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Broken Collarbone ... need advice...
Hi. Thanks for any help.

I'm writing for my husband...he's dyslexic. He was pinned between a wall and a truck at work on Feb. 8 this year. He's an auto mechanic. He's generally okay but his collarbone was broken. He heard alot of popping noises until he could turn his shoulders and get out from the truck and the wall, so I'm guessing that after he heals more he'll need some chiro adjusting.

We're new to workman's comp. The doc said he's off work for 6 weeks until she can check him again. She told us it would be 10 weeks until he can lift any weight over his head and 14 weeks until he was really healed. Alot of bruising showed up for days and now three weeks later it's starting to clear and the swelling in the arm/hand has gone down.

We belong to Prepaid Legal. But I wasn't going to call them until we started realizing that they could try and send him back to work unable to do his job and because he earns his $$ in "book hours" we could go down the tubes financially if he can't work his usual job. The man working for the firm handling the W/C told me that it was ok that they were paying my husband a little more than the 2/3 required here in IL and it "won't be an issue as long as you don't contact an attorney". Well I did call our Prepaid atty. recently and he told me about PPD. We didn't realize that was something we could have. Our Prepaid atty. isn't pushing us to sue and he gets no percentage if we get any settlement. But if we challenge the settlement they offer then Prepaid will farm us out to an atty. who will take a %.

Anyway... I told the man settling this for my husband's lg. national co. that I now know about the PPD. He acknowledged that my husband qualifies for it. He repeatedly suggested that we don't want to sue or have an atty.. He said that my husband can go back to work on "light duty" and that he would arrange for him to make his usual pay. Our Prepaid lawyer said that the # of weeks my husband stays out of work shouldn't affect the settlement because it's based more on the medical reports.

Our prepaid lawyer isn't too thrilled with the man handling our case. But he said that the 20% loss and the 50 weeks mentioned by the man was not unusual. The settler also mentioned $20,000. as a possible settlement.

We understand that my husband should wait and see how his injury heals. He can't shower alone or dress himself or pick up our four year old. He can't lift his injured arm/side very high. His fingers tingle sometimes.

We have a child with special needs and alot of medical expense. The $ my husband made at work barely kept us going. We were told today that we are responsible to pay our medical, dental, optical and life insurance premium portions. Even if we had my husband's old net income we couldn't afford to do that out of the net. But now that we take in less.... we certainly can't afford it. That is why he is considering going back to work to answer phones and help the mechanics verbally. My husband is the "go to" guy... the one with the experience and answers. We NEED health insur. for our medically fragile child. We NEED money to pay for his health issues at home. W/C pay isn't going to cut it.

Questions.... is it okay to go back to work on light duty? Is $20,000. an okay settlement if my husband's shoulder does heal well?

My husband does want to keep his job with this co. if possible. We were going to move for our child's health to a dryer climate and this co. would let him transfer once our home sells. Now things are on hold as he heals and we try to figure out W/C.

Thanks again!!! Smile DadToThree and his wife in IL
First of all, the injury is too new to even consider settlement!! I'm an ex-adjuster for an insurance carrier and I would never, ever even think about a settlement amount at this point. Your husband is only 20 days into this.

Prepaid legal has nothing to do with workers compensation. Also, I don't know what the law is in Illinois, but in here in Florida it is totally against all (adjuster, attorney, etc.) ethics to tell anyone that things will be OK as long as they don't get an attorney. Here in FL, you can NEVER, EVER, suggest to an injured worker that they shouldn't get an attorney.

Most WC attorneys will give you a free consultation and they only get paid if they get you benefits that have been denied you.

You don't always need an attorney if the insurance company is doing what they should. It's a little soon to say. Have they refused any treatment? Have they said that they are not paying for anything?
Unfortunately, sometimes when an attorney becomes involved when there are no real issues, it delays things. Reason being, some states, once you have an attorney, you can't communicate directly with your adjuster. Now you have to contact your attorney. Depending on his/her schedule, could take a few days. Then they contact the adjuster, who having 200 cases and calls on each of those, may not get back to the attorney for a few days. Attorney is not available, adjuster leaves a message.... , etc, etc, You see where this is going.

If you start having problems with getting treatment, getting paid, then you may consider getting an attorney. Right now, the injury is very new and other than you saying about the Prepaid Legal attorney, you haven't said that WC has denied anything.

As far as PPD, that is Permanent Partial Disability. That comes way after treatment. There is no way of determining a permanent amount of disability until AFTER treatment has been done. $20,000 for a settlement???? Who can say at this early point. It could be less if he heals well and has no further problems. It could also be much more if he has recurring problems. Again, WAY TOO SOON to even consider settlement.

Also, when they say you only get 2/3 pay, when you get paid your regular salary, they take out taxes. They do not take out taxes from WC payments so you are not really getting that much less.

There is also rules for how they determine your pay. based on prior earnings. You can look up the statutes on this site by going to the State info tab above. But if you have any specific questions, post them here and someone will try to help.

You said: Questions.... is it okay to go back to work on light duty? Only if the doctor says its OK.

Honey, it's only been 21 days according to the date of injury you posted. There are many people here that have had this ongoing for years. I only know the WC laws, but many here know some of the ways to get through this.

Hang on. I guarantee that there are people here who can help you with answers.
Hi Kate...

Thanks for the really good advice. Because of our circumstance with our youngest having Down Syndrome, a throat stenosis and vaccine damage that led to autism we are in a bind. I can't work outside the home right now. So that little bit of diff. in take home is hurting us. And now to have to pay for our insur. out of the W/C income... ouch!

You're right... the injury is so new. We're used to him getting hurt and usually working through it or getting back to work right away. But this time... he needs TLC and time.

He needs this job badly as I said before. We're very dependent right now unfortunately. If it turns out he has complications from this... I can see it stretching out. But if he heals pretty quickly and seems to get back to normal for the most part... he'll be wanting to just get back to work. But we don't want to be stupid and not get a settlement if that is due us in the W/C system. According to the people we talked with it is. You said it could be less or more than the figure mentioned to us. That makes sense.

The doc said no work for six weeks. We are the ones who just pushed for an earlier check so that perhaps he can go back to work "pushing papers". There's no way he can do his reg. job right now. But if he doesn't go back.... who will pay for our health insur. and the other insurances? Seriously... we can't afford that on his W/C takehome pay. We were already pushed to the limit. We don't do vacations, don't buy new cars, go to resale shops for clothes and we spend ALOT on our little guy with the health issues. My husband's not in great shape to stay home and take care of our youngest so that I can go out and work. His health issues are very complex. So what do we do? We're thinking pushing papers can at least get us a bit more income (that's what we were told... I'm hoping we're not messing ourselves up too bad by doing this) and also it makes it so that we only owe three weeks worth of insurance cost and that is still hundreds but maybe we can figure out how to swing that.

If the doc says no way.... then my hubby's stuck at home and we're stuck figuring a way to pay the insur. cost or we lose it?? That would be a mess especially the medical insur..

Anyway... I really appreciate your insight. We'll try to be patient and we're praying for healing. This looks like a good place to get answers.

W/C is paying us weekly and is covering all medical that pertains to the accident. The W/C pay is about $100 less a week than what my husband averaged net. When you don't make alot of $$ it makes a diff. as I'm sure you can understand.

DadToThree's wife, working on patience Smile
PS - it was the adjuster or whatever his title is from the co. handling the W/C for my husband's employer who suggested that a settlement could be in our hands in as little as ten weeks. I guess he's rushing it a bit. He said it's partly based on similar cases that have happened before. Is there some data base that gives the figures of settled cases? Thanks!
Believe me, I've been there. I won't go into detail about my problems because I want to stay as objective as I can.

If the doctor says he can go back "pushing papers" and the company will take him back doing that, by all means, he should do it. AS LONG AS THE DOCTOR SAYS HE CAN.

There needs to be communication between the docs and the employer. Sometimes the doctors don't know that an employer can take someone back in a different job while they are injured. Sometimes the employers are afraid to have anyone back if they are not 100%. This is what causes many of the problems. Talk t them.

I don't know anything about health issues for your little one but maybe someone here can give you some resources.
also make sure that the employer WILL take him back on light duty ok

Please make copies of everything and document what is said on phone calls to adjuster ....

Just to cover your butts

Does your state have any health programs for kids ... ??? try public health to get him covered
DadToThree Wrote:PS - it was the adjuster or whatever his title is from the co. handling the W/C for my husband's employer who suggested that a settlement could be in our hands in as little as ten weeks. I guess he's rushing it a bit. He said it's partly based on similar cases that have happened before. Is there some data base that gives the figures of settled cases? Thanks!

Every case is different. Age, Education, Past work experience, etc. Again, way too soon to even think settlement. I know that some insurance companies just want to get out ASAP.

21 days with his injury? I wouldn't even (as an adjuster for the insurance company!) consider that. Much less as the person who needs treatment. If you settle right now, you could get some much needed cash right away. However, what happens if your husbands injuries are worse than you thought? You've given up all future medical. Your health insurance may say that since he settled, they are not responsible.

Remember, the whole point of settlement is for FUTURE medicals and wage loss. You settle for $20,000 now and it turns out he needs $50,000 worth of medical, guess what? You're down $30,000. And that doesn't include the wages he loses while recovering from surgery.
I would check with his employer and see if he qualifies for FMLA, this will protect his job and health insurance for 12 weeks.
I agree with Kate and Tweety. It is only a few weeks into his injury. What if he needs surgery? If he needs therapy for his arm etc? I went to therapy for 7 months while i worked, 4 x's a week. I was on light duty for 2 months which only made my arm worse working with one hand. I eneded up with a frozen shoulder by protecting my hand/arm to much that i tightened up my shoulder.

My company i worked for paid for my insurance while i was out of work for 7 months. Told me that i would have to pay it back slowly when i returned to work, which i never ended up haveing to pay back when i returned. So check and see if his company is paying his insurance while he is out. There could be a way they pay it till he comes back to work and then take so much from his check weekly after to pay it back.

As far as settlement. He has to reach MMI which means the doctors did all they could to fix his injury and he is left to heal on his own, either with Permanent injury, or partial injury. He would then need to go for a PIR rating ( permanent impairment rating ) to see the loss he may have from his shoulder and get a percentage rating. I thought it would be simple to get, but when i got mine, my doctor gave me a great rating and now the ic is fighting it and got their lawyer involved and now sending me for a IME ( independent medical exam) to try to lower my rating.

Also i would not be so quick to settle, as others have said, he may need medical for the rest of his life from pain etc. I go to a pain clinic monthly and once i settle i need to find a GOOD doctor that will take care of my pain and find out what is wrong. Noone in the WC system would even do a MRI for me. Kept telling me it is not needed. I will have medical for life and NOT settle that part of my case.

I understand this is just the beginning for you and your family dealing with a injured member of the household. There is going to be alot of frustration, anger, and possibly bills pileing up. One thing you really need to remember, is to love this person who is injured, as it is also hard on him. He is the provider and this could get him very depressed and angry that this has happened to him. I have seen where others have said, cut back on the things you do not need. Try to make bills smaller if possible to get by. I wish i could say this will go quickly, but it does not. My injury has now been a year , and i am still fighting the wc system to settle. Hopefully after my IME in April i may reach the end of this terrible experience that i was thrown into.

I wish you and your family luck, and remember to stick together, and we are always here when you have questions, need to vent etc.

Best wishes, and welcome to the forum.
carpal tunnel recurrence/ neuropathy / RSD.
1/29/07 injury date. Permanent. PIR settlement 8/4/08 10%
One thing I can tell you is that I have broken both of my collarbones. Once when I was playing football and two years later when I got pinned between pallets with a forklift. After 3 or 4 months all pain was gone and I was back to my old self. So just tell him to do as his doc tells him even if he starts feeling better sooner.

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