WC Ending soon, what happens now?

[jddancy]

1171, thanks again! I really appreciate your help. What I was asking, is that you say the "rating" and if he is not done being evaluated, how can they rate him? Do they? If not, does he just get SDI after the 104 weeks? Sorry for all the questions, I am panicking about July. leavntn, yes, I applied in July 2008 and they say that is the best thing to do because they will go off of his income then, which is the last time he has worked. Almost 2 years ago. I think I am confused by state disability and SDI. Are they one in the same? I am not very up on that stuff and need to be. I was under the impression that once the 104 weeks was up, if they are not done evaluating him and seeing AME's, he will only get SDI. Is that correct or are you saying that he will get the supplemental from WC? So I guess that is my question. Thanks in advance and thanks for all the links. I had found the previous one from a Google search and it was very informative, looks like an attny site. Sorry to sound repetitive, but you didn't answer what you meant when you said "serious injuries are rarely "worth it". Thank you~~

[jddancy]

One more thing, when you say permanent disability, I am confused. Is that just what they call it after 2 years here in Ca.? If you are not done with all the Dr, I mean.

[jddancy]

Sorry to post again but 1171, I just went and looked at that site, the pdratings.com, WOW! I am more confused than ever! I guess I don't understand, like I said, the permanent disability stuff. I also don't know what "multiply pd % #of weeks". How do I calculate the # of weeks? The # of weeks for what? I am sorry if I am sounding dumb, but I am new to all of this and usually comprehend well.

[1171]

a carrier estimated rating is not the same thing as a formal state or court rating.
one is informal and the other is official.
SDI & state disability insurance are the same benefit.
he will get advance payments from the carrier once TTD ends
I think i'm repeating myself

you posted:.."they settle with a few thousand dollars, was it worth it??"
my opinion is that : serious injuries are not worth it.
I don't know how to explain it better until I know what you meant by "worth it"?

I thought you read the guidebook? it explains the difference between temporary and permanent disability benefits. go back and have your husband look at the factsheets on each of them.

I said it was complex. if you haven't read the material available it's a bit too involved to explain on a message board.
I'm not sure there is much more I can offer until you are familiar with the basics.

[jddancy]

No, I did read it and I was confused at just the lingo you were using, but you explained it now and I understand. They use different wording than on here that is what I was confused about. I do understand temporary and permanent disability benefits, what I had asked was regarding who rates you before WC is up? I thought SDI and state disability was the same thing so thanks for verifying it. I understand now you saying 'serious injuries are not worth it' because serious injuries are priceless. My husband can't read any of this, that is his injury. His brain. He can't comprehend stuff. That is why I am trying to figure it out for him and get him the simple revised edition. Being someone that knows all the lingo and is very familiar with the system and for someone like me talking to you, it is hard to understand, even the abbreviations that you use I have had to look up. If you are not used to it, it seems like a foreign language. I guess we didn't realize how complicated it was. Thanks for explaining the ratings. My question is this, when does the carrier tell you his rating or does he already have one and we don't know? I guess the permanent rating will happen when it is all over, right? I am familiar with the basics, the only thing I really have a question with is there are really 2 permanent disabilities, that is what is confusing. You kept saying perm dis. which is from WC not the state and the judgement. That is what I was confused on . Even on the sights I looked at, it really doesn't distinguish the two. That is what confuses me. We thought he would get help and go back to work someday. They don't want to help and fight us every step of the way!! It is crazy!

[1171]

carriers are required to at all times to have an estimate of the rating and all potential claims costs. they are not required to reveal their estimates-especially in litigated situations with negotiations going on.
rating should happen after recovery is complete. the doctor determines when maximum medical improvment (permanent & stationary) is reached and the patient is ready for rating.
there is an impairment rating from the doctor which is used by the work comp system to determine permanent disability rating and permanent disability benefits. they are not the same. that's a common mistake those on the inside who know the difference make.
if you haven't yet found the glossary it can help:
http://www.dir.ca.gov/dwc/WCGlossary.htm

yes, patience on both ends is needed to understand this stuff.
this was crafted by attys for attys and therefore drives most to get attys. it was never designed to be understood by those who have to live within it's rules.
if it was easily understood, we wouldn't need as many attys.

[jddancy]

Thanks 1171! I really appreciate it! So it sounds like, after reading the glossary, which I hadn't read that part, that we may get some money on top of SDI in July. Also, it sounds like if you are in the system, you have a rating, by your Dr., and just aren't told. Does anyone out there, from personal experience, know how long it took for them to permanently say how much you were disabled, after your last AME? I know that is vague, and everyones is different, but I was just curious. Thanks again 1171.

[jddancy]

One of the reasons I am so concerned, since we lost our house, we are renting and my lease is up in Aug and am not sure if I should renew it for another year if we can't afford the rent for a year. Thanks!! Anyone else that lives in Ca. that has gone the 104 weeks and was still in the system, being evaluated, please let me know your personal experiences. Thanks!

[1171]

not quite.
the carrier internally estimates what your rating might be, long before the doctor issues their opinion. this in-house estimate is used as a basis for paying advances after Temporary disability stops and before the court issues a formal official award.

too much information can be just as confusing as none at all; just takes patience to get the right amount.
continue to ask away whenever you need to.

[jddancy]

Oh, so it is the carrier. They must go off of your continued monthly Dr visits. So that is where the percentage comes into play. That is like playing god. They guess or estimate what your percentage is. That is horrible. They are probably already making an opinion too. We will wait, that is all we can do, but it is so scary putting your entire future in to the hands of strangers who don't care! We have kids and that makes it harder for our future.
Does the amount you get after the 104 days compare at all to your TD? I know it depends on the percentage, that they think you are disabled, right? I am just so scared when this stops, the bi monthly checks. We are struggling as it is.
1171, did you go through all this, is that how you know so much? Just curious. I know the laws have changed recently and I haven't heard of many people who got the help they needed, that is the part I worry about.