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Spinal Fusion/Mandatory Settlement?
05-09-2012, 07:52 PM (This post was last modified: 05-11-2012 11:20 AM by kate.)
Post: #1
Spinal Fusion/Mandatory Settlement?
Sorry for the long post. Just very worried and not sure where else to go. My lawyer is out of town for 2 weeks on vacation.


I was injured on the job in California, in Feb 2008. Been on temporary disability ever since. Have had 2 back surgeries(not fusions) since the accident for multiple things but mainly for ruptured discs due to the accident.

My ex-employers carrier is **no names please**

I am currently(not by choice) a stay at home dad of 2 young children. My wife works about 60 hours a week to support us. This has been going on since the accident. It has been 2 years since my last surgery and while I am in quite a bit of pain I am able tolerate it currently but unable to do much physical activity.


My neurosurgeon and orthopedist both recently recommend a fusion for 3 discs. My pain management doctor has recommended that I hold off as long as possible and only get the fusion as a last resort.

Workman's comp has denied my doctors request for the fusions and for additional pain management. I was sent to see a QME and he agreed that I needed the fusion surgery. Work Comp filed for a "Mandatory Settlement" which my lawyer attended but to no avail. I now have to go to court at the end of the month.

I am very worried about having the Spinal Fusion. I have talked with various doctors, friends, and neighbors who have had experience with spinal fusions and there seems to be a lot of mixed reviews. The first 2 surgeries were not successful. I am worried that this surgery will follow the same trend. Also I am afraid that if I have the surgery the additional strain on my family could be the end of my marriage.

Is the insurance company trying to force me to take a settlement?
If the judge decides that surgery is valid do I have to have it immediately?
If I chose not to have the surgery will I be at risk of losing future medical coverage for my injury?

I really just don't know what to do or where to turn to. Any help would be greatly appreciated.

Thank you for your time.
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05-09-2012, 08:25 PM
Post: #2
RE: Spinal Fusion/Mandatory Settlement?
if your marriage is in trouble get help for it now with your pastor.As for your surgery they cant make you do it but they can mark you as MMI if you refuse and you are done.Sounds like you and your wife need to sit down and discuss more than just this surgery....you got my prayers Buddy

........I love cats, I just cant eat a whole one by myself......
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05-09-2012, 08:56 PM
Post: #3
RE: Spinal Fusion/Mandatory Settlement?
depends on what you mean by a "settlement."
a buyout (compromise & release) can't be forced by the court or either party. and it does close out all future benefits.
an award leaves future medical open.
I suspect they want the permanent impairment fixed thru an award or to get a C&R figure they can accept.
you should have a rating from your doctors and they want an exact amount determined.
if the parties do not want to buyout or can't agree on an amount, the permanent disability will be paid out in bi-weekly payments and medical care will be left open.
after 5yrs from the date of injury the disability can't be changed.

you can find out more from the fact sheet on PD here
http://www.dir.ca.gov/dwc/iwguides.html
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05-10-2012, 01:48 AM (This post was last modified: 05-11-2012 11:20 AM by kate.)
Post: #4
RE: Spinal Fusion/Mandatory Settlement?
(05-09-2012 07:52 PM)Jherek Wrote:  Sorry for the long post. Just very worried and not sure where else to go. My lawyer is out of town for 2 weeks on vacation.


I was injured on the job in California, in Feb 2008. Been on temporary disability ever since. Have had 2 back surgeries(not fusions) since the accident for multiple things but mainly for ruptured discs due to the accident.

My ex-employers carrier is **no names please**

I am currently(not by choice) a stay at home dad of 2 young children. My wife works about 60 hours a week to support us. This has been going on since the accident. It has been 2 years since my last surgery and while I am in quite a bit of pain I am able tolerate it currently but unable to do much physical activity.


My neurosurgeon and orthopedist both recently recommend a fusion for 3 discs. My pain management doctor has recommended that I hold off as long as possible and only get the fusion as a last resort.

Workman's comp has denied my doctors request for the fusions and for additional pain management. I was sent to see a QME and he agreed that I needed the fusion surgery. Work Comp filed for a "Mandatory Settlement" which my lawyer attended but to no avail. I now have to go to court at the end of the month.

I am very worried about having the Spinal Fusion. I have talked with various doctors, friends, and neighbors who have had experience with spinal fusions and there seems to be a lot of mixed reviews. The first 2 surgeries were not successful. I am worried that this surgery will follow the same trend. Also I am afraid that if I have the surgery the additional strain on my family could be the end of my marriage.

Is the insurance company trying to force me to take a settlement?
If the judge decides that surgery is valid do I have to have it immediately?
If I chose not to have the surgery will I be at risk of losing future medical coverage for my injury?

I really just don't know what to do or where to turn to. Any help would be greatly appreciated.

Thank you for your time.
I wonder if my wife has the same attorney as you. Finally got her final QME report, treating doctors report and we are ready to go. Wife is going to CnR. And her attorney was going to figure out new settlement amount so we can get going on trying to end the nightmare. That was 2 weeks ago and now attorney is MIA. My wife has injuries to both wrists/hands, surgery on both, injuries to C3 to C7. She had one neck surgery as well to relieve pressure. Worked a little and fusion is in the future, recommended by both treating doctor and QME. I took a job with an epic health plan so she is covered which is why she will CnR. Her carrier is a nightmare and we don't trust them for future medical. Going through all you are going through. I have to work crazy hours since wife cannot work, we have kids and it's hard for my wife at home. Her carrier is so tight they would not approve a prescription by her doctor for a housekeeper to come clean our home twice a month.
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