[sonny1]

Hi everyone! Welcome to fall (if your in NYS) YUCK!! I went for a hearing the other day and it was decided that I am permanetly partially disabled @ 75%, as the IC IME stated. The IC had no objections, but they did raise some code 15 (8)(d) NYS comp and 15(8)(h)(2). I asked my attorney what that meant and he said that they had something to do with a pre-existing condition, and that now any negotiations for a section 32 would take longer because it goes through a "special funds" insurance. And that the IC gets re-imbursed for any and all monies paid out to me even if the pre-existing condition was a hang nail??? I don't understand all or any of it really.

Any info..in laymans terms would be great!!!

Thanks!

[1171]

New York has a couple of Special Funds.
The Special Fund for Reopened cases will assume the carrier’s role in a case, including full responsibility for payment. The Second Injury Fund will reimburse a carrier for payments made in compensation cases.

I suspect the one associated with your case is the subsequent injury fund.
the employer only has to pay for the results of their injury.
when there is a pre-existing condition that results greater injury/disability due to the pre-existing condition the comp carrier pays the full value but gets re-imbursement for the non-work injury portion so the employer is only charged with their costs.

[sonny1]

I see now, thanks 1171. My attorney talks so fast and half legal talk and half english by the time I leave I need a drink!!

[sonny1]

I see now, thanks 1171. My attorney talks so fast and half legal talk and half english by the time I leave I need a drink!!

[i5417]

Hi Have question re: section 32. I have had 2 shoulder sur. I need a shoulder replace- 42 yo Dr say I should wait as long as I can before having it.. Dr has slu at 50% been on wc for 3 years.rec payment. Question is Do they take out all the pass money I recv if im approve for section 32.
And how do i calculate money they are saying i have to put aside for medica?
And last any range of how much could could possible recv. by giving up all medical.
Thanks
p.s
To the ins companys
"No weapon formed against me shall prosper"

[1171]

this is sonny's thread with a different question.
you should start your own so others that are searching for similar information won't be confused.
http://www.workerscompensation.com/forum....php?fid=4

yes, your TD will be credited against your SLU payout.
more here
http://www.wcb.ny.gov/content/main/TheBoard/SLU.pdf
http://www.wcb.ny.gov/content/main/Worke...ossUse.jsp

you don't calculate the set aside amount; its done between the carrier and Medicare.
you can find more information on their website
https://www.cms.gov/Medicare/Coordinatio...rview.html