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ic offered a low amount.was choosing a hearing date a good idea?
#1
Hello. Im new to this forum stuff so hear it goes. I was injured on 9/9/09 when delivering a package for FedEx I fell into a sinkhole in the grass and broke my ankle and hurt my back. I tore ligaments in ankle and have bulging in lumbar at l-4 and l-5. I recieved surgery for my ankle on 2/20/11 and recieved ame report on 1/18/12. Report said that I was pd 13% and 17% wpi. I went from ttd payments of $340 a week to $230 a week as of 1/18/12. Which is shrinking my settlement every 2 Weeks when I get a check. My lawyer doesnt seem to have my best intrest at heart because we have had nuerous issues in the past. Last week he offered the ic a c&real of $30,000 and the ic counter offered today with $15,000 minus $2,300 for atty fees woupd leave me with $12,700!! That seems really low and my lawyer agreed. He said we can go to a hearing but he doesnt know what will happen. He said we can probably get an additional $5,000. Maybe more maybe less. My fmc says that I will need doctors visits, medication (disinflammitory, norco,prilosec) and a epidural shot. They said they dont see surgery for my back and ankle is mmi.I was offended by the $15,000 offer and off reflexes told him lets go to a hearing. If I go to a hearing will that likely increase the amount? Why would the ic low ball me like this?? Any advise aould be helpful. I have been working for FedEx since 07. Iive in Los Angeles and I was only 24yrs old when I was injured. I am 26 yrs old now and have a 2yr old son that demands alot more than $12,700 to support us until I find other work. Thank you
 
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#2
The insurance company starts out with a low ball settlement with settlement talks. To avoid a hearing sometimes the insurance company will come back with a higher amount that is more to your liking. IF not then go ahead with te hearing.

With my settlement talks $10,000.00 was the starting figure, and settled for a much higher amount.

Most important keep you medical open when you settle. It sounds as if you may need future medical care. Your personal health insurance will not cover a work comp injury so if you close your settlement with closed medical you will pay cash out of your pocket for your medical care in the future.

I also have an ankle injury, not work comp but from years ago.
That ankle is now giving me problems and there is talk of need surgery.

 
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#3
you might be confused by 2 different types of settlements.
one where just the disability is paid and the medical is left open
(a stipulation).
the other where there is a buyout of all benefits including future medical
(Compromise and Release)
Obviously the C&R will be the higher amount as includes $$ for medical care.
you can find out more about permanent disability benefits here (factsheet D)
http://www.dir.ca.gov/dwc/iwguides.html

you can change attys at any time- there will be a single fee that is shared.
you can talk to other attys first:
caaa.org.

Permanent disability calculations are set by law and neither party can agree to a lesser calculation so all the negotiation should be about open medical or the amount of the lump sum buyout.
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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#4
Thank you for the fast response. So basically your saying that they are just playing games with me. That they are dragging out time for no reason?? What could be the benefit of jerking me around and lolligagging like this??

As for the f.m.c. My ankle has had surgery over a year ago and it feels like its going to give out on me if I do any physical activity! Im really mentally untrustworthy of my ankles stability. Going down stairs even hurts during the summer. And if its cold outside-the pain is way worse. I told my doctor that I want more surgery for my ankle and he said its mmi. Can I push for surgery?? Even though I had it already?? I really feel that I need some screwes or something because I have constant pain.
The ic owes me $7,500 in pd payments yhat they have been paying me every two Weeks. They said they will close out everything(including medical) for $15,000. My lawyer said that they would only be valuing the fmc at just over $5,000 because they are using the $7,500 they owe me as a credit. Thats crazy to me! After bummer knees comments I am left with optimism. But still worried that I might not get the money I am untitled to. If the settlment were for $15.000 with fmc open then I would consider a settlement but its not.
 
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#5
I don't know enough about your case to guess at motivations.
if you want a decision without the carriers interference have your atty set a court date and let the judge award weekly PD and open medical.
that way you don't have to wait on them.

you can change doctors any time as long as you stay within the Medical Provider Network.
bi-weekly payments is law unless you negotiate a buyout.

as I posted earlier neither you nor the carrier can change the value of your disability as it's based on the AME rating and is not negotiable.

you seemed to be confused about workers comp and are expecting something else.
it's not like civil or tort law. payments are solely based on disability and subject to strict regulation. there is little leeway except as to value of future medical.
disability is controlled by the rules, and ratings.
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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#6
Understood. Lets say that the ic doesnt offer anythi.g at the msc and we do go to a trial. What could happen?? I know that the judge cant just tell the ic to pay me whatever he tells them to. How would the judge go about getting me more value?? I understand that the judge would either use the pd% or the fmc amount right??? Im basically asking if it goes to trial am I screwed because I diddnt settle at the m.s.c.???
Understood. Lets say that the ic doesnt offer anythi.g at the msc and we do go to a trial. What could happen?? I know that the judge cant just tell the ic to pay me whatever he tells them to. How would the judge go about getting me more value?? I understand that the judge would either use the pd% or the fmc amount right??? Im basically asking if it goes to trial am I screwed because I diddnt settle at the m.s.c.??? And are u saying that the$5,000 that the ic came up with for my fmc is final???
Understood. Lets say that the ic doesnt offer anythi.g at the msc and we do go to a trial. What could happen?? I know that the judge cant just tell the ic to pay me whatever he tells them to. How would the judge go about getting me more value?? I understand that the judge would either use the pd% or the fmc amount right??? Im basically asking if it goes to trial am I screwed because I diddnt settle at the m.s.c.??? And are u saying that the$5,000 that the ic came up with for my fmc is final???
Understood. Lets say that the ic doesnt offer anythi.g at the msc and we do go to a trial. What could happen?? I know that the judge cant just tell the ic to pay me whatever he tells them to. How would the judge go about getting me more value?? I understand that the judge would either use the pd% or the fmc amount right??? Im basically asking if it goes to trial am I screwed because I diddnt settle at the m.s.c.??? And are u saying that the$5,000 that the ic came up with for my fmc is final???
 
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#7
Your PD is determined by the WPI rating you received. The amount is set and is not negotiable. Once you are MMI, your TDD stops and your PD begins at a rate of $230 per week until it is all paid out. There is no negotiating this amount. That is your SETTLEMENT.

FM is different. Your Primary Dr. determines what FM is needed.

If you settle your case, you can C & R which will include a FM amount on top of your your remaining PD. The FM is negotiable and not only that, it has to be approved by Medicare.

Up to 15% of your entire settlement goes to your attorney before you are paid the balance. The PD you have been paid already will be deducted from the PD amount of the settlement.

If you settle with stipulations, in most cases you will continue to received your PD bi-weekly until it is all paid out, but your FM will be left open. All FM is subject to Utilization Review.

Any changes in your medical can possibly increase your PD.
Let Go, and Let God......
 
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#8
If thats the case then Iguess ill wait and see if the ic budges before the msc and offers more money. Or wait until the msc to see what happens. Im completely ok with the $7,500 owed to me but its the fact they they are only valuing my fmc for just over $5,000 thats my only problem.all I can do I hope that they offer more money for my fmc at the hearing I guess. This sucks.
 
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#9
in other words listen to your lawyer.the only thing that may change the dollar amount is closing the medical if you are having trouble that would be stupid.However that depends on you and how much you want the dollars remember no insurance will ever cover the injury you got on a WC injury so think it thru.My advice leave the medical open and get it fixed till you are satisfied all has been done to get it back to normal as possiable meanwhile looking for some sort of job to keep from starving to death and living under a bridge....Can you get retraining? go back to school maybe get grants to live on till you graduate?Here in Okla we have a program for low to no income families called Kibois that gets them retrained with help for living expences does your state have a program like this?
........I love cats, I just cant eat a whole one by myself......







 
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#10
You can do your homework and find out what an estimation of your FM will be. That amount will be a good starting point for negotiating at the MSC. If you have it on paper it will carry more weight than an off the cuff amount thrown at the WCJ.

Work out a settlement worksheet with your attorney. This should include the cost of your remaining PD, FM (approximately 70% of what you actually estimate), reimbursement of any self paid medical and prescriptions, any unpaid mileage.

Your I/C will be more willing to settle if you don't ask for the full FM amount you calculated 'cause they wouldn't pay that anyway. Consider such things as future surgeries, ongoing meds, mileage, doctor visits, physical therapy.

IMHO, and by experience, if everyone is willing to give an inch, an MSC will settle most cases without going to court.

Let Go, and Let God......
 
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