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Thread: Settlement

  1. #1
    Join Date
    Nov 2007
    Location
    Missouri
    Posts
    26

    Default Settlement

    I was released from my workmans comp doctor about 2 months ago. I was wondering what happens next as far as reaching a settlement goes. Do I have to contact anyone or does someone contact me? Thanks for any info you can give me.

    Wornslick

  2. #2
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Settlement

    Not all injuries are entitled to additional benefits or a settlement. Some workers recover. completely without any after affects or impairment. talk to your doctor about any lingering problems and see if there is some permanent impairments.
    Here is information about permanent disability
    http://www.dolir.missouri.gov/wc/forms/101-AI.pdf

  3. #3
    Join Date
    Nov 2007
    Location
    Missouri
    Posts
    26

    Default Re: Settlement

    When the doctor released me I asked him about my injury and what percentage he thought it would be. He said that the final decision would be up to the insurance companys doctor. Should I contact the insurance company? I am a little confused. Thanks,

    Wornslick

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: Settlement

    Compensation for a permanent disability. Once a doctor has done all he or she feels can be done medically to help you, and you are not as physically able as you were before the injury, then you have a disability. And if there isn't anything else the doctor can do to make you any better, your disability will be "permanent," meaning you will suffer the effect of the injury from that point on. That disability will either be "total" meaning you are unable to perform any work, or "partial" which means you are able to work but there are limitations or restrictions as to what you are able to do. If you are determined to be permanently and totally disabled, your benefits will continue for the rest of your life. If your disability is a permanent partial disability (PPD), the legislature has established a formula to convert that disability into a dollar amount. The maximum weekly wage amount for a permanent partial disability is less than the maximum for the temporary total disability because the disability is partial instead of total. Compensation is for the disability only. The law does not provide compensation for pain and suffering.




    Q My employer wants to settle my case, what should I do?
    A. If your employer, or the insurance company, wants to settle your case, you should have finished medical treatment and have been released to return to work by the doctor. If you have not finished medical treatment, have recently had major treatment such as surgery or if you are still on work restrictions, your case is not ready to settle. If the work restrictions are permanent, the doctor should have advised you of this.

    The disability benefit that is paid for any permanent residual effect of your injury is called permanent partial disability. This is a lump sum benefit that is paid to you after the injury has been treated and you have recovered to the fullest extent possible. The permanent partial disability benefit, often called PPD, is paid to compensate you for that permanent residual effect of the injury. These payments are based on a weekly schedule for various body parts, the rating of that permanent injury and your average weekly wage.

    In order for your case to be settled, the doctor should rate your work-related injury. This rating is the doctor's opinion on the permanent effect of the injury. It is usually given as a percentage of a body part such as an arm, leg or finger. A back or neck injury is rated as a body as a whole injury. Depending on the body part affected by your injury, there are a number of weeks that are set out for that body part. For example, the leg at the hip is rated at 207 weeks, the arm at the shoulder at 232 weeks, the index finger at the first knuckle at 45 weeks, and the body as a whole at 400 weeks.

    Your compensation rate is calculated the same way as the temporary total disability benefit, that is two-thirds of your average weekly wage. However, the maximum limitation is lower at 55 percent of the State Average Weekly Wage, or since July 1, 2003, $347.05. The maximum amount is determined by the date of injury.

    Your average weekly wage is computed based on your gross wages. If your wages are fixed by the month, multiply your monthly gross wages by 12 and divide that total by 52 to determine your average weekly wage. If your wages are fixed semimonthly, multiply your gross wages by 26 and divide that total by 52 to determine your average weekly wage. If your wages are fixed weekly, that is your average weekly wage. If your wages are fixed by the hour, or some other method such as sales output, take a total of your gross wages for the last thirteen weeks and divide that total by thirteen to determine your average weekly wage. If none of these situations apply to you, please call (800) 775-2667 during business hours, 8 a.m. to 5 p.m. Monday through Friday, for further information.

    Let's work through an example. Assume you have an injury to your wrist. The wrist is rated at the 175-week level. So if the rating is 10 percent, your settlement will be based on 10 percent of 175 weeks or 17.5 weeks. Assume your average weekly wage is $300.00. Your compensation rate (two-thirds of your average weekly wage) is $200.00. The compensation rate of $200.00 times the 17.5 weeks comes to $3,500.00. The total PPD benefit would be $3,500. Of course, an administrative law judge is the final decision maker on the appropriateness of the rating and the average weekly wage. So, just because the employer or insurance company has offered a settlement proposal, this does not mean your case is settled. You must appear before Division staff for final approval of the settlement.
    You can read a lot of information on MO WC rules and benefits here...
    http://www.dolir.missouri.gov/wc/faq_employees.htm

  5. #5
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Settlement

    sounds like a cop out; the carrier it's not going know you have impairment and need a rating unless the doctor tells them something.
    If the doctor is not going to then yes, you should contact the carrier and get the ball rolling.

  6. #6
    Join Date
    Nov 2007
    Location
    Missouri
    Posts
    26

    Default Re: Settlement

    Thanks to both of you for the advice. Today I am going to call my doctor and request a copy of the final report he made to the Insurance Carrier. I will also contact them. Hope I didn't come off as greedy but my hand is no where close to what it was before the accident and I just want whats coming to me. BTW I do not have a lawyer.

    Wornslick

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: Settlement

    my hand is no where close to what it was before the accident and I just want whats coming to me
    Medical treatment in WC is not intended to return you to pre injury condition...only to a status where you are capable of performing some type of 'gainful employment'...not necessarily in your pre injury job...

  8. #8
    Join Date
    May 2008
    Location
    Missouri
    Posts
    52

    Default Re: Settlement

    Up to ICs doctor? WHAT? I would first get things straightened out with MY doctor before I was seen by ANY "IC" Doctor, who BTW here in Mo. sounds like an IME.

    You need to ask your doctor about the lingering effects of your injury and what percentage of loss he would "guess it to be, hypothetically." I wouldn't necessarily take his word for anything unless YOU or YOUR carrier paid him/her the medical bills and other expenses directly. Is this a Dr. who your ER sent you to?

    Something doesn't sound right. You may want to talk with an attorney about a free initial consultation and discuss your situation.
    Injured worker learning to live again. Not a lawyer, just a disabled individual with an opinion a person can opt to listen to or ignore.

  9. #9
    Join Date
    Nov 2007
    Location
    Missouri
    Posts
    26

    Default Re: Settlement

    I contacted the doctors nurse who took care of my hand after the accident. She then had me talk to the workmans comp part of the medical center where I was treated. They told me that since the injury occured in Missouri but the doctor was in Illinois that he is not required to send a letter to the IC saying what he thought about the amount of disability was to my hand. They said that the IC had contacted them wanting to know if another doctor was available at the medical center to evaluate my hand. She said they could do that. She said the IC has not been back in contact with them. I called the IC but the person that is handling my case was away from his desk so I left my name and number but I have not heard from him. That was on Wedneday of this week.

  10. #10
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,018

    Default Re: Settlement

    The doctor who treated you is in the industrial medicine section of the clinic where you received treatment to your injury...
    But, he can't give you are impairment rating because he's in a different state...?

    Are you living/working ''bi-state'' ?
    Why are you treating in IL if you're working in MO ?
    If that is the clinic your ER sent you to, that is the doctor/PTP who should be issuing the medical reports, and subsequent impairment rating.

    WHO is the doctor who released you to RTW ?
    That is the ''primary treating physican'' and the ''rater''...


    See how many posts it takes where there is piecemeal information provided...like pulling teeth !
    So, Wornslick, is there a quesiton now, or are you just letting everyone know the status...?

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