude the patient is totally and permanently disabled at this time. This works well as it protects the Dr and gives the ins what they asked for, If you remain in NJ any flaw in your Drs report  can send you to job retraining      to see if you qualify.  If your in PA all you need is to be under the care of a Dr for work injury and that ends that.
AS said dont worry about the acting lawyer playing dumb in court your last hearing. The JUDGE has seen this act b4, and it works to help you.  remember its CREDIBILITY  THAT MATTERS MOST AT THIS POINT OF THE GAME.
Yes the carrier can change their position on total disability, but the JUDGE reserves his decision till the very end.
The ins co is getting you all uptight thus leaving you open for mistakes dont fall for their tricks

 Please don't worry just prepare yourself for each step and 4 sure I'll be here to here 2 help u all the way.;
OK?
ALWAYS YOUR NJWC HELPER & KITTY FRIEND,

BUG



My husband is nearing the end of his WC claim. Injured in 2013, he was an HVAC tech with pre-existing health issues (heart, diabetes). Fell, injured his lower back and had 3 surgeries for rotator cuff, and torn bicep muscles in each arm. Suffered a Pulmonary Embolism after 2nd surgery. (Never had a PE before) He reached his MMI in June 2015 and hasn't been paid since. He is collecting SSDI since Dec 2015. He was also in a car accident in July 2014, which aggravated his lower back issues requiring a partial Discectomy which resulted in drop foot, so that has complicated things.

Long story short (if that's possible) our Lawyer had a hearing with the judge 2 months ago where it was determined my husband will be getting 100% disability and NJM will be responsible to pay him for the rest of his life. No amounts were discussed regarding payments or back pay settlement and the insurance company was advised to get that authority at the end of the last hearing. All that was decided then is- who was going to pay. We were told that when they get in front of the judge at the next hearing, he will sort it out and it should be done then. We were told that the Insurance Carrier can agree, but hide behind the fact that they have to get authority and the Judge is used to that happening.

Fast forward to yesterday at the next hearing - NJM sends a different lawyer in who isn't aware of the decisions that were made at the last meeting and is now asking for an extension. Seems she had more questions regarding his PE history The judge granted extension for 3 weeks from now but now wants my husband to appear at that hearing

Is this normal? Can they reverse their decision regarding total disability after the next hearing?


So frustrated and worried.
If anyone can provide any other information please let me know. Thank you so much for any assistance!

[/quote]
 
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Messages In This Thread
NJ Workers Comp Question - mcats - 11-27-2017, 09:43 AM
RE: NJ Workers Comp Question - 1171 - 11-27-2017, 12:24 PM
RE: NJ Workers Comp Question - mcats - 11-30-2017, 12:36 PM
RE: NJ Workers Comp Question - mcats - 01-17-2018, 04:57 PM
RE: NJ Workers Comp Question - 1171 - 11-30-2017, 02:28 AM
RE: NJ Workers Comp Question - 1171 - 11-30-2017, 01:09 PM
RE: NJ Workers Comp Question - mcats - 11-30-2017, 01:54 PM
RE: NJ Workers Comp Question - 1171 - 11-30-2017, 03:45 PM
RE: NJ Workers Comp Question - bugmann - 12-03-2017, 08:37 PM
RE: NJ Workers Comp Question - bugmann - 12-07-2017, 07:59 PM
RE: NJ Workers Comp Question - mcats - 12-04-2017, 11:26 AM
RE: NJ Workers Comp Question - bugmann - 12-09-2017, 10:44 PM
RE: NJ Workers Comp Update - mcats - 12-04-2017, 01:45 PM
RE: NJ Workers Comp Question - mcats - 12-12-2017, 04:24 PM
RE: NJ Workers Comp Question - bugmann - 12-15-2017, 09:38 PM
RE: NJ Workers Comp Question - 1171 - 12-12-2017, 06:27 PM
RE: NJ Workers Comp Question - mcats - 01-17-2018, 05:14 PM
RE: NJ Workers Comp Question - bugmann - 01-24-2018, 10:55 AM
RE: NJ Workers Comp Question - mcats - 01-24-2018, 12:39 PM
RE: NJ Workers Comp Question - bugmann - 02-09-2018, 09:19 PM
RE: NJ Workers Comp Question - 1171 - 01-17-2018, 05:56 PM
RE: NJ Workers Comp Question - mcats - 01-23-2018, 01:56 PM
RE: NJ Workers Comp Question - 1171 - 01-23-2018, 02:28 PM
RE: NJ Workers Comp Question - mcats - 02-14-2018, 12:41 PM
RE: NJ Workers Comp Question - bugmann - 02-15-2018, 07:11 PM
RE: NJ Workers Comp Question - tbear6410 - 01-24-2018, 03:56 PM
RE: NJ Workers Comp UPDATE - mcats - 03-28-2018, 10:23 AM
RE: NJ Workers Comp Question - 1171 - 03-29-2018, 02:55 AM
RE: NJ Workers Comp Question - mcats - 03-29-2018, 02:55 PM
RE: NJ Workers Comp Question - 1171 - 03-29-2018, 08:56 PM
RE: NJ Workers Comp Question - bugmann - 05-06-2018, 11:55 AM
RE: NJ Workers Comp Question - mcats - 06-06-2018, 01:03 PM
RE: NJ Workers Comp Question - 1171 - 06-06-2018, 05:01 PM

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