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Giving up Medical in Settlement
#1
Hello, first time posting and need all the help I can get please. I've been on temp work comp benefits (State of CALIFORNIA) until last November 2012 and I am being offered a settlement and the option of receiving more cash to give up Medical. I don't have an attorney and have tried to obtain one with no luck. Officially w/c was giving me approx an extra $7500 for giving it up permanently (everything is working properly after surgery) and I'm not sure they are being fair with their $ value. I am asking for assistance to make sure I'm not short changing my medical $ value. Thanks in advance.
 
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#2
ask them for a printout of your medical treatment both to make sure it's all been paid and to get an idea of what things cost.

talk to your doctor and make two lists
one with treatment that you might need if things don't continue as well as they are now include regular maintenance and one time items
the second with what treatment you'll need to adequately carry on.
price out the items on both lists
find the mid point.
if it's above $7500 take the deal, if it's not leave the medical open.
or try more attys
start here
caaa.org
your case is at the settlement stage; it's almost free money. most should take your case.

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
How did you get W/C to even speak of a medical settlement so quickly? They have said they are working on mine since April, 2011. Backstory: I was injured in Nov. 2003, rated 14%. Had first surgery in 2006, then more in 2007,8 &9. Now rated at 82%. Injured in Calif., live in Texas now. In May this year, I was doing supervised PT on my claim when I pulled a back muscle. Doc wanted to do trigger point injections and was denied all the way through the IMR. That decision was made this month.
Injured parts are both shoulders, neck with fusion at C5/6. 10 lb lifting limit. Medically retired from state service. Constant headache from the neck, double-crush syndrome in both shoulders, numbness attributed to C-6 in both arms and hands. Pain in the shoulders of course.
Docs here only want to give meds out. I would expect future surgery to relieve the double-crush on the nerves. WC keeps denying testing for these problems. This is why I want the buyout.

So the question is: What's the magic words to say to WC to get them to complete the C & R?
 
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#4
"I'll settle for $1."

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
I settled and did not keep the medical open, big mistake!

I received $4,600. for my medical. What I did not know is health insurance will never cover my knee because it was a work injury and I received a cash settlement.

So think hard, will the money you are receiving cover your future medical needs for life?
 
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#6
(11-26-2013, 09:59 PM)Bummer Knees Wrote: I settled and did not keep the medical open, big mistake!

I received $4,600. for my medical. What I did not know is health insurance will never cover my knee because it was a work injury and I received a cash settlement.

So think hard, will the money you are receiving cover your future medical needs for life?

I have talked with my regular insurance and they said all would be covered. Also, with the ACA coming into effect, insurance companies cannot deny coverage for existing conditions. Might talk to your insurance company about that.
 
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#7
if your regular health will cover then take your comp denial to them and see if they'll make good.
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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#8
I would think long and hard about closing any medical. Even if things are going well (knock on wood), your still going to need checkups with the surgeon. Depending on the severity of your injury or surgery the surgeon will probably want a exray. Even if your checkups are only 2 years apart it don't take long to burn up 7,500. I have settled recently, 6yrs after injury and from day 1 the ins knew settling medical was not a option, but mine were severe that I need constant monitoring.
.
 
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#9
(11-27-2013, 04:10 AM)bronco54501 Wrote: I would think long and hard about closing any medical. Even if things are going well (knock on wood), your still going to need checkups with the surgeon. Depending on the severity of your injury or surgery the surgeon will probably want a exray. Even if your checkups are only 2 years apart it don't take long to burn up 7,500. I have settled recently, 6yrs after injury and from day 1 the ins knew settling medical was not a option, but mine were severe that I need constant monitoring.

I cannot get any followups with any of the surgeons. One doctor wants me to have an MRI of the neck with contrast (requiring a spinal tap) every year since 2010. I cannot get one. Been 3 years, almost 4 since the last one. And with the new changes in California, which I am under, I cannot take it to a judge.
 
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#10
(11-27-2013, 01:01 PM)sl380mbz Wrote:
(11-27-2013, 04:10 AM)bronco54501 Wrote: I would think long and hard about closing any medical. Even if things are going well (knock on wood), your still going to need checkups with the surgeon. Depending on the severity of your injury or surgery the surgeon will probably want a exray. Even if your checkups are only 2 years apart it don't take long to burn up 7,500. I have settled recently, 6yrs after injury and from day 1 the ins knew settling medical was not a option, but mine were severe that I need constant monitoring.

I cannot get any followups with any of the surgeons. One doctor wants me to have an MRI of the neck with contrast (requiring a spinal tap) every year since 2010. I cannot get one. Been 3 years, almost 4 since the last one. And with the new changes in California, which I am under, I cannot take it to a judge.

Sounds like they are STARVING you out of medical. This is happening all over CA and has only gotten worse with the new IMR process. IC simply deny everything and make workers wait months and months to go through IMR review. Reading IMR decisions online, most care is being denied. This process is quite arduous on the worker since obtaining docs to submit supporting requests for treatment is difficult within the time lines required to appeal and submit.

There really isn't a reason for IC to settle medical if they can deny treatment entirely. At most is costs them the IMR review fee and that's only for workers who request it when treatment is denied. Most won't bother because it's such a challenge to get the doctor and/or your attorney to followup on each denial of treatment request. Win, Win for the IC all the way around.
 
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