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Looking for answers before I go insane!!
#1
Hello everyone!  I am new to these forums and I figured I could reach out to you all; some of whom I am sure have gone through or are still going through.

I have been dealing with the workers comp. system for four years now since my injury in 2012.  I have had surgery once and I have reached MMI.  The IME doctor was on my side with my treating doctor all three times I saw her.  I have since switched doctors to the IME doctor, because she wants to perform scar tissue removal.  I saw yet another IME doctor for this and their doctor again said I could move forward with the surgery if I chose to.  I have a 43% disability rating.  In the four years I have been dealing with this nightmare, my comp pay rate has dropped well over $200 and I do not know how much longer I can survive.  The insurance company has put me in this very bad neighborhood that I currently reside in and my children can not even go outside to play (that's how bad it is). I was making very good money at my job until this happened.  i have permanent work restrictions of no lifting over 20lbs, and sedentary light duty work only. I am working with the vocational rehab division of my state's workers compensation commission.  In the summer of 2015 well after my MMI status, I sent a demand letter to the insurance company, and here we are a year later and I have yet to receive any reply from them ( not even a counter offer or a 'no thank you').  I see or hear of people settling their cases all the time and I feel like I am going to get NOTHING!! When I should be getting EVERYTHING!!!  FOUR YEARS OF HELL! FOUR YEARS AND I MAKE LESS THAN A MCDONALD'S EMPLOYEE! NO SETTLEMENT OFFER AND WHY???  WHY WHY WHY?  WHY WOULDN'T THEY WANT TO CLOSE ME OUT???

Anyone who can help with some words of advice in what the next steps could possibly be for me would be great, as I know every case is different!

Sincerely,

A family man whose children deserve better than a crime ridden neighborhood and an apartment that has a miuse infestation! 

THIS IS ALL BECAUSE OF THE INSURANCE COMPANY...... ALL OF WHAT I AM GOING THROUGH IS BECAUSE OF THEM AND SOME OF MY TREATMENT IS BEING PAID FOR BY PUBLIC HEALTH INSURANCE BECAUSE THEY CRY LIKE BABIES TO NOT HAVE TO PAY FOR MY WORK RELATED INJURY TREATMENTS!
 
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#2
not sure if there is a real question in your rant or not.
but for the many that come here looking for help i'll assume yes.


one possibility:
the basic rule in negotiation is to reduce your opponents expectations. by not replying they have increased your eagerness for a settlement and probably significantly reduced the amount you are willing to accept. there could be many other reasons for the carrier behavior; no one can read the adjuster's mind and I certainly cannot speculate too accurately without knowing more about your claim.

you should retain legal representation by an experienced work comp atty. they probably have dealt with the carrier before and, after learning the details of your case, will be in the best position to obtain a settlement.

permanent partial disability payments are only meant to supplement your new employment for a limited period; they are not meant to be total disability or enough to live on. any settlement will only offer temporary relief, you need to return to employment within your restrictions.

for additional help contact your county social services; they have many programs to help those in economic hardship.
you can also contact your church or local fraternal organizations for temporary/emergency aid until you obtain employment.
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
(07-13-2016, 12:58 PM)1171 Wrote: not sure if there is a real question in your rant or not.
but for the many that come here looking for  help  i'll assume yes.


one possibility:
the basic rule in negotiation is to reduce your opponents expectations. by not replying they have increased your eagerness for a settlement and probably significantly reduced the amount you are willing to accept. there could be many other reasons for the carrier behavior; no one can read the adjuster's mind and I certainly cannot speculate too accurately without knowing more about your claim.

you should retain legal representation by an experienced work comp atty. they probably have dealt with the carrier before and, after learning the details of your case, will be in the best position to obtain a settlement.

permanent partial disability payments are only meant to supplement your new employment for a limited period; they are not meant to be total disability or enough to live on. any settlement will only offer temporary relief, you need to return to employment within your restrictions.

for additional help contact your county social services; they have many programs to  help those in economic hardship.
you can also contact your church or local fraternal organizations for temporary/emergency aid until you obtain employment.
I guess the question is this: How long is the wait usually when you're looking for a settlement with them? Knowing the possibility of a second surgery and possibly more after that? And their doctor stated in his IME report that I'd never return to pre-injury work again.
 
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#4
there are no statistics published on universal/general wait times for every one of the hundreds of thousands of comp claims in the US.
many workers have to change jobs; it's almost expected for any general laborer with a rating more then 15 or 20%.
some states may allow you to return to temporary disability status if you have another surgery.
your rating could increase if your condition is worse after more surgeries.
it may not be an advantage to settle your claim with such an unresolved medical outlook.
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
(07-13-2016, 10:56 AM)ftboy07 Wrote: Hello everyone!  I am new to these forums and I figured I could reach out to you all; some of whom I am sure have gone through or are still going through.

I have been dealing with the workers comp. system for four years now since my injury in 2012.  I have had surgery once and I have reached MMI.  The IME doctor was on my side with my treating doctor all three times I saw her.  I have since switched doctors to the IME doctor, because she wants to perform scar tissue removal.  I saw yet another IME doctor for this and their doctor again said I could move forward with the surgery if I chose to.  I have a 43% disability rating.  In the four years I have been dealing with this nightmare, my comp pay rate has dropped well over $200 and I do not know how much longer I can survive.  The insurance company has put me in this very bad neighborhood that I currently reside in and my children can not even go outside to play (that's how bad it is). I was making very good money at my job until this happened.  i have permanent work restrictions of no lifting over 20lbs, and sedentary light duty work only. I am working with the vocational rehab division of my state's workers compensation commission.  In the summer of 2015 well after my MMI status, I sent a demand letter to the insurance company, and here we are a year later and I have yet to receive any reply from them ( not even a counter offer or a 'no thank you').  I see or hear of people settling their cases all the time and I feel like I am going to get NOTHING!! When I should be getting EVERYTHING!!!  FOUR YEARS OF HELL! FOUR YEARS AND I MAKE LESS THAN A MCDONALD'S EMPLOYEE! NO SETTLEMENT OFFER AND WHY???  WHY WHY WHY?  WHY WOULDN'T THEY WANT TO CLOSE ME OUT???

Anyone who can help with some words of advice in what the next steps could possibly be for me would be great, as I know every case is different!

Sincerely,

A family man whose children deserve better than a crime ridden neighborhood and an apartment that has a miuse infestation! 

THIS IS ALL BECAUSE OF THE INSURANCE COMPANY...... ALL OF WHAT I AM GOING THROUGH IS BECAUSE OF THEM AND SOME OF MY TREATMENT IS BEING PAID FOR BY PUBLIC HEALTH INSURANCE BECAUSE THEY CRY LIKE BABIES TO NOT HAVE TO PAY FOR MY WORK RELATED INJURY TREATMENTS!
Do you have an attorney? If not I recommend getting one.

If you use state and other insurance to pay for your treatments, the work comp carrier may not have incentive to settle (JMO).

Every state has different laws, so it is difficult to know what state you are in by your post. I know in my state California, they do not always close out the claim. Most people do not get any type of large settlement in this system.

 I am so sorry about your children. If there is a way for you to get out of this system and return to a job that will not injure you, I recommend to do it.

You may qualify for additional assistance (outside of work comp) especially if you have children with low income, but would need your state to provide link.
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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#6
Hi. Thanks for replying. I am in Connecticut. And the only treatment the State medical pays for is my pain management because comp refuses to pay for it even though it is related directly to my work injury. I sent them a demand letter last year. No response from them. A coworker of mines settled last year with the same employer same insurance company.
 
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#7
(07-13-2016, 07:28 PM)ftboy07 Wrote: Hi. Thanks for replying. I am in Connecticut. And the only treatment the State medical pays for is my pain management because comp refuses to pay for it even though it is related directly to my work injury. I sent them a demand letter last year. No response from them. A coworker of mines settled last year with the same employer same insurance company.

 I recommend hiring an attorney who can get the ball rolling for you .In my state and I believe all states they get paid a % of your settlement so you do not have to pay them upfront. They may be ignoring you if you do not have an attorney.(unknown)

Good luck.
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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#8
(07-13-2016, 08:16 PM)California_Help Wrote:
(07-13-2016, 07:28 PM)ftboy07 Wrote: Hi. Thanks for replying. I am in Connecticut. And the only treatment the State medical pays for is my pain management because comp refuses to pay for it even though it is related directly to my work injury. I sent them a demand letter last year. No response from them. A coworker of mines settled last year with the same employer same insurance company.

 I recommend hiring an attorney who can get the ball rolling for you .In my state and I believe all states they get paid a % of your settlement so you do not have to pay them upfront. They may be ignoring you if you do not have an attorney.(unknown)

Good luck.
That's where it gets tricky. If they're not wanting to settle now , what lawyer would want to take on a case pretty much for free. There wouldn't be any money in to for them
 
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#9
I would not make a decision for an atty without talking to one; they are in a better position to make that 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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#10
listen sometimes its the lawyers who get it done I was offered 3,000 to settle I got a lawyer and it took another year but the wait was worth it. Does your wife work? sometimes that helps. good luck and come on over to the off topic side where we try and be a family laugh and joke and goof off in a safe place....Do be carefull there are a few Democrats on this forum but not many but it does give the rest of us some one to pick on...all in good fun you know
........I love cats, I just cant eat a whole one by myself......







 
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