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closing case without future medical.whats this worth?
03-15-2012, 06:55 AM
Post: #1
closing case without future medical.whats this worth?
Brief background, WC in calif.. Shoulder injury, surgery, had QME rating.Formula for cash was for $ 15,000.Recieved letter to settle case without future medical.They are offering another $ 9,000. How do I know if this is fair or what my counter offer should be?Not using an attorney.
Thanks
Dahubb
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03-15-2012, 11:22 AM
Post: #2
RE: closing case without future medical.whats this worth?
talk to your doctors about future medical needs and costs.
request a breakdown of what was paid for medical benefits.
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03-15-2012, 11:32 AM
Post: #3
RE: closing case without future medical.whats this worth?
[quote='1171' pid='142828' dateline='1331824944']
talk to your doctors about future medical needs and costs.
request a breakdown of what was paid for medical benefits.

[/qu Injury has healed.Medical procedures cost comp carrier about 15,600. Had simaler surgery on right shoulder 20 years ago and it is still fine. So they offered me $9000.00 to close case. I talked to adjuster and she asked if I had a counter offer.I did not. She said how about another five hundred.I thought that was kinda a very low offer. Just trying to get Idea of what I should ask for in counter offer.
Its all a negociation I guess.
thanks for reply.
Dahubb
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03-15-2012, 11:49 AM
Post: #4
RE: closing case without future medical.whats this worth?
Never close a case without future medical!

How will you pay for the doctor appointments, x-rays, injections, physical therapy, medications, or perhaps a future surgery?

Once you settle the your claim with a cash settlement and no future medical care it becomes your responsibility to pay medical bills.

Health insurance will not pay for medical care for a work comp injury if you have settled for a cash settlement with no future medical.
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03-15-2012, 02:06 PM
Post: #5
RE: closing case without future medical.whats this worth?
if you take a disability award with open medical, you can reopen the PD rating within 5yrs of your injury. if you compromise and release, it's closed forever.

if you are confident that you won't use the future med $$, then take the offer.
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03-15-2012, 04:31 PM
Post: #6
RE: closing case without future medical.whats this worth?
(03-15-2012 02:06 PM)1171 Wrote:  if you take a disability award with open medical, you can reopen the PD rating within 5yrs of your injury. if you compromise and release, it's closed forever.

if you are confident that you won't use the future med $$, then take the offer.
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03-15-2012, 04:32 PM
Post: #7
RE: closing case without future medical.whats this worth?
but how can you be confident? if so i really need your crystal ball
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03-15-2012, 04:34 PM
Post: #8
RE: closing case without future medical.whats this worth?
As far as future medical I thought that if case was closed and I got a job that had health care and down the road my shoulder started hurting I could just use my health care.I do not think there are any preexisting conditions with employee health plans.
Does any one know for sure?
Dahubb in Calif.
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03-15-2012, 04:42 PM
Post: #9
RE: closing case without future medical.whats this worth?
(03-15-2012 04:34 PM)dahubb Wrote:  As far as future medical I thought that if case was closed and I got a job that had health care and down the road my shoulder started hurting I could just use my health care.I do not think there are any preexisting conditions with employee health plans.
Does any one know for sure?
Dahubb in Calif.

as soon as you settle this shoulder IS pre-existing and any insurance company will NEVER pay anything for it. thats the whole purpose of future medical. you really need it!
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03-15-2012, 04:46 PM (This post was last modified: 03-15-2012 04:49 PM by 1171.)
Post: #10
RE: closing case without future medical.whats this worth?
(03-15-2012 04:34 PM)dahubb Wrote:  As far as future medical I thought that if case was closed and I got a job that had health care and down the road my shoulder started hurting I could just use my health care.I do not think there are any preexisting conditions with employee health plans.
Does any one know for sure?
Dahubb in Calif.

you can have a new injury or an aggravation of prior injury.
they won't fix what was caused by the work injury but they'll cover new damage.

confidence is not about seeing the future; it's about the clarity of your current situation.
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