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Oscar Calculator and IME
#1
Heres the short story
Back Injury, MRI's, Injections, Surgery, PT, no argument from WC or company
received 6 months of weekly checks then reached the point of no improvement
MRI's show extruded herniation, EMG test positive for nerve damage
My doctors state 60 permanent partial disability of 60% Ortho
and 35% Neuro.
Their IME states 7.5% ortho,No mention of Neuro in terms of percentage
but states there is some deficit and mentions the postive EMG for nerve damage

Are these % added together to get a 95% rating?
NJ Case OSCAR calculator says yes?

What happens when I have reports from both a Nero and Ortho
and their side only provides an ortho report?

How are such huge differences resolved?

 
Reply
#2
whether you have two separate ratings for separate conditions or the doctors are just breaking down the components of your overall 60% rating of a single condition is unclear from your post.
differences are negotiated or taken to the comp court for 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.
 
Reply
#3
hello I have a workers comp claim  for 3 different injuries in the state of nj. I have had 3 surgeries on my hand arm and shoulder. i have had mt ime with the ic drs and with iw drs. the iw drs gave me ratings of 50% total 45% hand 45%  and 20% hand and 15% arm and the ic drs gave me ratings of 5% total 31/2% for arm and 31/2% hand and 10% arm. how would they calculate my final disability ratings? all this is so confusing to me. I am on ssdi and no longer work. my claim was denied and has never paid wc benefits. can someone to help me to understand what is going on. thank you for your time
 
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#4
looks very complicated.
i would only trust someone that is very experienced using the program.
if you have an atty, I would leave it up to them.
your post is confusing as you only give ratings for hand and arm yet you indicate you injured your shoulder but give no shoulder rating.
it matters whether you are right or left handed and which was injured--- which you need to designate.
the insurance company doctor gave you 2 different ratings for your arm? and your doctor gave you 4 different ratings? very confusing as to which ratings were for what .......
generally you only have one claim per injury even though multiple body parts are affected; no separate claim or injury for each individual body part.
generally you would rate each set of medical opinions separately and negotiate a rating somewhere between them.
it matters whether you are right or left handed and which was injured--- which you need to designate.
the calculation different depending on your date of injury and wages.
if you don't have an atty, you should consider talking to one.

occasionally Bugman, an expert in New Jersey comp matters, stops by to help.
he may have a better answer for you.
or you can send him a private message from his profile page.

PS
you can try putting inputting each doctors hand and arm ratings here
https://courtsonline.dol.state.nj.us/Osc...Total.html
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
#5
(06-18-2016, 01:57 PM)angel1954 Wrote: Dear Angel,
 
I've seen this situation many times. First why was the claim denied?  If its due in any way to causation the easiest way for an EXPERIENCED WC Lawyer is to ask the court for a sec 20 settlement, however considering you have been approved for SSDI ( I assume for the injuries mentioned) Then the EXPERIENCED WC Lawyer should be motioning the courts for a total disability claim. This is easier if you had any pre existing condition(s) that if happened at work would give you at least a 1% rating then you can apply for the 2nd Injury Fund and most carriers prefer this as the State assumes the payments of disability of your ACE figure ( 70% of your best years wages earned) instead of the carrier being liable for it all.
 
This is just a breif summery of the 2 things that are most likely possible with your case, but considering all cases are based on its on merits I wou;ld need MUCH more information before I can explain to you what is happening.
 
More importantly time is wasting and there still maybe enough time to fix this if you had the right lawyer so tell me what you want to know what is happening or a referral to the right lawyer who will examine your claim with a fine tooth comb and give you your best options and while this is going on I can explain to you what lawyers are not permitted to tell you due to ethics law I KNOW personally not knowing is the worst feeling on Earth.
 
I see we can private message and that's the best way to send personal case info next to private email) UNLESS YOU ARE HILLARY CLINTON Smile so your employer/ carrier doesn't see you are seeking info and may be able you use your own statements against you.
 
BUG   


PS: While your waiting do your homework on the your lawyer  Google his name/Firm call the NJ BAR ASSO. they will tell you how long he has been in practice,any disaplinaries, he should be spotless,and area of expertise or specialty. Call your family lawyer and ask of him as all lawyers know of each other and their fields of expertise. Lets get this going what has taken you so long to contact us. i work several WC sites and I have not seen you on any????   

hello I have a workers comp claim  for 3 different injuries in the state of nj. I have had 3 surgeries on my hand arm and shoulder. i have had mt ime with the ic drs and with iw drs. the iw drs gave me ratings of 50% total 45% hand 45%  and 20% hand and 15% arm and the ic drs gave me ratings of 5% total 31/2% for arm and 31/2% hand and 10% arm. how would they calculate my final disability ratings? all this is so confusing to me. I am on ssdi and no longer work. my claim was denied and has never paid wc benefits. can someone to help me to understand what is going on. thank you for your time
 
Reply
#6
(06-18-2016, 03:47 PM)1171, In NJ The shoulder is considered the arm in Permanent partial Disability claims. Thanks for your support and referral. I am sure I can help Angel BUG  1171 Wrote: looks very complicated.
i would only trust someone that is very experienced using the program.
if you have an atty, I would leave it up to them.
your post is confusing as you only give ratings for hand and arm yet you indicate you injured your shoulder but give no shoulder rating.
it matters whether you are right or left handed and which was injured--- which you need to designate.
the insurance company doctor gave you 2 different ratings for your arm? and your doctor gave you 4 different ratings? very confusing as to which ratings were for what .......
generally you only have  one claim per injury even though multiple body parts are affected; no separate claim or injury for each individual body part.
generally you would rate each set of medical opinions separately and negotiate a rating somewhere between them.
it matters whether you are right or left handed and which was injured--- which you need to designate.
the calculation different depending on your date of injury and wages.
if you don't have an atty, you should consider talking to one.

occasionally Bugman, an expert in New Jersey comp matters, stops by to help.
he may have a better answer for you.
or you can send him a private message from his profile page.

PS
you can try putting inputting  each doctors hand and arm ratings here
https://courtsonline.dol.state.nj.us/Osc...Total.html
 
Reply
#7
(11-17-2014, 03:22 PM)Seen it ALL,   Now see it NJ style    Oscar is very complex and it adds up interest owed on permanent injuries etc and many function.  To answer your question No they do not add them all up as you put it, you may have mis understood what you were reading see, how complex Oscar can be,    what they do is during rotation your case is called up before the JUDGE and he asks where the lawyers are on your case, meaning they are negotiating a % of impairment based on what all the expert finding are. Your injuries are considered DDD Degenerative Disc Disorder. The carriers Dr will rate your Permanent Partial Disability or impairment very low most likely 5% then your lawyers Dr will rate your PPD at 60% which is certainly total disability range.   Did you file and win your total disability claim for SSDI? If so that will GREATLY help your case and if your lawyer is great he will be going for total disability and file an application for 2nd Injury Fund so you can collect your ACE till death if you remain disabled and unable to earn the wages of your ACE. SO TO DIRECTLY ANSWER YOUR QUESTION IS THEY ARE RESOLVED BY NEGOTIATION and if that fails there will be a hearing and the JUDGE will make a ruling but lawyers dont like this because many JUDGES feel this is a waste of their time unless there are true issues where both parties feel they are correct and that\s what a JUDGE is seated for besides his rulings are final but subjected to appeals which take several years longer to complete.  I Hope I have explained this well enough for you, if you have any other questions please feel free to return or write.  ALSO SEEN IT ALL, BUG      PS:  You are paid based on your ppd rating of your DDD which is a non-scheduled injury which is why you do not see any listing on the Dept of Labor  schedule of ratings chart for DDD Wrote: Heres the short story
Back Injury, MRI's, Injections, Surgery, PT, no argument from WC or company
received 6 months of weekly checks then reached the point of no improvement
MRI's show extruded herniation, EMG test positive for nerve damage
My doctors state 60 permanent partial disability of 60% Ortho
and 35% Neuro.
Their IME states 7.5% ortho,No mention of Neuro in terms of percentage
but states there is some deficit and mentions the postive EMG for nerve damage

Are these % added together to get a 95% rating?
NJ Case OSCAR calculator says yes?

What happens when I have reports from both a Nero and Ortho
and their side only provides an ortho report?

How are such huge differences resolved?
 
Reply
#8
Seen it ALL,
 
Now see it NJ style :(   Oscar is very complex and it adds up interest owed on permanent injuries etc and many function.  To answer your question No they do not add them all up as you put it, what they do is during rotation your case is called up before the JUDGE and he asks where the lawyers are on your case, meaning they are negotiating a % of impairment based on what all the expert finding are. Your injuries are considered DDD Degenerative Disc Disorder. The carriers Dr will rate your Permanent Partial Disability or impairment very low most likely 5% then your Dr will rate your PPD at 60% which is certainly total disability range Did you file and win your total disability claim for SSDI? If so that will GREATLY help your case and if your lawyer is great he will be going for total disability and file an application for 2nd Injury Fund so you can collect your ACE till death if you remain disabled and unable to earn the wages of your ACE. SO TO DIRECTLY ANSWER YOUR QUESTION IS THEY ARE RESOLVED BY NEGOTIATION and if that fails there will be a hearing and the JUDGE will make a ruling but lawyers dont like this because many JUDGES feel this is a waste of their time unless there are true issues where both parties feel they are correct and that's what a JUDGE is seated for besides his rulings are final but subjected to appeals which take several years longer to complete. 
 
I Hope I have explained this well enough for you, if you have any other questions please feel free to return or write. 
 
ALSO SEEN IT ALL,
[Image: 01]
BUG 
 
  
 
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