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Sell my medical rights or keep lifetime care?
#1
I wish I knew about this forum back in the spring of 2016. I was wondering if maybe anyone reading this could offer me some insight or advice as I have never been through this before and handling it on my own has been an exhausting experience.

I had no choice but to file a WC claim in April 2016 after suffering severe nerve damage and a herniated disk due to repetitive motion at a very physically demanding job. I desperately tried to find a Dr to put me on temporary disability since I was unable to work but they refused, stating, if I was able to go to work that day but couldn't work at the end of the day, I HAD TO file a WC claim.

It's an ADR WC case which as far as I understand, attorneys don't usually want to come anywhere near. I did have an attorney involved for a short time (I didn't hire her until a year after trying to handle the case on my own. She said she had a lot of experience with ADR cases but when my ombudsman told me I wasn't allowed to have representation, my attorney pretty much dropped off the face of the earth so I'm on my own again.)

It's over a year and a half later now and I'm still experiencing daily nerve pain in my back. I accepted a small PD payment a couple of months ago and now the WC insurance company is offering me a buy-out offer of my future medical rights. I'm terrified of losing the option of life long medical care but I'm thinking of accepting the buy out (it's only 10% of what my then attorney told me to ask for) because I have already payed $2,000 out of pocket this year for treatment and could really, really use the few thousand they are offering me. I'm really nervous about accepting the offer though because, after 24 sessions of physical therapy, attempts at traditional chiropractic (which brought the nerve pain back in spades), 6 months of spinal network analysis chiropractic and multiple visits to an acupuncturist, I still haven't made much progress physically.
If any of you have any helpful advice I would welcome it greatly.
I'm not sure which details are the most important so feel free to ask me questions if it will help determine what is the best option for me.
Thank you and Happy Thanksgiving.
 
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#2
What state?
Have you had problems with comp carrier handling your treatment?
Have you had a comprehensive medical evaluation by a specialist?
If so, when & what was the prognosis and recommended treatment program?
You should use the search feature to review other posts on the subject; it may help you form more specific questions.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
Are you still there or We're you just teasing?
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#4
(11-24-2017, 11:46 PM)1171 Wrote: Are you still there or We're you just teasing?

Hello! and thank you for reaching out. Between work, the holidays and elder care responsibilities, I haven't been able to follow up until today. Please see your other messages for answers to all your questions.
 
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#5
(11-22-2017, 08:17 PM)1171 Wrote: 1. What state?
2. Have you had problems with comp carrier handling your treatment?
3. Have you had a comprehensive medical evaluation by a specialist?
4. If so, when & what was the prognosis and recommended treatment program?
You should use the search feature to review other posts on the subject; it may help you form more specific questions.

Hello,
Thank you for the reply. I apologize for the delay in responding. I will try to be more timely with replies from here on out.

1. The WC claim was filed in CA but I am currently living in VA. (I had no family or means of adequate financial support in CA so I had no choice but to move back in with family in VA).

2. There were many problems with how my treatment was handled. The first and biggest issue is that I wasn't seen by an orthopedic doctor until weeks after the injury. The insurance company had me going to an urgent care type of facility where I was seen by a different PA or family doctor weekly the first five visits. It was a joke. I only got to see an orthopedic specialist after a friend told me that's who I really should have been seeing. There was one on staff the whole time I could have been seeing! He even apologized about the situation once I finally saw him. Other stuff I had to deal with was that I never received any TD payments from the insurance company and I lost my health insurance through my employer since I wasn't able to return to work "unrestricted". The list goes on...

3. I believe so. I had a QME do an assessment.

4. The QME exam was done on 6/20/16. It was determined that my injury was work related and if I remember correctly, the QME assigned 10% PD and said I was not a candidate for surgery. I will see if I can dig out the paper report. I never received a copy from the insurance company. I had to call the QME's office and ask for a copy of the exam results.

Please let me know if you need any additional information.
 
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#6
Glad to find out you are working.

Settlement depends on the $$$$.

One of the big reasons to buyout your future medical can be to avoid the hassles of actually getting the treatment. California has placed a lot of restrictions  on physicians as to what they can and cannot do under a workers comp claim.
Since you are out of state, the ability to get treatment that conforms to California rules is doubly difficult-- even if you could find a doctor willing to do it.
Since you are an Alternative Dispute Resolution carve out claim, Any disputes would have to go thru mediation and arbitration before litigation. All requiring you to travel to California.
While you still have physical complaints and symptoms, you are not at a stage requiring surgery and/ or significant time off which would make the future treatment much more valuable and your decision more difficult.

You still have the ability to file a new claim if there is another injury, even though there wold be credit taken for any overlap from your prior disability.

Of course, All of this is moot if the $$$ aren,t acceptable.

Those are some of the things YOu shOuld consider before making your decision.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
Reply
#7
(11-22-2017, 03:47 PM)138 Wrote: I wish I knew about this forum back in the spring of 2016. I was wondering if maybe anyone reading this could offer me some insight or advice as I have never been through this before and handling it on my own has been an exhausting experience.

I had no choice but to file a WC claim in April 2016 after suffering severe nerve damage and a herniated disk due to repetitive motion at a very physically demanding job. I desperately tried to find a Dr to put me on temporary disability since I was unable to work but they refused, stating, if I was able to go to work that day but couldn't work at the end of the day, I HAD TO file a WC claim.

It's an ADR WC case which as far as I understand, attorneys don't usually want to come anywhere near. I did have an attorney involved for a short time (I didn't hire her until a year after trying to handle the case on my own. She said she had a lot of experience with ADR cases but when my ombudsman told me I wasn't allowed to have representation, my attorney pretty much dropped off the face of the earth so I'm on my own again.)

It's over a year and a half later now and I'm still experiencing daily nerve pain in my back. I accepted a small PD payment a couple of months ago and now the WC insurance company is offering me a buy-out offer of my future medical rights. I'm terrified of losing the option of life long medical care but I'm thinking of accepting the buy out (it's only 10% of what my then attorney told me to ask for) because I have already payed $2,000 out of pocket this year for treatment and could really, really use the few thousand they are offering me. I'm really nervous about accepting the offer though because, after 24 sessions of physical therapy, attempts at traditional chiropractic (which brought the nerve pain back in spades), 6 months of spinal network analysis chiropractic and multiple visits to an acupuncturist, I still haven't made much progress physically.
If any of you have any helpful advice I would welcome it greatly.
I'm not sure which details are the most important so feel free to ask me questions if it will help determine what is the best option for me.
Thank you and Happy Thanksgiving.
This may sound stupid ,but what does ADR stand for ?
 
Reply
#8
Alternative dispute resolution
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
Reply
#9
My case is in California, I been denied surgery for lower back surgery of S1, L3&4 which was recommended by their own orthopedic surgeon. However they keep denying surgery and keep wanting to settle case. Now my pain radiates down my legs numbing pain. Last September I feel and fractured my right foot and rtknee too. I am so tired of games, I d like to settle asa they include the new injuries. Any idea what my payout could be?
 
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#10
You should start a new thread as this topic is different then the original poster
http://www.workerscompensation.com/forum....php?fid=4

Your future benefits are TEmporary disability while off work, medical treatment for the injury, and permanent disability.
A fair settlement would be the mid point between a high and low estimate of these costs.
You can't settle until you have a medical opinion that you have reached maximum medical improvement.
More nformation in the PD fact sheet
http://www.dir.ca.gov/dwc/iwguides.html
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
Reply
  


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