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Settlement for future medical questions - Printable Version

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Settlement for future medical questions - Allboys - 01-02-2018

Hi all. I'm in PA and on 1/4/18 it will mark 2 years in my exhausting journey with WC. I suffered a third degree burn to my right (dominate) hand that involved half of the back of the hand and all fingers to some extent. I underwent a skin graft a few days after the injury, and then later had to have another graft on part that did not take the first time. From this injury I developed and was diagnosed with CRPS in June of 2016. I do not go to a pain management clinic. I see a neurologist, the one who diagnosed me every couple months.

The insurance company is currently responsible for 35% of my medical bills for my lifetime. I am responsible for the remaining portion. The insurance company has repeatedly requested to settle for the last year and a half. They were willing to settle for the amount I previously asked for if I gave my employer my letter of resignation. I refused. Not long after my employment was terminated. As soon as that happened they sent me for an IME. I know the insurance companies request the IME's to hopefully receive a report that is contradictory to the worker's doctor and claim. My lawyer sent me a copy of the IME report as soon as he received it. Their IME doctor agreed with the diagnosis of CRPS, stated I am able to work, and actually listed the restrictions he felt would be appropriate for me. The restrictions he listed were far more than my own doctors had me on. It also left very little for me in terms of what work I would be able to do. I did find other employment that should conform to all restrictions by all doctors.

Once again, as soon as that report was delivered the insurance company sought to settle and asked for a number we wanted. When my lawyer gave them the number they filed for a mediation hearing. What I don't understand is why they filed for a mediation. My lawyer told me it was a good thing, but I don't see how it is. They never countered with the number we asked for, they just went straight to mediation. I know they don't want to be tied to me for life, and settlement on this case is hard. CRPS can spread, and mine already has, from just my hand to my entire arm. The medications and compression gloves are expensive. I carefully sat down and figured out what they would be paying over the course of normal lifetime when I gave my lawyer the number I requested.

What goes on at a mediation hearing? What should I be prepared for?

RE: Settlement for future medical questions - 1171 - 01-02-2018

unresolved  issues are identified. Possible solutions and next steps are proposed. Settlement numbers are exchanged.
You should be prepared to compromise on some issues and amounts. Failure to close out the case here will likely result in another lengthy delay as each side prepares for a trial later in the year.
You need to listen to the mediating judge about the strengths and weaknesses of your claim and adjust your settlement demands accordingly.
You are not required to settle your claim during mediation.
The mediating judge will not be involved in any subsequent trial of your claim.

RE: Settlement for future medical questions - Allboys - 01-28-2018

Thank you. I had no idea what to expect tomorrow. I do have a lawyer that has been on the case from the beginning. I still have no idea how this is a good thing but will be asking him tomorrow.