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  1. #1
    Join Date
    Sep 2008
    Location
    MD
    Posts
    3

    Default Who Can Make a Settlement Offer

    My claim is out of MD.

    My attorney told me that he sent an offer to the IC for my award. I thought that the IC has to come to you with a number before negotiations could begin. It seems backwards for my lawyer to initiate that. If anyone has any experience with this I'd appreciate the help. Thanks

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Settlement offer

    My attorney told me that he sent an offer to the IC for my award. I thought that the IC has to come to you with a number before negotiations could begin.
    There really isn't much room for figures to change from what is provided by the WCC/statute.

    There are a set number of weeks pre determined for each % of a PPD award.
    Any additional monies in a settlement would be for future medical. any benefits that have not been provided to date, and any penalties that may exsist due to an 'unreasonable delay' of benefits during your claim.

    Settlements can be a catch 22...neither side wants to tip their hand first.
    If you/AA submit a demand for settlement that is too high, it is unlikely that it would generate a response. If the dollars are too low...of course the ER/IC might jump at the offer.

    If you know what the ER/IC is willing to offer you...of course you are going to balk at the figure, feeling you are 'entitled' to more money for what you have suffered.

    Neither side can force a C&R/settlement by lump sum...the ER/IC is free to let the money/indemnity pay out over time, and leave the medical open.

    The numbers set by the WCC are beginning figures...as the final amount, IF there is a lump sump payment will be paid in ''todays dollars'' which can be significantly less than would be paid over time.

    You can read about WC benefits here...http://www.wcc.state.md.us/Gen_Info/WCC_Benefits.html

  3. #3
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Settlement offer

    either side can initiate settlement negotiations. The worker or their atty often make a settlement demand especially since the carrier has usually already paid benefits or denied the claim.

  4. #4
    Join Date
    Nov 2008
    Posts
    2

    Default Re: Settlement offer

    just be careful with an offer that your attorney might want to settle on, my attorney was out for the pay-off, not my welfare. I was injured 14 years ago and they want to settle my medical, they started with 97,000, and by the end of the meeting I had them up to 200,000. I'm representling myself so there's alot of searching laws and rights but it's worth it. I'm finding out 200,000 is not near enough to even pay my medications let alone doctor bills, xrays, MRI's and any possible surgery. I'm trying to find a post that said don't ask for more than 250,000 (I know that's Montana's limit for the adjuster to be able to make the decision) but I was wondering if there was more to it. No amount of money can compensate the pain I suffer every single day, and everything I've lost since my injury, which, by the way, is everything, including my home. I know there are some excellent attorneys out there but I was screwed on my w/c and SS disability (also fighting that myself, it's at the Appeal's Court level, next step is the Supreme Court).
    Good Luck, and don't cut yourself short, do some research yourself.
    Cheryl

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Settlement offer

    No amount of money can compensate the pain I suffer every single day, .
    Unfortunately, there is no provision in WC for 'pain and suffering'...or 'lost wages'...
    Generally settlement are limited to any indemnity due for the impairment due to the injury, and future medical...

    I was screwed on my w/c and SS disability (also fighting that myself, it's at the Appeal's Court level, next step is the Supreme Court).
    There is an appeal at the Administrative Court level...and if denied there, you could to to federal court... I doubt you will ever see your SSA/SSDI issues or denial taken to the Supreme Court of the United States...

    BUT... as you have made application for SSA/SSDI benefits, and could/should be Medicare elibible within 30 months of any settlement that affects your medical entitlement though the WC carrier... you MUST take the steps to protect Medicare interests through the use of a WCMSA...

    I'm trying to find a post that said don't ask for more than 250,000
    I've read your question on that issue, and I think you have misunderstood the concept of the $250K dollar amount mentioned by another poster.
    The laws don't mandate how much money you can be awarded though a negotiation... only the indemnity due to any PPD/PD.

    At any rate, you have a lot of research to do BEFORE you agree to any settlement on the medical of your claim... and should not even being negotiating with the IC on this matter UNTIL you determine IF a setaside account is necessary.
    There is more to your settlement, due to the SSA issues, than simply agreeing to a dollar amount for your future medical benefits.
    And you as an IW, really have no idea how much to ask for, or where to even begin in a medical negotiation...as it appears you have already found.
    I'm finding out 200,000 is not near enough to even pay my medications let alone doctor bills, xrays, MRI's and any possible surgery.
    A Medicare setaside vendor is the person to make those calcuations... and IF you need a WCMSA, CMS will make that determination...and HOW MUCH is required to be deposited.

    At this point, you are spinning your wheels negotiating with the IC on your medical..AND, IF you come to any agreement, they will want to pay in 'todays dollars'... If you have a WCMSA... Medicare does NOT allow for any commutation...
    These are but a few of the considerations you need to be thinking of...

  6. #6
    Join Date
    Jul 2010
    Posts
    20

    Default Re: Settlement offer

    Bvia

    They gave me 600 weeks and the total amount from that figure of 400K they put that in to present day dollars and then the bottom line was 220K and MSA is 500K I need help to understand this . What about wage loss etc? I did have a career I was a NURSE not an aid ( not that is a lesser job ) 4 years of school gone on SSDI and My shoulders are worse i am need of surgery again . Also didn't go for PT cause the lawyer said no cause of not finishing Voc? However the Commissioner asked why we are not seeking Total? Oh and I know a settlement isn't a lottery winning lol. PLEASE HELP ME UNDERSTAND I HAVE TO GIVE AN ANSWER EITHER TO DO THE C & R OR REFUSE ALL.

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Settlement offer

    They gave me 600 weeks and the total amount from that figure of 400K they put that in to present day dollars and then the bottom line was 220K
    As I said in your other post (California), IMHO, you should not take that cash... but rather have the carrier buy you an annuity to fund the PPD inemnity... you'd be paid a life pension, tax free. You cannot self invest and produce the same weekly benefit you are receiving today.
    The underling premise to "todays dollars" is you can deposit that money in an interest bearing account and wait for it to grow the same as they do. That's how IC"s make the money to pay weekly benefits. Of course, you could never duplicate that as you have to consider taxes and inflation....they don't.
    What about wage loss etc? I did have a career I was a NURSE not an aid ( not that is a lesser job ) 4 years of school gone
    WC is not like PI, the benefits are predetermined based on % of impairment to the body part or whole person. PI you can recover as deep as the pockets of the defense. WC does not provide compensation for your school/degree loss, or wage loss going forward... that's what the PPD indemnity compensation is supposed to be.
    My shoulders are worse i am need of surgery again
    That surgery would be included in the MSA calculations...but, even the first two years funding wouldn't likely cover the full cost, nor would the subsequent years deposit, once the MSA is exhauated annually, Medicare will begin to pay...but YOU will pay the out of pocket copays/deductibles.... that's part of the "compromise" in cashing out.
    You do not have to accept this settlement... no such thing as "now or never"... don't let anyone try to intimidate you into accepting any agreement you are not comfortable with.

    That "huge" lump sum payment may look attractive, and being "on your own" for treatment too... but a C&R is rarely in the best interests of the IW where there is serious injury and on going, long term medical required.

  8. #8
    Join Date
    Jul 2010
    Posts
    20

    Default Re: Settlement offer

    BvIA, I understand what you are trying to say. So what I understand is I should just leave it alone and keep my weekly checks and my medical open that would be the safe way to go?? The MSA deposit yearly isn't enough to cover my medications let alone and medical appointments etc. I don't think that is fair !! The insurance company is saying all that they are going to offer is the TODAY DOLLARS 220,000 AND DROPS EVERY WEEK THAT GOES BY AND THE MSA IS 500,000 WITH DEPOSITS YEARLY FOR 31 YEARS. I DON'T FEEL LIKE THIS IS A GOOD IDEA I AM SCARED AND IF I DON'T TAKE IT THEN EVERYTHING REMAINS THE SAME WHIC H I FEEL IS THE SECURE WAY TO GO HELP ME

  9. #9
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Settlement offer

    The WCMSA proposal is review by CMS/Medicare... that's the amount they want to see to protect Medicare, and your interests... if the carrier doesn't like that number...you can't force them to fund the MSA... there are no "todays dollars" where a MSA is funded... it's the full amount, or nothing.
    The MSA deposit yearly isn't enough to cover my medications let alone and medical appointments etc. I don't think that is fair !!
    None of this has anything to do with fairness... you aren't entitled to any money for future medical.
    Once the annual deposit is exhausted...Medicare will pick up the cost of treatment/medications...but you pay the copays, and deductibles until the next deposit is made. So you do have "insurance"/Medicare coverage.

  10. #10
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,048

    Default Re: Settlement offer

    Cheryl, you probably need an MSA. Without one your whole settlement may end up being owed to Medicare. Which means that you may end up with no medical coverage for anything, related or not, at some point. So you should move forward carefully. Representing yourself may turn out to be the biggest mistake of your life.

    Shoulder4, you need to get a competent work comp lawyer to evaluate your situation and give you some advice you can rely on. I think the 220K represents your wage loss, whether actual or presumed, and of course the MSA represents a facsimile of your future medical. What you are describing sounds like a fairly typical settlement for someone who is unlikely to return to work, but I am not familiar with the law in your state. You really should ask a good work comp lawyer in your state to give you some guidance if you are not sure about it.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

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