Got Final Rating Now what?

[Football71]

Finally my doctor gave me MMI after 21 months
Have two Herniated Disc (California)
Doctor Gave Whole Impairment 18% Rating Im ok with that rating,
I have few questions, The insurance Denied my claim
I never got a single check all this 21 months
My questions are
what happens now?
My attorney is filing to go to court
But before that will there be any negotiations? and If so
will my backpay be included? even thou I was denied?


Thank you for reading,
First timer!

[jayne]

if you were denied nothing may happen.....you may go to court and they may win.you may walk away with nothing except alot of Dr bills...you didnt say have they been paying the Dr bills?did they accept you got hurt at work?we have nothing to work with we need more to work with....1171 is the Ca expert...give him something to work with

[1171]

yes.
california requires a Mandatory Settlement Conference (MSC) before they will schedule a hearing.
settlement negotiations can happen at any time.
I don't know what the issues are but I assume your atty will be asking that the value of all benefits (including past disability payments be included in the settlement.
the final result is unknown.

[Football71]

(08-20-2011 01:04 PM)1171 Wrote:  yes.
california requires a Mandatory Settlement Conference (MSC) before they will schedule a hearing.
settlement negotiations can happen at any time.
I don't know what the issues are but I assume your atty will be asking that the value of all benefits (including past disability payments be included in the settlement.
the final result is unknown.

We already had a mandatory settlement conference and nothing was accomplished, The doctors report stated that my injury was work related,
My only issues are that They never accepted my claim, they have not payed the doctors bills and they where the ones who filed declaration of readiness (DOR) 21 Months of backpay is alot, So have you seen a case like mine? Im worried that I will not get my backpay,

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(08-20-2011 12:41 PM)jayne Wrote:  if you were denied nothing may happen.....you may go to court and they may win.you may walk away with nothing except alot of Dr bills...you didnt say have they been paying the Dr bills?did they accept you got hurt at work?we have nothing to work with we need more to work with....1171 is the Ca expert...give him something to work with

No the Insurance Co. Has not payed one penny to the Doctors bills, The doctors report said my injury was work related,
Thank you for your input Jayne

[1171]

then settlement before judge's decision is unlikely..
workers comp does not reimburse back pay. they only pay disability that is capped at a maximum weekly rate.
yes, many cases are denied, unable to settle, and go trial for a decision.
either party can appeal the decision so the case could continue for awhile.

[Football71]

(08-20-2011 03:21 PM)1171 Wrote:  then settlement before judge's decision is unlikely..
workers comp does not reimburse back pay. they only pay disability that is capped at a maximum weekly rate.
yes, many cases are denied, unable to settle, and go trial for a decision.
either party can appeal the decision so the case could continue for awhile.

Wait so your saying they dont have to pay me the 21 months Ive been Disabled.. WOW.. Im screwed big time

[1171]

depends on how much over the maximum disability rate your wages were.
those with high weekly earnings loose a lot.
in 2009 the maximum weekly earnings used to calculate your weekly disability rate was $1437.01.
anything over that is not compensated for.

[Football71]

(08-20-2011 04:21 PM)1171 Wrote:  depends on how much over the maximum disability rate your wages were.
those with high weekly earnings loose a lot.
in 2009 the maximum weekly earnings used to calculate your weekly disability rate was $1437.01.
anything over that is not compensated for.

I was earning roughly about $1200 a week,
I would get 2/3 of that right?
and Would it be for the 21 months correct?

[1171]

yup.
the time limit is 104 weeks.
you "loose" about a third, but it's based on net so it'll be close to your take home amount.
if you got SDI for some of that period, it'll be deducted and repaid to EDD.

[kristin0]

My case is little bit different,I m in state Florida.I was hurt on work in febuary 20111,I hurt right arm,neck and back.I was treated only for right shoulder and only receive 2 checks from WC,I had to fight with them to put me on mri for back and neck which like their doctor said didn t show nothing.After almost 2 months they put me on full duty job,I went to my doctor done mri s again showing my problems.I even end up on surgery of llumbar spine,scheduled for 2 nd,I try to show workers comp doctor new findings but they refuse saying that my claim is denied in full and it s not work related but my attorney said they admit it happen on the job so I don t understand why they are denyinig.I had to take loan for surgeries because private insurance doesn t wan t to cover it since it is work related.WC wanted mediation offering 15,000$ at most 30,000$ I refuse and now I m heading to administrative hearing in October.My attorney said we had prepare for trial,I don t know nothing about that,can someone explain me whole that process and how long does it takes?My attorney saying we have strong case,all of the medical evidences but why then WC denying my benefits and covering my bills?Thank You!

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My case is little bit different,I m in state Florida.I was hurt on work in febuary 20111,I hurt right arm,neck and back.I was treated only for right shoulder and only receive 2 checks from WC,I had to fight with them to put me on mri for back and neck which like their doctor said didn t show nothing.After almost 2 months they put me on full duty job,I went to my doctor done mri s again showing my problems.I even end up on surgery of llumbar spine,scheduled for 2 nd,I try to show workers comp doctor new findings but they refuse saying that my claim is denied in full and it s not work related but my attorney said they admit it happen on the job so I don t understand why they are denyinig.I had to take loan for surgeries because private insurance doesn t wan t to cover it since it is work related.WC wanted mediation offering 15,000$ at most 30,000$ I refuse and now I m heading to administrative hearing in October.My attorney said we had prepare for trial,I don t know nothing about that,can someone explain me whole that process and how long does it takes?My attorney saying we have strong case want s to schedule me for IME before hearing,we have all of the medical evidences but why then WC denying my benefits and covering my bills?Thank You!