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settlement question - daverg - 10-03-2013

Was initially injured in 2002 while lifting pipe. I had surgery in 2003 and then again in 2006, but was finally told that I would not be able to work again. I reached MMI in 2/2007 and WC quit paying TT. My claim is still open and I still see DR twice a year for pain issues. WC pays for these visits. Last yr was having quite a bit of neck pain again & WC would not approve an MRI to check out. My question is should I try to settle this claim and be done with WC since it is a fight to get anything approved at this point.
Also, how do I know how much to ask for. At injury I was 39 years old and working as union boilermaker. I am now on SS disability and 50. I really don't understand how to figure out a fair amount.


RE: settlement question - jayne - 10-03-2013

your TT wc checks stopped in Feb of 2007 did they then pay you PTD payments for a while or did you settle that part of the claim? If they havent reached out to you to settle in 6 years I dont think they will. You arent costing them much a pain Dr visit every 6 months and your meds...Because you are on SS you will have to do a medicare setaside for your medical.So no cash in your pocket most likely


RE: settlement question - daverg - 10-03-2013

I was going to apply for PTD and was told that they did not know of anyone being approved for it & SS would subtract any should they approve it. They contacted me a couple of years ago & said that I could fill out a form with an offer to settle, but I have no idea an amount. The form breaks it down into indemnity, medical & prescription. Do you know if settlement impacts SSDI monthly payments or not.


RE: settlement question - 1171 - 10-03-2013

any money you take in settlement amount of your medical benefits will likely have to be approved by Medicare and put in a Set Aside account to be used only for work comp injury treatment. if the carrier agrees to a buyout of your treatment they will work with Medicare to determine an amount. you can participate in the negotiations as well. since you lack expertise, representation by an atty would be advisable.
More on set asides here:
http://www.cms.gov/Medicare/Coordination-of-Benefits/Workers-Compensation-Medicare-Set-Aside-Arrangements/WCMSAP-Overview.html

benefits and settlements depend on the comp laws in your state.
without knowing yours it's difficult to provide specific information.

more on SSDI offset of disability payments:
http://www.socialsecurity.gov/pubs/10018.html



RE: settlement question - Manley2 - 10-03-2013

I second that on the need of a lawyer. Would think they should be paying PTD since TTD stopped but I don't know the rules in your state