[inpainallthetime]

ok this is my 1st time on this sooo her it goes.

I'm in Georgia. Injured both shoulders at work in 2006. Had a total of 4 surgeries 3 on right and 1 in the left. Still in pain and they think the pain is coming from my neck which I injured at the same time. In Ga they have a 400 week cap on weekly payment so that end in Oct 2013. However, they said I have an lump sum of impairment % $17,000+ owed to me. But my medical treatment settlement for my neck & shoulders for life is $40,000. Total of $57,000

My question is this: Do this amount sound fair? It sound to low to me. They know that I may need treatment / surgery for my neck?

Please help!

Thank you so much for your time.

How does the MSA (Medicare Set Aside) work with this. They stated I have sign something about not getting medicare or ssi????

[1171]

only you and your doctor can come up with an experienced guess as to what your future treatment will cost.
your disability is calculated on your impairment rating.
you don't have to do a lump sum settlement of your claim, you can agree to let the medical remain open.
here is some information about settlements in Georgia
http://sbwc.georgia.gov/settlement

[inpainallthetime]

I went to the site you sent me.... Thank you for that. However I'm still confused. What you are saying is I could take the impairment settlement of the $17,000+ and ask to keep the medical open? They said I can counter offer. By the way I do not have lawyer because they have always met all my requests for treatment. This is why I'm asking for help. I hate to ask for a lawyer at the end of this unless someone thinks I should get one to help.

(05-08-2014, 08:33 PM)1171 Wrote: only you and your doctor can come up with an experienced guess as to what your future treatment will cost.
your disability is calculated on your impairment rating.
you don't have to do a lump sum settlement of your claim, you can agree to let the medical remain open.
here is some information about settlements in Georgia
http://sbwc.georgia.gov/settlement

[1171]

yes.
you don't have to counter offer with more $$.
let them know you are afraid to guess wrong about your treatment $$ and be without coverage and would prefer if they continued to pay all the future medical.
if you keep pressing them for the open medical, they'll raise their offer.

look at item 16 page 3 from the settlement check list on the link I gave you
http://sbwc.georgia.gov/sites/sbwc.georg...gUsers.doc
have them stipulate to open medical.

you can also ask for a print out of the treatment they've already paid.
it'll give you an idea of how much things cost.
and do talk to your doctor about what you'll need and for how long.

[Manley2]

Your doctor would be a good source to get an idea of what your medical cost could be but remember it could go up. Also if you get a print out of what your costs have been so far remember this maybe at the cost this company paid and they got a discount for these treatment that if your paying on your own out of this money you might not get. For my medicine WC only pays 60% of what they would charge me if I was paying for this myself so for me this could make a big difference in the money I would spend. Now there is always a chance you can get a deal on your treatments so you don't spend as much but it's hard to say.
Bottom line is it's hard to figure out what a fair amount would be but as 1171 said if you keep pushing for open medical they will up their offer. Then it will be up to you to decide what you can live with

[inpainallthetime]

(05-09-2014, 09:14 AM)Manley2 Wrote: Your doctor would be a good source to get an idea of what your medical cost could be but remember it could go up. Also if you get a print out of what your costs have been so far remember this maybe at the cost this company paid and they got a discount for these treatment that if your paying on your own out of this money you might not get. For my medicine WC only pays 60% of what they would charge me if I was paying for this myself so for me this could make a big difference in the money I would spend. Now there is always a chance you can get a deal on your treatments so you don't spend as much but it's hard to say.
Bottom line is it's hard to figure out what a fair amount would be but as 1171 said if you keep pushing for open medical they will up their offer. Then it will be up to you to decide what you can live with

Thank you so much for your time. How does the MSA (Medicare Set Aside) work with this. They stated I have sign something about not getting medicare or ssi????

[inpainallthetime]

(05-09-2014, 01:56 AM)1171 Wrote: yes.
you don't have to counter offer with more $$.
let them know you are afraid to guess wrong about your treatment $$ and be without coverage and would prefer if they continued to pay all the future medical.
if you keep pressing them for the open medical, they'll raise their offer.

look at item 16 page 3 from the settlement check list on the link I gave you
http://sbwc.georgia.gov/sites/sbwc.georg...gUsers.doc
have them stipulate to open medical.

you can also ask for a print out of the treatment they've already paid.
it'll give you an idea of how much things cost.
and do talk to your doctor about what you'll need and for how long.

Ok I understand a little better.

Medical Benefits

15. _____Electronically file a recent medical report or summary from the ATP(s), not rehab personnel and not the entire medical file. [Rule 15(a)(6)] If the claimant has not received medical care recently, please indicate that to us in the body of the Agreement. Otherwise, we may contact you to ensure a more recent report has not been overlooked.

____If open medical is not a part of the Agreement, a rationale for
closing medical treatment must be provided. [Rule 15(b)(2)]

17. _____If a portion of the Settlement is based on the on-going medical needs of the claimant, ensure the claimant attorney’s fee is not taken as a percentage of money designated for the medical treatment or expense. [Rule 15 (e)]. Note, Board Rule 15(h) allows us to make informal inquiry regarding a Settlement.

18. _____Indicate that all authorized medical has been or will be paid up until
the date that the Stipulation is approved by the Board. [Rule 15(b)(2)]

19. _____If the Settlement includes an MSA, the Agreement shall contain a
provision as to the actual cost of the MSA. [Rule 15(d)]

20. _____The Stipulation shall not contain an indemnification clause that
shifts the risk of Medicare or other liens for medical treatment related to the
work injury from the employer/insurer to the claimant.