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EDD Lien Against W/C Settlement
#1
Can anyone explain to me (I asked my attorney but he never returns my calls or emails) how the EDD lien against any workers comp settlement works in California. I have been on State disability for 9 months now; w/c claim was denied at the gate. My attorney told me a while back is is trying to settle with workers comp . . . what if the offer from w/c is less than the amount of disability benefits I have collected so far? This is all so very confusing and frustrating. Am ready to throw in the towel . . .
 
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#2
when your claim is finalized: settled or awarded by court, any liens have to delt with.
medical or disability liens like EDD have to be denied or paid or reduced.

generally in cases where the injury is denied and then eventually settled by compromise and release liens can be proportionally reduced or pro-rated e.g.
a $10K claim is settled for $5K the lien holders would get $.50 on the dollar.
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
Thank you for this info; does the insurance company for the employer have the power to negotiate the EDD lien part of the settlement? I mean, if this settles out of Court, which it most likely will, who deals with the EDD lien issue and does EDD have input/say? How does this process work?
 
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#4
yes, all parties to the settlement negotiate among themselves: carrier, worker, lien holders.
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
Okay one last question if you please . . . what if there is no award? how is the EDD lien treated in that case?
 
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#6
no problem; ask away.
it is very rare that the court does not finalize or make a determination on a filing. occasionally the applicant no longer wishes to pursue the matter legally.
if they don't request a dismissal and abandon the claim generally after a time of inactivity on a litigation file, usually the carrier/employer asks for a dismissal.
if the action is dismissed, then the claim and all liens are also dismissed with no court decision/determination.
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
(03-28-2014, 03:30 PM)1171 Wrote: no problem; ask away.
it is very rare that the court does not finalize or make a determination on a filing. occasionally the applicant no longer wishes to pursue the matter legally.
if they don't request a dismissal and abandon the claim generally after a time of inactivity on a litigation file, usually the carrier/employer asks for a dismissal.
if the action is dismissed, then the claim and all liens are also dismissed with no court decision/determination.

 
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#8
Makes me kind of wonder how many people get frustrated and walk away before its over . . .
 
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#9
That is what they want sometimes. They hope if they give you enough crap you will just put up with your pain and go away.
 
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#10
(03-28-2014, 07:03 PM)CaseyandMarie Wrote: Makes me kind of wonder how many people get frustrated and walk away before its over . . .

Try not to let this get to you. Please know the work comp process moves VERY slow, and sometimes takes a few years with a denied claim. It will be much better for you to be patient. Walking away only helps the insurance carrier.

I recommend to try and do other things to keep your mind off of this.

My opinion is if your claim stays denied, and is ruled by a judge that the injury is not work related, then nothing changes as far as state disability. There is nothing that you have to pay back to state disability when a claim is denied. They place a lien on their payments for you. If your claim is accepted, and an AME/QME states you should have been off of work during that period, the insurance company will then have to pay state disability back, as you should have been receiving TTD payments from workers compensation.

Before you sign your settlement ask your attorney to explain everything, and what amount of money will be paid to you AFTER all liens etc are paid (if you get a settlement, unknown).

Things you may lose if you walk away from your claim. PD payments, (if you get a rating that shows permanent disability). Possible C&R settlement money, if you are offered this to close out the medical in your claim, and agree to this. Future medical treatment for this injury, and further injuries relating to this which they pay 100% of not like private insurance. Reimbursement for mileage to and from doctors appointments (keep track of this and dates, doctors seen and round trip mileage, because if your claim is accepted, they will have to pay this money to you). I would also keep track of any out of pocket expenses like medication co-payments, etc for this injury, as that may also be reimbursed if the claim is proved work related, and those treatments are ruled by a judge to be reimbursed to you. If your injury flairs up and you need to be taken off of work, you can receive up to 104 weeks of TTD payments, as opposed to state disability which is only a year. You can also lose current job protections if you walk away from your claim, and need restrictions from your employer to work. The employer may try to fire you for some BS reason, and you will not fall under the protections of being an injured worker, and able to file 132a against them, if you no longer have a work comp claim.

One other thing I have read can happen if an injured worker is treated on a lien basis with a doctor and walks away from their work comp claim, the doctor, MRI facilities etc have requested reimbursement of ALL of their costs from the injured worker (rare but I have read about it).

Before you decide anything, I recommend discussing this with your attorney. If you are having difficulties with him not responding, I recommend making a face to face appointment, or phone appointment with him. Write down all your questions before hand. Try to be patient with your attorney, it may be very difficult to find another one with a denied claim. The number one reason injured workers fire their attorney is communication issues. This may be resolved making an appointment. I would discuss your concerns with him, but really, the state disability issue will only be determined IF you claim is deemed work related. Your claim is not at that point yet, so I would not be too concerned about state disability and your settlement at this point.
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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