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NJ WC Help
#1
Getting down to the end of my husband's case. He has been deemed 100% disabled with Insur Co paying 80% & SIF paying 20% for 450 weeks.

Our attorney is now telling us that back pay (lump sum) only will go back to the date of Dr's exam and not when NJ stopped paying him. There is a 10 month difference. My husband was let go from his WC surgeon in May 2015 . Had a 2nd opinion from a WC group (TOJ) who said "No Work" in July 2015. Then he had the disability determination exams with the State in May 2016 and with our Lawyer's Dr in October 2016. So our attorney now is saying that we will get back pay from October 2016. Shouldn't we get money from when they stopped paying him in 2015? If anybody can answer this question I would greatly appreciate it.

Also some other questions if anybody knows...
In addition to lump sum I read there is a rating impairment award. Is that a lump sum or does it get paid weekly? How does that get figured out & does the Lawyer get a percentage of that?

Is back pay part of 450 weeks or is it in addition to?

My husband has been on SSD and his award will be offset. Will the lawyer get his percentage based on the offset amount of $350/wk or the full amount $718/wk.

Any help with these questions would be greatly appreciated!!
 
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#2
sounds like they are taking the opinion of the "Drs. exam" rather then the prior off work orders. Not all opinions or medical evidence are treated equal.
it appears that the 100% is his impairment rating and there would beif no additional disability payments.
if the back pay was for temporary disability it should be in addition to; if its permanent disability it's part of the 450.
the atty fee should be based on the $350 the client receives in work comp benefits and would not include any SSD payments.

all of this should be spelled out in any written settlement agreement or decision by the comp court; you didn't give the type of finalization. was your husband told it would be lump sum payment?
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
(06-20-2018, 01:57 PM)1171 Wrote: sounds like they are taking the opinion of the "Drs. exam" rather then the prior off work orders. Not all opinions or medical evidence are treated equal.
it appears that the 100% is his impairment rating and there would beif no additional disability payments.
if the back pay was for temporary disability it should be in addition to; if its permanent disability it's part of the 450.
the atty fee should be based on the $350 the client receives in work comp benefits and would not include any SSD payments.

all of this should be spelled out in any written settlement agreement or decision by the comp court; you didn't give the type of finalization. was your husband told it would be lump sum payment?

Thank you for your reply
He is supposed to be getting medical for his work related injuries going forward. So I do not believe he is getting a lump sum. I didn't think NJ did a lump sum.
We are under the impression it's a lump sum for back pay and then going forward bi-weekly payments? Is that correct?
 
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#4
The method and manner of award payments should be spelled out in the finalization papers. Make sure your husband reads and understands them before signing. There are provions under New Jersey law for commuting future payments into a lump sum. If that’s what was agreed to, make sure a commutation is included.
http://www.nj.gov/labor/forms_pdfs/wc/pd...tation.pdf
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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#5
In other responses I have read "1st Lump Payment" . Is there more than the 1st one?
 
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#6
Looks like neither of us know the details of the finalization agreement.
PD is enumerate in weeks because by default it’s paid out periodically.
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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#7
He is also supposed to get medical for his injuries. He is on Medicare currently with SSD How does that get paid or figured in to all of this?
 
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#8
https://www.nj.gov/labor/wc/wc_index.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.
 
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#9
Our lawyer has finally relayed this information The final order is to be reviewed this Friday
My husband's total amount is more than $252,000 but his net will be approx $185,00 after cost, liens and fees. This includes his back pay(MMI) from Oct 2016. The lump sum will be less attorney fee and the rest will go to him.
There is NO hold back of any of his money for future medical. That is their total responsibility. Insurance Co. will pay out first and then when they are done, the state will pay out next until the 450 week total is exhausted. My husband will still be entitled to medical during that time. He will probably have to undergo a medical exam during that time to prove he is still disabled from work

Now my question is ....What happens after the 450 weeks?
 
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#10
Usually medical is lifetime.
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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