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Rating done & Settlement Conf. tomorrow!
#1
Hi all,

I just completed my PQME and my Case Settlment Conference is tomorrow.
Feeling nervous! My rating is around 75%.

I have a few questions:

1). How does the rating work? Will that effect my SSDI?

2). Any do's or dont's for tomorrow? Attorney says Be ready to sign. (He's knowledgable, but super dismissive & gruff!)

3). Any other words of wisdom?

4). Medicare Set Aside - he wants me to sign form for outside Vendor to review my MD records.

Thanks much!

Oh, I'm in California
 
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#2
assuming your case is under california laws.

yes your SSDI is capped at 80% of your earnings.
more here
http://www.socialsecurity.gov/pubs/10018.html

depends on if you are doing a lump sum or stipulation with open medical?

if a set-aside is on the table, then you will not be doing a stipulation and are a long way from any lumpsum settlement.

you cannot buyout your future medical until CMS approves a set aside amount and a workup and review takes many months.
depending on the set aside amount the carrier may not want to put that much towards your future medical and decide not do a Compromise and Release.
the carrier may want to dispute the QME.
using an AME will delay any rating for many months.

be familiar with how set asides work; they can be complicated:
http://www.cms.gov/Medicare/Coordination...sion-2.pdf

Be prepared for no settlement and more delays; the litigation process is a notorious time consuming process.
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.
 
Reply
#3
Thanks 1171.
Yes, California. My Atty said I won't get a lump sum, but bi-weekly checks. Do those max out at a certain amnt as to not exceed the 80%? (For instance, I've been receiving $230 week which ends soon.)

I'll likely accept a Medicare set-aside in lieu of lifetime medical. My employer prefers that too.

I really don't want AME, but they'll see me and prob think I look "fine."


(03-03-2014, 05:36 PM)1171 Wrote: assuming your case is under california laws.

yes your SSDI is capped at 80% of your earnings.
more here
http://www.socialsecurity.gov/pubs/10018.html

depends on if you are doing a lump sum or stipulation with open medical?

if a set-aside is on the table, then you will not be doing a stipulation and are a long way from any lumpsum settlement.

you cannot buyout your future medical until CMS approves a set aside amount and a workup and review takes many months.
depending on the set aside amount the carrier may not want to put that much towards your future medical and decide not do a Compromise and Release.
the carrier may want to dispute the QME.
using an AME will delay any rating for many months.

be familiar with how set asides work; they can be complicated:
http://www.cms.gov/Medicare/Coordination...sion-2.pdf

Be prepared for no settlement and more delays; the litigation process is a notorious time consuming process.

 
Reply
#4
On the CAP for medicare if your over the 80% your medicare will be cut down so you lose some money if it is. And not sure on CA but if they have not looked at your set-a-side that will take some time to get done. Around here I'm hearing at least 6 months
 
Reply
#5
(03-03-2014, 06:12 PM)Cali Gal Wrote: Thanks 1171.
Yes, California. My Atty said I won't get a lump sum, but bi-weekly checks. Do those max out at a certain amnt as to not exceed the 80%? (For instance, I've been receiving $230 week which ends soon.)

I'll likely accept a Medicare set-aside in lieu of lifetime medical. My employer prefers that too.

I really don't want AME, but they'll see me and prob think I look "fine."

I had to go back to your earlier posts to remember what your situation is.
I think it goes like this:
you are negotiating a structured settlement with comp.
they will do a lump sum buyout of your claim and will put part in a set-aside and the remainder will be used to purchase an annuity that will pay you every other week. the amount of the 3rd party payments and the duration has to be negotiated.

f they are talking structured settlement then sounds like there won't be a dispute over rating.
your situation is complicated when it involves an annuity purchase as prices change depending on the terms of the payout.
I gave you some key points in your prior posts; review those
if you are able to come to an agreement make sure you get enough upfront $$ to carry you over until the first annuity payment arrives as their could be a long gap.
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.
 
Reply
#6
Thanks all.

Well hopefully I'll have some answers today. Eek!

The future medical won't be dealt with today. I'm more curious about the PD benefits and how they'll be figured, disbursed. Rating came in at 79%, for multiple injuries.

And Yes, this is California Court.

Fingers crossed those attorneys won't beat me up too bad today.

Rolleyes




(03-03-2014, 08:02 PM)1171 Wrote:
(03-03-2014, 06:12 PM)Cali Gal Wrote: Thanks 1171.
Yes, California. My Atty said I won't get a lump sum, but bi-weekly checks. Do those max out at a certain amnt as to not exceed the 80%? (For instance, I've been receiving $230 week which ends soon.)

I'll likely accept a Medicare set-aside in lieu of lifetime medical. My employer prefers that too.

I really don't want AME, but they'll see me and prob think I look "fine."

I had to go back to your earlier posts to remember what your situation is.
I think it goes like this:
you are negotiating a structured settlement with comp.
they will do a lump sum buyout of your claim and will put part in a set-aside and the remainder will be used to purchase an annuity that will pay you every other week. the amount of the 3rd party payments and the duration has to be negotiated.

f they are talking structured settlement then sounds like there won't be a dispute over rating.
your situation is complicated when it involves an annuity purchase as prices change depending on the terms of the payout.
I gave you some key points in your prior posts; review those
if you are able to come to an agreement make sure you get enough upfront $$ to carry you over until the first annuity payment arrives as their could be a long gap.

 
Reply
#7
Good luck! Hope everything goes well for you today
 
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