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settlement opinion, lumbar fusion
04-20-2011, 03:11 PM, (This post was last modified: 04-20-2011, 03:13 PM by quick79.)
#1
settlement opinion, lumbar fusion
I spoke with my attorney the other day and am not really happy. I'm hoping anyone that reads this can offer me their opinion. I live and worked in Illinois.

In 2006 I suffered a back injury at work that stopped me from working. After a year of Physical Therapy and other treatment my doctor recommended an L5-S1 spinal fusion. The WC insurance company requested an IME which determined that I did not need a surgery and could return to work immediately, thus ending my WC benefits.

I had the surgery in late 2007, followed by a few months of Physical Therapy. I was ultimately released from my doctors care with a "light-duty" designation for work.

I applied for and received Social Security Disability in 2008 and still receive it now. I attempted to return to work through the SS Right-to-Work program in 2010, and was unable to work for more than 6 months.

As of today, I am unemployed and receiving SS Disability payments.

My attorney has given me the following details on the current settlement negotiations.

1. Approximately $50,000 for injury to man as whole
2. Backpay of TTD checks and unpaid medical bills from date of the IME to my doctor's release after the surgery (6 months)

So, I'm looking at under $70,000, minus attorney fees.

Is that really low or am I unrealistic?
Reply
04-20-2011, 03:29 PM,
#2
RE: settlement opinion, lumbar fusion
you only can settle for the value of the comp benefits the carrier is liable for.
what other comp benefits do you think should be included?

if you don't trust your atty you can change at any time.
Reply
04-20-2011, 03:52 PM, (This post was last modified: 04-20-2011, 03:52 PM by quick79.)
#3
RE: settlement opinion, lumbar fusion
I trust my attorney, primarily since his payment is a percentage of my settlement... so it's in his interest to maximize the settlement.

I feel that the 50k is low... that's not based on any solid info I have, just my feeling. Am I wrong? How is that determined? Is it negotiable?
Reply
04-20-2011, 05:12 PM,
#4
RE: settlement opinion, lumbar fusion
(04-20-2011, 03:52 PM)quick79 Wrote: I trust my attorney, primarily since his payment is a percentage of my settlement... so it's in his interest to maximize the settlement.

I feel that the 50k is low... that's not based on any solid info I have, just my feeling. Am I wrong? How is that determined? Is it negotiable?

Will this settlement give u continued medical coverage, here in my state your impairment payments are based on a formula from a dr's rateing
Cervical Fusion 2003, c5-c6. Herniated and damaged Disc L1- L4-L5 S1. Lumbar Spinal Cord stimulator implant 09-2008. Cervical ACDF revision with hardware c4-c5-c6-c7 Sept 2009.
SSDI approved 3-2010. NOW OFFICIALY RETIRED
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04-20-2011, 05:35 PM, (This post was last modified: 04-20-2011, 05:37 PM by 1171.)
#5
RE: settlement opinion, lumbar fusion
employers & carriers feel it's too high and workers feel it is too low.
if you are not professional in the business you should not trust your feelings.
you should take the advice of professionals like your atty.

you can learn what benefits you are entitled to here
http://www.iwcc.il.gov/handbook.htm
Reply
04-20-2011, 08:44 PM,
#6
RE: settlement opinion, lumbar fusion
Is it possible WC could send you to school to learn a new job you could do with your light duty restrictions?
Reply
04-20-2011, 11:41 PM,
#7
RE: settlement opinion, lumbar fusion
My attorney has given me the following details on the current settlement negotiations.

1. Approximately $50,000 for injury to man as whole
2. Backpay of TTD checks and unpaid medical bills from date of the IME to my doctor's release after the surgery (6 months)

So, I'm looking at under $70,000, minus attorney fees.

Is that really low or am I unrealistic?
[/quote]



If you dont mind me asking, how old are you...?
You say any unpaid medical bills, is this comming out of your settlement..? Thier is so much in a settlement you couldnt possibly tell us... Most lawyers get 20% and some a few fee's are involved as well. If you accept this offer, your attorney will get atleast $14,000 + misc fees then subtract medical bills.

One thing for sure you will not get rich, my father was injured years ago and a raiting of 70% he had no income for 3 years files and got ssdi. When he settled it didnt even make up 2 years wages after misc bills and attorney fees... So to say if its low or good, we cant really tell you.. But $70,000 is much higher then some get..
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04-21-2011, 12:29 AM, (This post was last modified: 04-21-2011, 12:32 AM by weezle735.)
#8
RE: settlement opinion, lumbar fusion
I am going to attempt to explain this in a way others are able to understand.
My attorney ( state of PA, wich may be different) said that when looking to settle a case the IC will look at what you can potentially make compaired to what you were receiving as your average weekly wc wage.
Example- say you were making $265 a week average weekly rate wc
But you are rated light duty, which means that all the IC would have to do is prove that you are able to work a PT minimum wage position.
This would give you (in pa) $7.25 an hr for lets say 20 hrs a week. This would pay you $145 a week. The difference being $120 a week. Now take that and multiply it by the 500 week total for some wc and you get $60,000. This is the amount that you could expect the IC to prob not go over during settlement. They will try and get you down to as low as possible. And off the top you have to take lawyers 20% which leaves $48,000, and then medical unless that was additional to the amount.
Now remember this is what my PA lawyer used to get me to understand settlement cases and each state is different, but I would say that if you are released light duty then the IC is prob looking at a senario that is of some sort like this.
And since every injury and state laws are different noone can tell you if what your being offered is too low or just right.
One thing that seems to be a resounding opinion on the forum is to never settle medical.
If I am wrong with my example I apologize and please disregard. Just thought it may be relating a little.
31 year old mother of 3. Working as Pre-K Teacher. Tripped over leg of therapy swing, twisted and jammed lower back.
Diagnosed w/ SI Joint Dysfunction. Moderate to severe pain daily. Limiting most functions.
Reply
04-21-2011, 10:55 AM,
#9
RE: settlement opinion, lumbar fusion
Wow, the quantity and quality of replies here have been great! Thanks!!

The unpaid medical bills are for things like my Dr appointments, surgery, and physical therapy. The WC carrier stopped paying those after the IME.

My attorney told me that the WC carrier is willing to pay all of those with a check to me, and he is negotiating with the providers to lower the amounts so that I can potentially pocket some of the difference. He already got the WC carrier to not pay those directly, which is what they initially wanted to do.

So, the $50,000 for my injury was explained to me as a cash amount that I will receive in addition to the medical bills being paid off. Is that supposed to be used for future medical bills? What would cause that number to increase or decrease?

I'm almost 30 and I had a relatively low-paying job for my profession of about $50k/yr when I got hurt. I returned to work for like 3 months prior to my surgery and was at my correct wage level of $90k/yr.

I have Medicare but have not used it once for anything related to my back injury. From what I read, it sounds like I need to have a Medicare Set Aside created in the settlement... but will they do that if they determine that I haven't had any back-related Medicare bills?

I'm hesitant to tell my attorney that I feel his numbers are low because I don't want to seem ungrateful... but I know that $50k wouldn't even make up for the amount of loans I had to take out to pay my bills when they cut off my benefits. Not that they really care but I lost my house, cars, and destroyed my credit.

I really want to return to work within the next couple years. Last year I couldn't handle it, but I'm hoping that I'll improve over time.
Reply
04-22-2011, 01:49 AM,
#10
RE: settlement opinion, lumbar fusion
Future medical is a very detail in a settlement. If your dr. thinks you will need future care. You need to talk to your attorney about it.

With all that being said. Some people have a lumbar fusion and they are great for the rest of there life. Meaning they don't have a problem with it ever again. Then there are some people that have problems years down the road.

Take Care
8-05, Micro laminectomy/disectomy. 10-05 lumbar fusion L5-S1. 2-07 exploritory surgery. 12-07 medical implant, Spinal Cord Stimulator. now receiving SSDI. Jesus died for our sins. Soilders died for our freedom.
Reply


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