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1st offer / Lump sum settlement
#1
Smile 
Today I talked with my WC adjuster and received a letter from him by email that stated my permanent partial disability benefit entitlement is 440 weeks at the weekly rate of $311.55, for a total value of $137,082.00

I told the adjuster I would like to settle for a lump sum. He said the company might like to settle for a lump sum but it was very likely they would only offer 50% of the total value.

I don't think the $137,082.00 is fair as it is, but having to settle for half that is even worse. In fact that 50% would be less than a full years pay.

My question is, is this normal? Offering only half of what you are suppose to get? I am disabled for life and that's all I get?

A little additional info: I live in the state of New Mexico, my impairment rating is 41% and I had laminectomy surgery on three of my vertebra in the lumbar area.

Any information would be much appreciated.
 
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#2
its normal in negotiations to start at the extreme and work your way towards what's acceptable.
since you are not an experienced negotiator you should have an atty represent you.
you can also petition the court to order some or all paid early.
contact the ombudsman or complete the petition for early payment form here
http://www.workerscomp.state.nm.us/downl...ms_pdf.php


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
if you have a PD rating that comes out to $137,082.00, then they owe you the whole amount. when I was rated at 20% the sent all the money at once. When my rating was changed, they sent all the monies to make up the difference. They still owe me money, and have said, since my rating will be going up again, they will wait, and pay it all at once.

1171 knows far more than me, but I wouldn't take anything less than, ALL of it.

They may have the option of paying monthly, and I'm sure that is a decision only the company can make, but as far as settling for 1/2. NO WAY.

You can negotiate your FM, but as far as PD, there is a set amount for a rating, and I would not let the insurance company off for anything less. Have you read all the stuff ins. com. are doing to injured workers now?
 
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#4
Thanks for your replies. Here is what that letter said:

It is my responsibility to advise you have been placed at maximum medical improvement by Dr. Slaughter as of 3/17/15 and assigned a 6% impairment rating. As you have not been able to return to work as a result of your restrictions, you are also entitled to 35 modifier points, totaling 41% impairment; therefore, you will be entitled to Permanent Partial Disability benefits at the weekly rate of $311.55.

The impairment rating assigned is an unscheduled injury; therefore, you will be entitled to a total of 500 weeks of benefits minus the temporary total disability benefits you received while you were off of work. According to my calculations you received 50 weeks of temporary total disability benefits. There was also an overpayment on your file in the amount of $3,039.56 for benefits paid after you were placed at MMI during period 3/17/15 – 4/15/15. This overpayment is credited as 10 weeks of benefits at your permanent partial disability rate. Therefore your total permanent partial disability benefit entitlement is 440 weeks at the weekly rate of $311.55.


Your permanent compensation rate was calculated based on following:

$759.89 (maximum compensation rate) x 41% (impairment rating) = $311.55 (PPD comp rate)

Your remaining benefits will be placed on a repetitive payment schedule to be issued on a bi-weekly basis until your benefit exhaustion date of 8/22/2023. You will remain entitled to the 35 modifier points until such time that you are able to return to work earning your pre-injury wage. Should you return to work, your permanent partial disability benefits will be reduced to the 6% impairment rating only.

I have been talking with an attorney but was hoping I wasn't going to have to hire him. I just want to put this all behind me but not if I am going to get screwed over by getting only half of what is due to me.
 
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#5
You are talking about things I've never heard of. what state are you from? I have never heard of "modifier points"

(Your remaining benefits will be placed on a repetitive payment schedule to be issued on a bi-weekly basis until your benefit exhaustion date of 8/22/2023)

That's what I was talking about. They can choose to pay you in bi-weekly payment's, or all at once. It's up to them My claims adjuster contacted me and said my rating was 20$ and the would sent the check to cover the rating, which they did.

You are going to have to wait for someone who knows more than I know about the modifier, (which is nothing) Sorry I couldn't help you with that part.
 
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#6
I am in the state of New Mexico. They did tell me in the letter bi-weekly payments or I could get the lump sum if my employer agreed to give it to me and we can settle on an amount. If I take the bi-weekly payments I will get the whole $137k. If I want a lump sum the WC adjuster said the employer will most likely offer 50%.
 
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#7
I don't think it is up to the employer, I think this is between you and the ins. comp. They are the ones paying you.
 
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#8
Yeah, I think the WC adjuster is playing some kind of game. I told him he was the insurance company and my previous employer no longer has anything to do with me or the case. He said he was just acting as like a go between. I call BS. I don't what he is up to. Waiting to hear from a lawyer I have been talking with. I wish I could settle this without an attorney but you know how insurance companies are. They don't want to pay for anything.
 
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#9
you are not really negotiating for $137K.
the upfront (Present Value) value is closer to $107K.
what they are really negotiating is the chance of you returning to some employment and the PD dropping to only 6%.
they are not going to give you full value today and let you go back to full wages tomorrow.
the negotiations are to find a mid-ground that reflect the most likely possibility and it's value.
understanding that is the value of using an experienced atty.
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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#10
I must be missing something. the monies you are talking about are from a rating, not future medical. They owe you that amount regardless if you are talking today's monies or future monies. That is a conversion, that is used for future medical costs/monies. I've never heard of a rating going down. if they didn't agree to the rating, they should have challenged the doctor on that. Once accepted, they owe you that money. If they pay you, and next week you recover, they are sh##t out of luck. Both parties have to agree to the rating to settle. No different than you taken the money, then you get worse, you can't come back then and ask for more money, or a higher rating.

I would contact the CA, and ask that they pay whatever you feel you want. All they can say is no. They still have to pay you bi-monthly payments, till paid in full.

I don't know if you have medical set aside in NEW Mexico, but I would mention possibly selling out future medical while I was asking for the PD money, that may be enough incentive for them to consider your request. Just a bargaining tool.

 
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