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Settlement Questions- Michigan
#1
Ok. Long story short(most likely not short as I ramble and here is a perfect example of why it won't be short)

I hurt myself this last summer at work. Pretty serious sprain injury to the ankle that tore a bunch of tendons and ligaments. Obviously my work fought me on this and tried down playing it until I FORCED them to schedule me an MRI for the ankle. Come to find out I need surgery to fix it, and then I MIGHT be able to go back to work... Surgery is scheduled for a few weeks out from this point, at which point work comp notifies me that they are not denying my claim, but it hasnt been approved.

I get a lawyer, this is in August '19, he says based on info I gave him I have a very strong case. I go to the work comp IME doctor in september, but never get the results. Neither does my lawyer.

Mind you I have been taken off work as I cannot drive and there is no public transportation and I live 50 miles from my place of employment.

I had to meet with an investigator for the insurance company who interviewed me and the witnesses from work. Everyone verified my story of what happened, but work comp still "denies" my claim(I say "denies" because they havent approved or denied but come on, it's been 3 months at this point)

My lawyer gets me in with a "truly" independent IME, who says 100% my injury is work related. Come to find out, the very next day my report from that first IME (3 months prior, AND remember it was the IME that work comp chose) came in the mail at my lawyers and he told me it ALSO is in my favor, that his findings were that my injury was work related.

So at this point, I have 2 IME reports that are in my favor, as well as a investigation done where the witness all corroborated my story.


We have a court date in a few days where he is going to ask for a trial date as we are ready to proceed. He said he fully expects them to come forward with settlement offers between now and then. When I asked him what we could expect, he told me we are requesting my back pay + 5 years wages as I have only ever worked manufacturing and due to my injury I will most likely not be able to be in a standing position longer than an hour at a time so I cannot go back to my previous field.

I know Michigan work comp pays 2/3 of your pretax wages, will that apply to the settlement as well? Or if it goes to trial and we win, will it apply there or how is an offer calculated?

I am extremely confident with my case, and my lawyer is too. I am confident in his abilities, but he is a little bit "standoffish" is not exactly the right word but he could be more people friendly. So getting information out of him can be difficult at times.

Also, sidebar, but I don't for the LIFE OF ME get why this has been such a hassle. Why does work comp have to fight so hard on this when it should be a clear cut and dry case...

Anyways, any help on how settlements? Say they go "your 5 years of wages are calculated at $XXX,XXX" do they pay that, or 2/3 of that?
 
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#2
What about treatment?
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
(01-06-2020, 11:26 PM)1171 Wrote: What about treatment?

Only treatment available is surgery to reconnect the ligaments and tendons, however that itself presents me with a set of possible risks, such as completely paralyzing my foot. As of now I am in a custom molded leather Arizona brace. I have yet to decide if I am going to take the risk of surgery...
 
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#4
Are you just cashing out your disability or all benefits including treatment
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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#5
(01-07-2020, 08:01 PM)1171 Wrote: Are you just cashing out your disability or all benefits including treatment

Sorry for the delayed response. I had a lot of personal stuff come up recently and until just a few moments ago I honestly forgot I even had a thread going on in here.

We are going to be cashing out on everything, including treatment. I did end up speaking with my attorney and he told me they calculate it based on the 2/3 work comp rate. We are asking for 5 years of wages, plus ?fringe? benefits, and medical payout. Everything seems rather straight forward, and I have been able to provide myself with a rough estimate of what we are hoping for, however I am unsure on the fringe part. I understand that is along the lines of vision, dental, 401K, insurance, etc... How are those calculated? My lawyer has a meeting set with me in about a month, and until then I am trying to now figure out more information on fringe benefits as they pertain to my settlement.

If it helps I was getting:
Vision for myself and spouse
Dental for myself and spouse
Life insurance on myself, spouse, and 2 children
401K (contributing at 5% with employer matching at 4%)
Long Term Disability
Accident Insurance
 
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#6
If you are unable to work due to your injury and your LTD policy covers injuries at work, I recommend applying.
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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#7
A settlement is a negotiation so what you ask for and what is finally agreed on are different. You are already aware of how difficult the carrier can be.
“Generally you should receive 80% of the after-tax value of your AWW. the value of discontinued fringe benefits such as the cost of health insurance, employer contributions to a pension plan, and vacation and holiday pay can be included in determining the AWW.
The law provides that the maximum rate of benefits is 90 percent of the state average weekly wage for the year prior to the injury. In 2018 it was $999.31. A worker cannot receive benefits higher than this amount regardless of how high his or her earnings might have been.”
If you hit the maximum, then the calculation is relatively easy.
Your atty should advise you to what extent treatment dollars are included.
If Social Security or SSDI is involved, separate calculations have to account for an offset.
Settlements are complicated and customized for every individual so there is very little that can be predicted
or calculated. Its often best to approach it without a single fixed amount but rather a high-low range.
What you hope for and what you,d rather risk a trial. Your atty can help set that range. BE aware that attys are highly motivated to settle and avoid a trial. If you and your atty disagree on the final arrangement, you should consider talking to other attys and switching if necessary.
Hope it turns out well.
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
#8
(01-19-2020, 09:19 PM)1171 Wrote: A settlement is a negotiation so what you ask for and what is finally agreed on are different. You are already aware of how difficult the carrier can be.
“Generally you should receive 80% of the after-tax value of your AWW. the value of discontinued fringe benefits such as the cost of health insurance, employer contributions to a pension plan, and vacation and holiday pay can be included in determining the AWW.
The law provides that the maximum rate of benefits is 90 percent of the state average weekly wage for the year prior to the injury. In 2018 it was $999.31. A worker cannot receive benefits higher than this amount regardless of how high his or her earnings might have been.”
If you hit the maximum, then the calculation is relatively easy.
Your atty should advise you to what extent treatment dollars are included.
If Social Security or SSDI is involved, separate calculations have to account for an offset.
Settlements are complicated and customized for every individual so there is very little that can be predicted
or calculated. Its often best to approach it without a single fixed amount but rather a high-low range.
What you hope for and what you,d rather risk a trial. Your atty can help set that range. BE aware that attys are highly motivated to settle and avoid a trial. If you and your atty disagree on the final arrangement, you should consider talking to other attys and switching if necessary.
Hope it turns out well.

I just want to say I TRULY appreciate your input. I am confident in my attorney, who told me, along with his junior partner, that they will present me with the settlement offer and negotiate, but if I am not happy with it they are 100% prepared to take it to trial, fully my decision.

After some more research, I see Michigan allows for 2 years of Vocational Rehabilitation, up to and including tuition reimbursement. Since I am probably never going to be able to return to my previous field, we should be pushing for that as well, correct?

One final question(at the moment at least) my doctor took me off driving. I cannot drive with my right foot, and we only have a small sedan(i am a big guy) so there is not enough room for me to drive with my left foot. Can I ask for the cost of a vehicle that either has hand controls or a bigger vehicle that I can use my left foot with?

Thank you again for you help
 
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#9
You can’t settle everything and have them keep the case open for vocational rehabilitation.they are looking for a bottom line cost to close all their liability.
You might be able to have them put some more $$ in the pot for rehabilitation help.
As far as driving goes, i would suggest getting an evaluation for assistive controls. A professional will make recommendations and provide a cost analysis. Again how much if any they’ll kick in for that is upto negotiations.
If you haven,t already you should review the information on the states website and keep a record of your question so your time with your atty will be as efficient ad possible.
https://www.michigan.gov/leo/0,5863,7-33...--,00.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
#10
(01-20-2020, 08:52 PM)1171 Wrote: You can’t settle everything and have them keep the case open for vocational rehabilitation.they are looking for a bottom line cost to close all their liability.
You might be able to have them put some more $$ in the pot for rehabilitation help.
As far as driving goes, i would suggest getting an evaluation for assistive controls. A professional will make recommendations and provide a cost analysis. Again how much if any they’ll kick in for that is upto negotiations.
If you haven,t already you should review the information on the states website and keep a record of your question so your time with your atty will be as efficient ad possible.
https://www.michigan.gov/leo/0,5863,7-33...--,00.html

I just got a letter from my attorney that we have a trial date coming up soon, about 60 days out(not giving exact date to remain anonymous, well, at least as anonymous as possible)

I am surprised by this, as everything I see online shows that normally a trial date doesn't happen until 2 years after the case is first filed... I am confused why this is moving so fast. Don't get me wrong, I am happy with it, just unsure why it got pushed along so fast...

Anyways, with a trial date looming, I wanted to make sure I am doing my job logs correct. Every day I call a different business that is within a reasonable distance of my house(I am going with a 50 mile radius in all directions?) and I ask if they are hiring for any clerical, entry level office type positions. So far everyone has told me no, and I call back a few weeks later to double check.

I have just started applying online to positions as well, but wanted to get advice or reassurance I am doing this correctly. Thanks!
 
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