Hello There, Guest! Login Register
Index    |     Search    |     Members    |     Help

Thread Rating:
  • 1 Vote(s) - 2 Average
  • 1
  • 2
  • 3
  • 4
  • 5
Who's watching out for me?
#1
I will try to make this as simple as possible. I have concluded that all involved in my case are only watching out for themselves. Which I understand but who is watching out for me?
Im a 42 year old that tore my ACL last June 2017 while performing. (I'm an entertainer)
While diagnosing the ACL tear the Dr. also said that the meniscus was torn. But he could not distinguish if this injury happened at the same time of the ACL tear or not so the ACL tear was the only injury that was addressed and treated in the work comp claim. In December of 2017 I had surgery to replace my ACL, completely covered by my work comp insurance but while the surgeon was in there he also repaired the meniscus tear.

At my follow up visit with the surgeon told me that he had also taken care of the meniscus tear. He said and it is in the report that there was no lateral meniscus left after this surgery. (I have had three previous tears of the lateral meniscus. None of those tears were turned in to work comp but all operated on)
The Dr and report say that in the lateral meniscus area is now bone on bone. Which mean-less to say is extremely painful at the end of any active day. A pain that I was not dealing with before the surgery.
After several months of therapy for the ACL and released by the Dr. the work comp insurance company called me to settle. The adjuster told me the Dr. had given my knee a 10% rating. This only addressed the ACL tear.
The adjuster said that with the formula that it came to a little over $4,000. She said that the insurance company thought that I deserved a little more so she said they would instead offer me a little over $6,000.
I told her that I needed to think about it because I was suffering pain from the now "bone on bone" Status of the lateral meniscus area. She told me that they were only addressing the ACL tear.

Fast forward a month and she called back to see if I was ready to settle. I told her I was still concerned with my knee and that my Dr. said I was now a candidate for a partial knee replacement due to the bone on bone issue.
She said that was not their problem. Again they were only there for the ACL.
I asked why was the rest of the meniscus removed during the surgery if the work comp Dr. was only there for the ACL. Even though there was torn material in the meniscus cavity at least it was providing some pading and now I have none.
The adjuster came back with an offer of $9,600. and the insurer was anxious to settle.

I have talked to a few attorneys and they say I need to get representation to get a bigger settlement to cover my inevitable knee replacement.
I have been putting everything off because I feel like everyone's watching out for there own a$$ and not mine.
A couple of days ago I received a "Request For A Conference" letter from the insurer's attorney.
So that is where Im at. Any help or advice on what this means or what I should do from here. Also any questions I can answer to help please ask.

Update:
I have found in the Dr's notes where he says that the meniscus tear that was discovered in the same MRI scan that found the ACL tear was in his opinion was a "chronic condition"
Can a meniscus tear be a "chronic Condition"?
His reasoning is because I had torn it twice before. Both times were caused by trauma/hit to the knee. But he said this new meniscus tear was due to a "Chronic Condition"

I have already spoken to three different attorney's.
All were eager to take my case. All telling me that they believe they can get me a much larger settlement.

What happens if I go back to the work comp insurance company and tell them that I do not have an attorney at this point and like them would like to get this settled so all parties involved can move on before it gets more complicated.
That being said I do think that your offer of $9,600 is low considering the knee issues I am continuing to have and inevitable surgery in the future. I am not trying to get rich but want to settle for a little more to help with my out of pocket expenses for my upcoming partial knee replacement. I would happily settle for something between $15,000 and $20,000.

What do you all think of this approach?

Also I was told by one attorney that if I settle as is with the work comp insurer and go for the partial knee replacement form my normal insurance group they could deny it. Saying it was because of the work comp injury and they should have taken care of it.

All thoughts are greatly appreciated.
Thanks
 
Reply
#2
what state?
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
Missouri
 
Reply
#4
seek treatment thru your other insurance now. the results will help you decide how to handle your comp issue.
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
duplicate
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
  


Forum Jump:


Browsing: 1 Guest(s)