Brain Injury and Workers Compensation

[kycountrymom]

We finally got a diagnosis on my husband's back/leg/spine issues; L4/L5 radiculopathy with lumbosacral plexopathy. Due to the amount of nerve damage involved we've been told that surgery is not an option. He started ESI this week, if that doesn't work (and the Dr wasn't optimistic) they're talking about doing a nerve block.
What I'm wondering about now is his brain injury. He had a full neuro-psych eval done, the results we received today from it weren't real good. "Predominantly diffuse traumatic brain injury due to a history of a work related accident." Difficulties with abstract verbal/non-verbal skills, working memory, processing speed, verbal ability, the list goes on. The Dr goes on to say that while estimated pre-accident intelligence range was Average, his current measured level at 75 is below that expected and suggests cognitive decline due to TBI from the accident. (this was the IC's Dr)
Suggested plan off attack is to get him into speech and occupational therapy ASAP to take advantage of the remaining window of time that will allow as much recovery as possible although he'll never be 100% mentally again.
Our attorney will be getting back to me in the next couple of days after she's had a chance to review the Dr's report. I'm just wondering what sort of affect an injury like this has when finally closing the WC case. Any ideas as to how it is factored into the IW's final impairment rating?
Thanks-

[.SH]

Case might not be closed; disability could be permanent and total.
Ratings aren't done until recovery is maximized which could be a while yet. Impairment ratings are complex and should be discussed with the doctor as treatment winds down. generally it's based on perfomance of different levels of complex tasks.

[kycountrymom]

.SH, thanks for posting! I wasn't sure if, in a situation like this, the case would be left open indefinitely or not. What I'm understanding from the Dr & NCM is that as far as dealing with his physical issues with the back/spine/legs they are almost done with what they can do. If the ESI & nerve block don't work then they're saying all that can be done is manage his pain via meds and let the nerves heal as they will naturally.
Hopefully getting him into ST & OT will be able to help him learn to function around his mental impairments better. Wondering how hard the IC will try to avoid this!

[BvIA]

If you haven't made application for SSA/SSDI benefits yet, it would be a good idea to get on this...the longer you wait to make the application, the more in retro benefits you stand to lose...

Good luck with the therapies...

[kycountrymom]

BvIA, applied in Jan. & got the approval letter the first of this month, it'll start coming in April.

[bob304]

I have a brain injury and 20 years of experience with workers comp for my brain and other physical injuries.
Be prepared for a fight re: each neuro psy eval but get them every 3 years, to continue and monitor for any decline.
My own case I lost 37 IQ points and the ability to remember this along with the pain from broken bones and entrapped nerves
make life difficult.
Recently Workers Comp offered a settlement. It was less than my money benefit for 10 years
Of course I said NO.
But, does anyone have experience with Comp and what is appropriate settlement amount? As much as I don't like lawyers
I think the time has come to reacquaint my self with the legal system.
I was told I must settle or go to a mediator? Does anyone know if this is true? This forum and one member in particular have kept me semi sane and from harming myself when I was in great despair.
Thank you in advance for your knowledge, your compassion for those of us in mental and physical and perhaps spiritual pain of
the fight with Sedgwick / Workers Comp.
Bob

[ransa]

Hello People,

I'm still recovering from TBI, myself. During this process a something-Neuro-something (they've been so many...)suggested I use stuff that kids and travelers use to fight boredom on long trips. He suggested kids games, puzzles, crossword puzzles, connect-the-dots, anything that would exercise that vacuum between my ears. Visual accommodation issues made it difficult, and vestibular/proprioception problems kept me from running out for batteries. Thus I had to make do with the local supermarket magazine-rack. Anything will help. All the best.

[BvIA]

Recently Workers Comp offered a settlement. It was less than my money benefit for 10 years
.
But, does anyone have experience with Comp and what is appropriate settlement amount?

Not really enough info Bob.
What is the claim status today?
What is your PD/WPI rating ?
What is the anticipated need/cost of FMC/Future Medical Care ?
Have you applied or are you receiving SSA/SSDI benefits, and/or Medicare eligible ?

If you can answer those questions... it would be easier to offer more info I think.

IF you are Medicare eligible for any reason, or applied for SSDI benefits, you must take Medicare interests into account in any resolution that affects the medical in your claim. What that changes or closes the medical coverage. You may need a WCMSA/WC Medicare Setaside Arrangement.
There are more than one issue to be considered in any settlement... the MSA is but one.

The atty issues we can talk about another time.

[bob304]

RE:: Brain injury its a difficult situtation and one that I hope you all never had to deal with

Not really enough info Bob.
What is the claim status today? OPEN CLAIM THEY ARE STILL PAYING MONTHLY AND DOC AND PERSONAL CARE
What is your PD/WPI rating ? MY RATING WAS 64 both brain and body
What is the anticipated need/cost of FMC/Future Medical Care ? THEY SAID 1,200 per month but my caregiver is 1,600
Have you applied or are you receiving SSA/SSDI benefits, and/or Medicare eligible ? RECEIVE SSDI was approved immediately and 2 years before WORKERS COMP gave me PTD
Does this help?
Its a never ending struggle with workers comp for all of us. I don't know what to do
sometimes they make me so angry and I am always fearful they will stop paying

If you can answer those questions... it would be easier to offer more info I think.

IF you are Medicare eligible for any reason, or applied for SSDI benefits, you must take Medicare interests into account in any resolution that affects the medical in your claim. What that changes or closes the medical coverage. You may need a WCMSA/WC Medicare Setaside Arrangement.
There are more than one issue to be considered in any settlement... the MSA is but one.

The atty issues we can talk about another time.