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  1. #1
    Join Date
    Aug 2007
    Posts
    16

    Default What Settlement Will They Offer?

    Hi,
    Injured at work (fall) in July 2006. Back, neck and right arm. 2 surgery's for rotator cuff and tendon repair. Lots of therapy for degenerative disc disease and bulged discs. The bottom line is I can't lift my arm over my waist or behind my back and lots of pain in my neck and low back. The doctor treating my back has released me with a 15lb lifting restriction (ha! Can hardly lift 5 lbs) and a 5 percent whole body disability rating and the arm doctor gave me a 6 percent right shoulder rating and a 4 percent whole body rating with a over the head restriction for my right arm. I have decided not to go back to work (retail store) because I am 63 in Oct. and I know I can't stand for 8 hrs anymore and can't do the stocking work required. I live in tennessee. Can anyone venture a quess at what they might offer me in a settlement? I certaintly can't figure it out.

    DS

  2. #2
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: How do you figure this out?

    Doni, welcome to the forum. Shew that is a bucket load your have going on there. I will leave the particulars up to the resident expert, JLJ is a TN attorney that drops in from time to time he would be an excellent source. I defer simply due to the complex way that TN figures PPD with all the multipliers and all, I get throughly LOST real fast. Others besides JLJ may dare to tackle it but I'll just have to serve as the welcoming committee. Sure as I tried to do all the cyphering I'd make a big old mess out of it. Hang around and hopefully someone who understands the multipliers and all will drop by soon and can give you a good answer.

    Take Care,

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


    Take Care and Be Well.

  3. #3
    Join Date
    Aug 2007
    Posts
    16

    Default Re: How do you figure this out?

    Thanks Steel,
    I forgot to add that they paid me 178. a week when they paid me. Does the fact that I have decided not to return to work (I tried and was in so much pain I had to have my husband have someone drive him to my job and drive my car home) have any bearing on this. I am uncomfortable driving with a right arm that does not work properly, however both doctors released me to go back to this job. I know no
    one cares about pain so I have just had to decide what is best for me at this point in my life. TN law and my workers comp rep states that they must make me an offer in 30 days. Not expecting much.
    Doni

  4. #4
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: How do you figure this out?

    OK Doni, if you "PROMISE" not to hold me to it I will give it a stab. I do need just a bit more information.

    1) Do you have a High School Diploma or GED? Do you have reading and writing skills at least equal to 8th grade education?

    2) You are age 55 or over as you say your are 63 yrs old correct?

    3) Do yo have any reasonably transferable job skills from a previous vocational background or training?

    4) Is the reasonable employment opportunities in your local area that you could work at considering your permanent medical condition?

    5) Do you have an attorney? IF not WHY?

    6) Have you used the services of a WC specialist through the Board of Work Comp? IF not WHY?

    7) Do you THINK that your authorized treating physician'(s) gave you a fair evaluation as far as there assessment of your ability to return to your previous employment.

    8) Do you agree with the percentages of impairment assigned to your arm and your body as a whole, BAW, are reasonable given what you know you can or can NOT physically do? Keep in mind that pain is considered a subjective finding and can not be used toward figuring your total partial disability, TPD, impairment ratings. Basically these impairment ratings are derived from your loss of range of motion, your strength, and dexterity.

    9) Are you willing to attempt to return to your previous employment one more time if even for a few days. It can make a huge difference in what you might be eligible to claim if you were to have to come back out of work from the same employer. Don't be anything more nor less than 100% honest based solely on your physical or mental work injury related issues.

    Again Doni I am telling you up front that I might get you somewhere in the ball park. I can give you the figures of what can be the lowest to what might be the highest as I am not at all sure how the multipliers play into the settlement. There are some sketchy guidelines but to me they are sketchy at best.

    If you will get back to me with the answerers to those 9 items I will give it my best shot. What we might be able to hope for is for JLJ, a TN WC attorney that drops by from time to time, will come by and see what a mess I am making and jump in here and rescue the both of us . If you would prefer to PM me with the additional information that would be fine as well. I have no problem posting this here. But, if you would rather keep the rest of your information private that is fine with me, it is your call.

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


    Take Care and Be Well.

  5. #5
    Join Date
    Aug 2007
    Posts
    16

    Default Re: How do you figure this out?

    In reply

    1. yes, yes
    2. yes
    3. no
    4. don't know. not much in paper, I know I need to be able to sit down part of the day
    5. yes hasn't told me much still gathering info
    6. no called several times didn't feel they were on my side
    7. no
    8. no
    9. no

    Doni

  6. #6
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: How do you figure this out?

    OK sorry it took me so long to get back to you Doni, it has been a busy day around here. Now remember this is VERY ballpark and has some serious variables involved. The basic formula goes as follows:

    Multipliers are any number from 0-6. They are decided on a number of different facts including, your age, education, skills, available employment that your doctor determines you are capable of doing, just to name a few. I am going to use the middle or the road multiplier which is 3. Your multiplier may be a little lower or possibly with the right attorney it could be a little higher. You gave me two figures for Body as a Whole, BAW, I am going to add the two together as they are separate rating based on the two different injured body parts. For now I am going to leave out the arm as an individual amount as I am not at all sure it will be included as well as the two BAW ratings. OK so here goes:

    3 (multiplier) X 9 (BAW impairment rating) = 27% Adjusted Disability
    rating.

    27% (PPD) X 400 weeks = 108 total weeks

    108 weeks X $178.00 (your wage rate) = $19,224.00

    $19,224.00 X 20% (attorney fee) = $3,844.80 Attorney fees
    you will likely also owe some for expenses.


    $19,224.00 (PPD) - $3,844.80 (atty fees) = $15,379.20 (Approximate
    net settlement to you)

    Doni, you have to keep in mind that the multiplier can go up or down I used the middle of the road based on the answers you gave me. The multiplier is based on your age, education, transferable skills, and training. Local job opportunities and your capacity to work at types of employment available in your disabled condition. It is also based on your ability (per your WC doctors opinion) to return to your previous work.

    The way I understand it is if your WC doc would have put you out of work, or as not being able to return to your previous job in any capacity then along with the other multiplier criteria you would have a multiplier of 6. IF you were to get a multiplier of 6 then the PPD doubles to $38,844.80. You would still only be paid 218 weeks which would not put you over the allowed 400 so no deductions for weeks already paid.

    You also have to consider that you may be entitled to the individual arm impairment rating of 6% which would be based on a 200 week PPD. I assume that the applicable multiplier would be used as well. If the arm is allowed in addition to the BAW ratings it could potentially amount to an additional $2,136.00 using 0 multiplier to $12,816 using 6 as the multiplier. Also keep in mind that for some off the wall reason you may have 0 for a multiplier for the BAW ratings which would only come to a total of $6,480.00 for the two BAW ratings combined.

    Remember I am guessing that the two BAW impairment ratings, were to be added together. It makes sense to me that they would but hey let's face it this is after all WC and when you find anything about WC that makes sense please let me know. (I am sure by now you understand why I hesitated to try to figure this for you.)

    Those variables where that multiplier is concerned is huge. Based on your age alone you should qualify for some portion of the multiplier I am not sure how many points are based on age, etc.

    Now you see why I asked if you were represented by an attorney. A good WC attorney in the state of Tennessee can increase the value of your PPD rating considerably if they know what stings to pull. Said GOOD WC attorney knows what to do to maximize your multiplier. Which also maximizes your PPD rating.

    Doni, you need to be aware that if don't to return to work even for a trial period you most likely will loose out on having the option to have your PPD reconsidered for an increase in payment IF your condition were to worsen within 200 weeks of the time you settle your PPD. I will say this if you are certain that it is not in your best interest to try this then that is good enough for me. It is your body and you know what you can and can not do.

    This furthers my suspicions about how good of an attorney as at the surface it appears that you have some very low impairment ratings in light of what you can and can not do. Perhaps this is not entirely fair of me to make that judgment because I AM NOT an attorney of any kind. Nor am I a doctor. Shoot I am not even a resident of TN. It just seems very odd to me and those numbers just don't make sense for a woman who has the physical restrictions that you have. OK OFF my soapbox.

    The other BIG issue you need to consider in all this is future medical care. In TN you don't have an option for the first 3 years your medical will remain open. At the end of 3 years from the time you settle the PPD portion of your claim you can revisit the FM issues. At this time you can continue with open medical, I certainly would not consider letting the IC buy out this very valuable benefit especially if I had the physical problems and need for on going care that you do. Also you must consider that although you will be of age to be eligible for Medicare, you may already be for that matter, you MUST understand that Medicare will NOT be responsible for any medical bills for care/treatment you receive for any body parts included in that PPD settlement.

    The only way around this is at the end of the three years the IC can propose an "ADEQUATE" Medicare Set Aside, (by adequate Doni I mean by Medicares standards not the IC's ideas of what is or isn't enough money for a MSA. You leave it up to the IC and you are sure to be shorted severely for your future medical needs), to cover any further needs you have for your WC related injures.

    That is something you can not afford to let your attorney or anyone else skimp on as the bills for any future medical treatment will land squarely in your lap. Medicare will NOT pay them if it is determined by MEDICARE that your MSA was inadequate. So please when it comes time to consider this very important piece of the WC puzzle make sure you understand what is on the line concerning FM care where your work related injuries are concerned.

    Now IF I don't have your totally confused by now, I didn't do my job very good, ...Just kidding of course. There are others here that can explain that MSA to you a whole LOT better than I can. At the end of the day if nothing else happens if JLJ were to drop around and recheck this information I gave you and feel FREE to correct my errors I would feel a least 66 2/3% better.

    Have a great rest of the day,

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


    Take Care and Be Well.

  7. #7
    Join Date
    Aug 2007
    Posts
    16

    Default Re: How do you figure this out?

    Thanks Steel,
    I understand all the ifs, ands, and buts of the whole thing. The part about medical care was an eye opener! I will be eligible for medicare at 65 but had NO IDEA they wouldn't cover me for this injury. I don't know yet how good my attorney is as he is still gathering medical info from all the doctors and hasn't commented yet on the disability percentages. I am hoping he will have a plan of action soon. As I said I did try to go back to work and found in just that one day that I would only be getting worse every day I continued
    to push myself. My sister has reached the state where her discs in her low back have disintgrated to the point she just falls down. Surgery for her is eminent. She is 7 yrs younger than me and may very well end up in a wheelchair. This is not where I want to see myself because the money aint worth it. THe medical will be very important to me so thanks for the info.
    Doni

  8. #8
    Join Date
    Mar 2007
    Location
    Georgia
    Posts
    1,928

    Default Re: How do you figure this out?

    Doni, you are more than welcome. So sorry about your sis. That must be devastating. There are many new procedures coming out including disk replacement. No long term studies to speak of but, for one near being in a wheelchair anyway it might be worthy of looking into.

    You are being very smart in sticking to your guns as far as NOT returning to a position that is surely only going to contribute to worsening your condition. Too bad your docs don't see it that way. It would make the financial end of it more in your favor if they did.

    I was so hoping that JLJ would happen by this post and toss his opinion in on your ratings and such. It may not hurt to repost this in the TN section as it seems to me that when he does come on here it is usually in the TN section. Can't say for sure that he never checks out these other areas but it might be worth it to you for him to take a look at your information. He is an expert in TN WC law and could possibly advise you of a way to enhance your settlement. Something I have no idea of how to go about other than asking to be reevaluated for your impairments.

    Take care and Be Well,

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


    Take Care and Be Well.

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