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Sell my medical rights or keep lifetime care?
#11
1171,
Thank you, yet again, for the valuable information.
Yes, I am working, if you count sitting at a desk. I have been given a lifetime push, pull, lift limit of 25 lbs which might as well be a death sentence for someone like me. I used to be very physically active and independent and now I can't even life a small foldaway table without asking for help. I feel like a shell of who I used to be. If you knew me better, you'd know that I am not wired for a desk job but we all have to do something to get by, right? I was doing union commercial electrician work and loving it when this all went down. After the injury, they said they could no longer put me to work because I was no longer able to work at 100% capacity. I had no choice but to drop out.
Based on how difficult, inept and sub-par my medical treatment has been through the insurance company and how I was constantly having to jump through hoops to even do something small like switch pt providers, I think I'll take the settlement and get what I can out of it by seeking out my own medical treatment.
I with I could take on these bast*rds and fight back and get a new attorney and fight for the medical treatment I need but after a year and a half of doing that, I honestly don't have any fight left in me. The ADR WC process has crushed my heart and soul.



(11-27-2017, 08:03 PM)1171 Wrote: 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.
 
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#12
Since your injury was in California and after 1/1/2013 and your employer would not allow you to return to work you qualify for 2 vouchers. The first one is SJDV $6,000. and $1,000. can be used towards computer and $500. can be used for whatever and the rest can be used for college. The second voucher is in the amount of $5,000. and can be used for whatever you want. Make sure you ask your attorney to request this for you.

Having a spinal fusion is risky and it may be a good thing you did not have it (unknown).

If you need assistance with how to request and/or appeal UR denials for medical treatment I can try to help. I highly recommend trying to get out of the CA WC system with open medical, especially living in another state. It is extremely difficult receiving proper treatment by CA physicians who somewhat know the guidelines and how to jump through hoops needed to get treatment approved. Physicians from another state can be lost. If you are getting treatment out of state it is important your doctors are requesting treatment on RFA forms. It can be difficult to attempt to get out of pocket reimbursement. If there is a test or treatment you really need, let me know via pm and I will try to look up appropriate guidelines to give your doctor a better chance of getting it approved beforehand, but the request needs to be made on a RFA form or they can legally ignore it.

Please stay strong and do not allow these people to crush your heart and soul. As everything in life the situation you are in is temporary. I am glad to read you are currently working. My best advice from a person who also has a spinal injury is to try and control the things you do have control of, such as maintaining a healthy diet and weight. Try to get home exercises from your doctor and do them. Do not isolate yourself from family and friends. You may have to learn a new skill and new profession. Hopefully the supplemental job displacement vouchers will help if needed.

Best to you.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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#13
Thank you California_Help. This is all great info. Sorry about the delay in getting back to you. I have had a lot of trouble logging into this site on computers other than the one I created my account on.
The insurance carrier has offered me an SJDV in the amount of $6K of which $1K can be used towards a laptop. The $500 you say that can be used for whatever I want, can I just ask them to cut me a check for that amount or do I have to spend the $500 first and then ask to be reimbursed? That sounds like it would leave me $4,500 left to for training/college, correct? The insurance company did not offer me a second voucher in the amount of $5K. Is there a name for this second voucher so I can specifically request it? Can that one be used for anything I choose or is it purpose specific?

Yeah, I feel that surgery would be risky as well and am grateful I didn't rush into it. Other guys I worked with went that route and some are glad they did, others are not. Thank you for offering to assist with appeals and the RFA process. After reading through all the advice I have gotten on here, from counseling sessions and sleeping on it some more, I have decided to accept their settlement offer and seek out my own treatment to make my body whole again.

Thank you for the inspiring words at the end of your last message. I have really been trying to better myself and not let this whole situation define me. I have been trying to eat better and strengthen the parts of me that are not injured. Once I receive the settlement money, I am going to try other treatments I haven't tried yet to help with the nerve damage.

Regards.

(11-29-2017, 06:23 PM)California_Help Wrote: Since your injury was in California and after 1/1/2013 and your employer would not allow you to return to work you qualify for 2 vouchers. The first one is SJDV $6,000. and $1,000. can be used towards computer and $500. can be used for whatever and the rest can be used for college. The second voucher is in the amount of $5,000. and can be used for whatever you want. Make sure you ask your attorney to request this for you.

Having a spinal fusion is risky and it may be a good thing you did not have it (unknown).

If you need assistance with how to request and/or appeal UR denials for medical treatment I can try to help. I highly recommend trying to get out of the CA WC system with open medical, especially living in another state. It is extremely difficult receiving proper treatment by CA physicians who somewhat know the guidelines and how to jump through hoops needed to get treatment approved. Physicians from another state can be lost. If you are getting treatment out of state it is important your doctors are requesting treatment on RFA forms. It can be difficult to attempt to get out of pocket reimbursement. If there is a test or treatment you really need, let me know via pm and I will try to look up appropriate guidelines to give your doctor a better chance of getting it approved beforehand, but the request needs to be made on a RFA form or they can legally ignore it.

Please stay strong and do not allow these people to crush your heart and soul. As everything in life the situation you are in is temporary. I am glad to read you are currently working. My best advice from a person who also has a spinal injury is to try and control the things you do have control of, such as maintaining a healthy diet and weight. Try to get home exercises from your doctor and do them. Do not isolate yourself from family and friends. You may have to learn a new skill and new profession. Hopefully the supplemental job displacement vouchers will help if needed.

Best to you.
 
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