Tennessee Worker's Compensation - Help For Injured Tennessee Workers

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  1. #1
    Join Date
    Jun 2007
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    92

    Question Tennessee Workplace Injury

    I have at the L3-L4 a small left foraminal and far lateral disc protrusion/herniation with mild to moderate left foraminal stenosis and at the L4-L5 there is a minor left foraminal disc protrusion/herniation with contact of the exiting left L4 nerve root and finally at the L5-S1 there is a tiny central disc protrusion/herniation withannular tear without significant copressive features. I really don't understand all this other than I have 3 herniated disc and a tear some place and something else to do with a nerve root. And I am screwed up and in pain.

    I m seeing a nerosurgeon Thur. After talking to some other that has been operated on and some that know's someone that been operated on and reading some of the posts on here. The don't do it over weighs the do it. Aounds like I will be in just as much pain if not more after the operation. Thats not goos So if I don't have the operation how will that effect my setlement. Will I be less / more or the same? then On top of it the employer is talking about letting me go cause the dont have light duty work.

    The labor workforce of tennessee want to be the mediator. Will the have my interest at heart or there's ?

  2. #2
    Join Date
    Mar 2007
    Location
    Georgia
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    1,930

    Default Re: tennessee injury

    Hey there Hunter, I am not sure how to answer the questions you asked but don't want you to feel igonred ... God knows you get enough of that from the IC's to last a life time.

    Concerning your surgery I have heard both sides and most definately the decision is up to you. The way I look at is if something causes loss of use do to paraylsis then I would. If it is a matter of putting up with the pain, that's what pain management docs are for. Bottom line it is a personal decision that only you can make.

    As far as the IC. Good question and the best way I know hao to answer it is talk to a WC specialist attorney in your area. You can also go to the TN WC web site and educate yourself about the various laws and rules. KNOWLEDGE IS POWER.

    http://www.state.tn.us/labor-wfd/wcomp.html

    Your employer would be smart to not terminate you because you filed for WC. It is illegal in all 50 states. The other side of that sword is they can legally terminate you in spite of your filing a WC claim. Just don't let yourself be suckered into going back light duty and having them drum up some half baked excuse to fire you as they can withhold TTD benefits from WC. The way that works is you were fired is why you don't have income, not that you were unable to work due to the injury. Be real cautious if they all of a sudden come up with light duty if they have already told you they don't have any work for you that accommodates your restictions.

    Have a good one and hopefully someone with more knowledge about TN WC laws will come along and answer your questions.

    Steel
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  3. #3
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: tennessee injury

    First off, let me say that I wish you my best for a speedy recovery. So you know, I am a Tennessee attorney specializing in workers' compensation claims, so I have seen countless claims with similar medical facts as yours.

    Let me try to briefly provide you with some information that might help your understanding of the medical side of things and the legal side.

    First, you have a diagnosis of a number of herniated discs (HNPs). Also, you have diagnosis of foraminal stenosis and an annular tear. Many of these conditions come through the normal aging process, but some are caused by injury, or can be made worse by injury.

    From your post, it sounds like the main culprit in your back pain is the L4-L5 level. There, you have an HNP that is touching your L4 nerve root. This is commonly known as sciatica. You will have back pain and numbness and radiating leg pain into your leg with this condition. The HNP could be caused by injury, and if there was no history of prior back pain problems, was most likely caused or made worse by the injury.

    The foraminal stenosis that you have at all levels is essentially degenerative. The foramen are the small holes in the spine through which nerves enter/exit. Over time, there is a build-up of bone spurs that causes these holes to get smaller. When the holes get smaller, they start to cause pinching of the nerves, which in turn can cause pain.

    An annular tear is harder to explain. The spinal discs are hard to describe, but they are circular, and have different levels, kind of like the rings of a tree. If you think of it that way, the "nucleus pulposis" is the center of the disc, with the annulus fibrosis being a tougher outer layer surrounding the nucleus.

    With a full herniated disc, essentially the whole piece of disc material has squeezed outside of the spinal column. With an annular tear, the outer most material of the disc has squeezed out and become torn.

    All of these conditions are treatable surgically, typically with at least a total or partial diskectomy (removal of the disc), and with surgery to re-open the holes (foramen) by removing the bone spurs. Recovery from surgery is lengthy, and you will be in pain for some time following. Surgery will most often (if successful) remove any radiating leg pain and numbness, but you will probably still have the generalized back pain (sore, stiff back).

    Getting surgery is a tough decision to make, and depends on how you feel generally about being operated upon. Don't make the decision on whether or not to have surgery based on your workers' comp benefits, though.

    As far as your employer firing you because they "don't have light duty," they can certainly do this. Tennessee is an employment at-will state; they can fire you for any reason or no reason. However, if they are firing you because you filed a WC claim, then you may have a right to sue them for retaliatory discharge.

    The TN Dept. of Labor is the agency assigned to handle mediations of workers' comp issues in the state. They are neutrals in the process, and don't give preference to either side. I've worked with TDOL offices across the state, and for the most part, they are capable professionals doing a commendable job in difficult situations.

    Once you have fully recovered from your injuries (with surgery or not), the doctors will place you at Maximum Medical Improvement (MMI). MMI means you have essentially gotten back to as good as you are going to be from this condition. It does not mean that you are healed, or can return to your former job. At that point, you can request a Benefit Review Conference to try to settle your WC claim. If you don't get to settlement, then you can then file a lawsuit.

    Given the complexity of your case and your medical condition, I would definitely recommend that you retain an attorney of your choosing. If you would like, depending on the area of the state in which you live, I can certainly recommend a number of my colleagues in those areas who can do an excellent job for you. If you want to send me a private message, I'll be happy to speak with you further.

    Again, I hope this information helps, and best of luck in your situation.

  4. #4
    Join Date
    Jun 2007
    Posts
    92

    Question Re: tennessee injury

    One of the questions I was trying to find out is if I dont have the surgery .Will that affect the settlement if any is offer. I do have a problem with surgery like someone would have a problem with heights.

  5. #5
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: tennessee injury

    Well, any settlement or trial judgment you might be entitled to will be based on the medical impairment rating that you would receive from your doctor.

    In the case of surgery for your back condition, as described, unless you have a lumbar fusion surgery (fusing two or three of the vertebrae together), your impairment is not likely to be significantly different with or without surgery.

    Your impairment could be as low as 5-8% as is, or if a diskectomy is done, it could go to between 10-13%. If you had a fusion, the rating is likely in the 20% range of permanent impairment.

    Any settlement you might receive is likely to be based on some multiplier of this impairment rating. If you are able to make a meaningful return to work, you can get up to 1.5 times the impairment rating. If not, you can get up to 6 times (though that is rare).

    The calculation of the actual dollars is just some algebra. You multiply your average weekly wage times 2/3 to get your workers' comp benefit rate ("comp rate"). This is the amount you should be getting on a weekly basis in TTD. You then multiply your comp rate times your medical impairment rating. Then, multiply that number times 400 weeks. All of those steps are the same in every case. Once you get to that number is where negotiation starts. You are essentially going to have a dispute with the insurance company about what multiplier you are entitled to receive, or that they'll agree to settle for. That number could be lower than 1.5, or it could come closer to 4. If you're unable to return to work, if you live in a favorable jurisdiction, you could see up to 4 times. To settle without going to trial, you probably won't get more than 3 times, and definitely won't get that much without a lawyer, because the IC just won't pay it without the threat of an actual lawsuit.

    Good luck.

  6. #6
    Join Date
    Jun 2007
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    92

    Default Re: tennessee injury

    It's would seem that the range of permanent impairment with or without a operation would be the same. It's likely that its just not going to go away either. I drive a truck for a living. I was told that they are thinking of letting me go. They told me they don't have light duty. Wouldn't restructions be the same a light duty? Right now I can't sit for long periods of time. That would put me out of the driving a truck. I have to see the nerosurgeron tomorrow. will he tell me my inpairment rate then? I read on this site that they use AMA guide book and for the back it was 20 - 23%.rating. As for my education I was in special ed most of my school years we didn't really learn much of anything just how to play games they took me out of that and put me into 6th grade. They just past me even if I faild. These day I have others help me with reading spelling math ect; so It's is hard for me to find jobs. Driving trucks has worked out the best for me. If I can't do it. Would they give me some kind of voc rehab. I am 50 years old and the job around here are very slim to none with my education.

  7. #7
    Join Date
    Jun 2007
    Posts
    92

    Default Re: tennessee injury

    I have been looking into lazer sugery on the back. Anyone know how thats worked out

  8. #8
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: tennessee injury

    Hunter,

    That 20-23% rating is only if you have a lumbar fusion done. You would be very hard pressed to find any doctor to give you a rating that high without having had a major surgery. If you don't have surgery, I'd suspect that the highest impairment rating you could get would be the 10-13% range.

    There is a procedure being done now called IDET that some claim helps with low back disc issues.

    Tennessee doesn't give injured workers vocational rehab benefits directly as part of the workers' comp process. There are other state agencies you can work with for those benefits, though.

    I will tell you this, given your age, your statements about your education, and the prospects for anatomic impairment rating that you have, you could possibly be entitled to Permanent and Total Disability benefits. This would provide you with weekly benefits until your age of eligibility for Social Security Old Age Benefits.

    That, however, is only likely to come after fighting tooth and nail all the way, and getting a good result at a trial.

  9. #9
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,930

    Default Re: tennessee injury

    Hunter what is your DOI, Date Of Injury? If this is a fairly new injury you are most likely jumping the gun way ahead of things. Impairment ratings and settlement talks should only happen once you reach MMI, Maximum Medical Improvement.

    Given your level of education, not having other significant employment history, and not being able to return to driving have you filed for SSDI, Social Security Disability Income? If not then you need to do that ASAP. It sometimes takes years to get approved if you qualify and filing early on protects your eligibility date. Not only this but if you wait to file say 2 years from now your SSDI award can be considerably less due to not having recent taxable income. Upon reaching retirement age these benefits automatically revert to SSOARB, Social Secuirty Old Age Retirement Benefits. As well if you get the SSDI approved and you are still on WC, Workers Compensation, SS will pay the difference of what WC pays you up to 80% or your previous wage. Don't let anyone talk you out of filing for SSDI now if there is any chance you won't be returning to your job in the near future. SSA also has help available for retraining but this is only offered to claimants after they are found to be disabled under SS guidelines and approved for award.

    Within your settlement WC will set up what is called a MSA, Medical Set Aside for future medical treatment from part of any settlement you agree on. Yes, the MSA reduces the cash settlement you get for immediate use but more importantly it protects your future medical needs.

    JLJ do you happen to also handle SSDI cases? Perhaps you can explain these things better to him than I can.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  10. #10
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: tennessee injury

    Well, I do handle SSDI claims as well, but the process is not as simple as state workers' comp. You are correct in saying that you should apply if there's any real prospect of you not being able to continue to work in your field. Given that it's truck driving, if your back does not improve, that may be tough. It's a basic fact that you'll get denied for SSDI probably multiple times before you might get it.

    But, I do want to clarify what an MSA is, and what it means. Actually, at this point, under the post July 1, 2004 TN Work Comp Act, I don't think it's really going to be necessary in a workers' comp claim settlement. The MSA, or Medicare Set-Aside, is essentially an agreement where the IC agrees to buy out your statutory rights to future medical treatment under workers' comp. The MSA is there to protect the employer/IC from Medicare.

    Medicare has what is called a "Secondary Payer Statute" that essentially says that if Medicare is forced to pay medical care for something that a secondary payer (for example, workers' comp) has a statutory or contract obligation to pay, then Medicare can sue that Secondary Payer for double the amount of medicals paid.

    Under the new amendments to the TN Work Comp Act, an employee can't agree to close his rights to future medical care for at least three years. With someone with a significant back injury, there's no way in the world I could see recommending that you close your meds anyway.

    Hope that helps a little.

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