Impairment Ratings and Settlement Amounts

[bladesmith]

I'm blonde and male, so I get confused easily. When it comes to work comp, it's even worse.

I have my MMI's one at 4% for chronic pain induced depression, and 16% for my back, post laminectomy syndrome, they call it.

The insuance carrier wants to settle, we've consulted an atty and know what amount they have to spend and what a fair settlement should be.

What I want to know is this: How does my impairment rating "rank" for lack of a better word as it pertains to SS disability, and how does it rank as far as a settlement?

Any info would be greatly appriciated.

[aj]

You have not provided enough informaton to address either of these issues. Settlements are based on the future medical as well as indemntiy exposure. From an SSDI standpoint your age and employment history is also taken into consideration.

[bladesmith]

Erm...ok what info would you need? Also, the insurance company has informed us that we are the ones who should first suggest an amount to settle, not them. The rep also said she wasn't sure if future medical and lost wages are covered. any input on that?

[aj]

The carrier is always going to ask you to provide a demand first. That way they have an idea as to what you are looking for an determine if there are even interested. Are they denying the future wages and medical? What is there reason for saying this may not be covered?

[bladesmith]

The case manager (number seen in a series, and so far the only one to show an iota of intellect) is now saying she doesn't know if they are responsible for lost earnings and future medical/medication. Which is odd since she's been very knowlegable until discovering my wife is in the insurance biz. We're noticing a lot of backpeddling and "I don't knows" now that its settlement time. Which is something they suggested not I.

Now we've already established via an atty we have standing by what a fair settlement would be. Anything lower, according to the lawyer would lowballing us and an unfair settlement. She suggested 240,000 as a fair settlement, and yes, they are responsible for future earnings and medical. We were thinking of an initial demand for 3-400,000, to allow for dickering and wiggle room, but we aren't sure. We certainly aren't trying to screew the system or get rich, but I'm 44 years old this june, and I have a family to provide for. If this is all the money I will be earning for the rest of my life, exceting SS disability, we need to make it count.

What say you?

[my2cents]

Are you using a work comp attorney? $240K seems way too high for such ratings; this is not negligence law. Unless there are significant medical issues I think your attorney is painting an unrealistic picture. Is there a real liklihood that the carrier will pay that much in benefits if the case doesn't settle?

[bladesmith]

She is a work comp and disability atty. She broke it all down into what they have for care, what they've spent, what remains to be covered, etc etc. I dunno, inability to walk far, sleep, function, and mobility impairment, coupled with constant unyielding pain seems like signifigant medical issues to me, but I've been hurting for 3 years now.

[sh]

Good. If she's done a lot of these then she knows how the comp board will rule if you have to go to court to get benefits.
Medical issues are one thing; ratings are another. Sounds like most of the settlement $$ will be medical.

[aj]

I am not sure what type of indemnity benefits there are currently paying you but the numbers being mentioned here are permanent total type dollars. How much is the carrier spending in medical a month including prescriptions? If you are looking at permanent total numbers the carrier will do a present day value report based on your life expectancy. They may also look at a structured settlement. You have mentioned ssdi. If this is in the picture then a Medicare Set Aside will need to be done with the dollars you are talking. If you are receiving a lot of rx a month then this will come back high and could cause the carrier to back off of settling.

[bladesmith]

Well SSDI isn't in the picture yet, they are reviewing my application.

But as far as meds go, it's between 800 to 1000 dollars a month. Some of this stuff ain't cheap.