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SETTLEMENT wo attorney
#1
I have a spine injury, 360 spine fusion approved, discectomy approved.

Defense offered to settle. I said I'm interested and we are actively engaged in negotiating a settlement. But they keep asking if I scheduled the surgery. Why do they keep asking if I scheduled the surgery while we are negotiating settlement?

2nd issue, I had a minor car accident 3 months after work injury. PI attorney is handling that case & he requested settlement for the 360 spine fusion.  Should I tell the PI attorney to withdraw settlement with 360 fusion since my fusion is approved through WC?
DA wants all details of the PI case. He asked if there's a settlement & if there's a civil case filed?

What should I do with my PI case?  Since defense is wanting to settle.

What dollar value should I be looking at for future medical since surgeries are approved?

I appreciated your help!
 
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#2
Claim can,t be finalized until you are at Maximum Medical Improvement.
It,s approved today but no guarentees about tomorrow. Keep your atty advised of your claims status.
Have comp atty contact your P I atty
There Is no set figure. Medical costs vary by location, Doctor, patient condition.
Will they be successful? Have to be redone? Will you be worse off?
Will you need more or less treatment afterward? Talk to your doctor.
How much is your PI including for the surgeries?
http://truecostofhealthcare.net/#
http://clearhealthcosts.com/
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
(05-27-2016, 03:41 AM)CA spine injury 1256 Wrote: I have a spine injury, 360 spine fusion approved, discectomy approved.

Defense offered to settle. I said I'm interested and we are actively engaged in negotiating a settlement. But they keep asking if I scheduled the surgery. Why do they keep asking if I scheduled the surgery while we are negotiating settlement?

2nd issue, I had a minor car accident 3 months after work injury. PI attorney is handling that case & he requested settlement for the 360 spine fusion.  Should I tell the PI attorney to withdraw settlement with 360 fusion since my fusion is approved through WC?
DA wants all details of the PI case. He asked if there's a settlement & if there's a civil case filed?

What should I do with my PI case?  Since defense is wanting to settle.

What dollar value should I be looking at for future medical since surgeries are approved?

I appreciated your help!

They are asking this because they may offer to close your claim by a C&R and this will be different if you go ahead with the surgery.

I agree with 1171 and both of your attorney's (work comp and civil) should be forthcoming with all information to each other. Something does not sound right with both your car accident attorney and work comp attorney stating they/defense will cover cost of fusion. Is this correct?

  I recommend getting a second opinion from a neurosurgeon who specializes in spine surgery (not brain) and google your doctors.
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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#4
Simple.... DON'T DO IT. you'll get ripped off with an attorney sure but what the Insurance Company SHARKS will do to you without an attorney will not be pretty.. Hell!! Truth Time; IT WILL END IN TEARS!!
Sad  CDC Guideline 2016 Prescribing Opioids for Chronic Pain will be the death of me.
[url=http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm]http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm[/url]
 
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#5
The claim you are expecting can vary based on your medical insurance. The personal injury attorney can help you in recovering the medical cost of your surgery.
 
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#6
Think he posted he didn't have a WC lawyer. Maybe I'm wrong. You are right in something doesn't sound right. PI attorney maybe trying to settle and get out before the WC case screws everything up. If you have an surgery that is because of both the work injury and an accident then both are not going to pay and this maybe why you PI attorney is trying to get some money before it gets screwed up. I don't understand CA WC rules so listen to what 1171 and some others that know the rules out there. Just remember lawyer are suppose to be there to help you but some only are looking for a payday and may not be looking out for you in the long haul. Settling before you are at MMI is not a good idea
 
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#7
(07-30-2016, 11:19 AM)Manley2 Wrote: Think he posted he didn't have a WC lawyer. Maybe I'm wrong. You are right in something doesn't sound right. PI attorney maybe trying to settle and get out before the WC case screws everything up. If you have an surgery that is because of both the work injury and an accident then both are not going to pay and this  maybe why you PI attorney is trying to get some money before it gets screwed up. I don't understand CA WC rules so listen to what 1171 and some others that know the rules out there. Just remember lawyer are suppose to be there to help you but some only are looking for a payday and may not be looking out for you in the long haul. Settling before you are at MMI is not a good idea

Too, much to go over in a paragraph, at some point you should get any settlement approved by a professional before signing.. Even if you have to pay for the attorneys time. If they miss something you can sue the attorney for misconduct as well as the insurance company for fraud. Always cover as mush as you can.
Sad  CDC Guideline 2016 Prescribing Opioids for Chronic Pain will be the death of me.
[url=http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm]http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm[/url]
 
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#8
(05-27-2016, 09:45 AM)I do NOT have an attorney. Defense is only offering 50K for WC injury. The area I am in is Los Angeles area, the doctor that was suppose to do my surgery "lumbar spine fusion 360 degree and remove and replace disc"(approved by Ins. Co.) was using non surgical grade materials as explained by DA\s office. This doctor is no longer a consideration for my surgery. I am battling the Ins. Co. myself and I will continue to be relentless in my pursuit for justice. Most people I speak to say the 50k number is to low, what numbers should I be expecting to settle. What about putting surgery as future medical? I do have additional injuries, maybe we can communicate offline also???1171, are you located in California?I will also check your websites provided, thank you!1171 Wrote: Claim can,t be finalized until you are at Maximum Medical Improvement.
It,s approved today but no guarentees about tomorrow. Keep your atty advised of your claims status.
Have comp atty contact your P I atty
There Is no set figure. Medical costs vary by location, Doctor, patient condition.
Will they be successful? Have to be redone? Will you be worse off?
Will you need more or less treatment afterward? Talk to your doctor.
How much is your PI including for the surgeries?
http://truecostofhealthcare.net/#
http://clearhealthcosts.com/
 
Reply
#9
(09-09-2016, 07:39 PM)CA spine injury 1256 Wrote:
(05-27-2016, 09:45 AM)I do NOT have an attorney. Defense is only offering 50K for WC injury. The area I am in is Los Angeles area, the doctor that was suppose to do my surgery "lumbar spine fusion 360 degree and remove and replace disc"(approved by Ins. Co.) was using non surgical grade materials as explained by DA\s office. This doctor is no longer a consideration for my surgery. I am battling the Ins. Co. myself and I will continue to be relentless in my pursuit for justice. Most people I speak to say the 50k number is to low, what numbers should I be expecting to settle. What about putting surgery as future medical? I   do have additional injuries, maybe we can communicate offline also???1171, are you located in California?I will also check your websites provided, thank you!1171 Wrote: Claim can,t be finalized until you are at Maximum Medical Improvement.
It,s approved today but no guarentees about tomorrow. Keep your atty advised of your claims status.
Have comp atty contact your P I atty
There Is no set figure. Medical costs vary by location, Doctor, patient condition.
Will they be successful? Have to be redone? Will you be worse off?
Will you need more or less treatment afterward? Talk to your doctor.
How much is your PI including for the surgeries?
http://truecostofhealthcare.net/#
http://clearhealthcosts.com/

If they state you may need surgery as future medical does not mean you will get it. Everything in the California work comp system has to be approved by your claims adjuster or go through utilization review, even if it was mentioned in settlement with future medical. Many patients are being duped into believing what their QME wrote or doctor wrote as future medical means they will automatically be given the procedure or medication.

With your injury and complex case I recommend hiring a work comp attorney. There are many ways you can get screwed by a savvy defense attorney.

FYI just because a work comp doctor in LA has stated you need a fusion does not always mean you need such an evasive surgery. I recommend getting a second opinion. You may need this surgery but it is always good to get a few other opinions.Be careful.
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.
 
Reply
#10
(09-09-2016, 07:39 PM)CA spine injury 1256 Wrote:
(05-27-2016, 09:45 AM)I do NOT have an attorney. Defense is only offering 50K for WC injury. The area I am in is Los Angeles area, the doctor that was suppose to do my
 surgery "lumbar spine fusion 360 degree and remove and replace disc"(approved by Ins. Co.) was using non surgical grade materials as explained by
 DA\s office. This doctor is no longer a consideration for my surgery. I am battling the Ins. Co. myself and I will continue to be relentless in my pursuit
 for justice. Most people I speak to say the 50k number is to low, what numbers should I be expecting to settle. What about putting surgery as future 
medical? I   do have additional injuries, maybe we can communicate offline also???1171, are you located in California?I will also check your websites 
provided, thank you!1171 Wrote:
if you need very specific help on a continuing basis you should get an atty. they know the judges in your board and how the different carriers behave.
you do not have to agree to a lump sum buyout. you can get periodic permanent disability payments and open medical.
that way you won't get less $$ then you deserve.
without a rating no one can guess how much disability you are entitled to let alone how much damage was done by the second injury.
the comp judge has to approve any agreement to make sure the numbers are according to law and supported by the medical record especially when the injured is unrepresented.
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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