Difference in PTD and PPD Awards in Ohio

[jhoward]

I say my spine doc yesterday and he says I am disabled and will be MMI on January 2, 2010 after my vocal therapy is complete. Social Security deems I am disabled as of August 09 so I get no backpay and have to wait until Feb 2010 for it to begin. So if I understand this correctly, my TTD will stop in January and I will have no other income but the Social Security in Feb and I will have to wait awhile to be raised to the full amount. Then since my injury was in 2005, I will have to wait 40 weeks from Jan 2 to file for a Partial Perm award or a Perm Total award??Really don't understand the difference and what I fall under. Also how it that calculated in Ohio. I looked at a chart but it said 1/3 of AWW x200 weeks?? And then at some point I can file for the final settlement?

Thanks for any information.

[hubert]

first of all, all claims with TT have to be done and over, then you go for PPD, after that is settled and done, then you go for the PTD. never ever settle out. for what they give, you will not beable to cover medical bills for a year. i know this fore i have been going thru this with my back since 1990. they made a offer to me last year, it would only been enough to cover my medical costs for 8 months. by all means, i know this is so very hard to deal with, but never ever settle the claim out. by all means, keep it open.

[cat]

I saw where you posted to always keep your claim open, do you mean the medical part or never settle period? I have been in this mess since 2000 with a self insured company. Been nothing but BS since day one. I was just informed I can not see my pain dr. anymore cause the insurance company says I don't need to ?????? Back to fighting, hearings and stress This is why at times i feel like throwing in the towel and settling but I know they would love that!!!! any suggestions would be helpful. I have a 42% whole body and have 9 allowed claims thanks

[jhoward]

Thanks hubert for the info. Really sorry to hear that you have been going through this BS for so many years. I just can't wrap my head around that since I know all the crp I have had to go through every time there is a new diagnosis added because of the injury or surgeries, ect..... I was injured in 2005 and had shoulder surgery and was still in constant pain until 2008 when they finally did an MRI and fount the herniated disks..2 spine surgeries later I am disabled. I was under the impression that since I will be Medicare eligible that WC would have to fund an MSA account for future medical as a part of a final settlement.
..Do you know the formula for figuring out the PPD award? And how long after MMI do I have to wait to file for it? No matter what is is, I don't think I will get it in time to save my house or anything else at this point.

[BvIA]

I was under the impression that since I will be Medicare eligible that WC would have to fund an MSA account for future medical as a part of a final settlement.

That is correct. ANY settlement that closes the medical in your comp claim, as you are Medicare eligible, will require a WCMSA, if the threashold is met.
You have a lot of reading to do on the WCMSA subject. There are lots of posts on these boards... under Disability Benefits you'll find most of those.
After you finish reading there, and www.cms.gov, or www.ssa.gov, come back with your specific quesitons. It's too much to answer the -same ones again and again... It is not always in your best interests to close the medical in your claim. What that does is shift the liability of the medical costs to you, out of pocket, not Medicare. You become the 'claims administrator' of your own medical account/treatment. There can also be out of pockets to you, for those services Medicare does not normally cover. It's complex, to say the least.

[jhoward]

Thank you BvIA.....

[hubert]

I saw where you posted to always keep your claim open, do you mean the medical part or never settle period? I have been in this mess since 2000 with a self insured company. Been nothing but BS since day one. I was just informed I can not see my pain dr. anymore cause the insurance company says I don't need to ?????? Back to fighting, hearings and stress This is why at times i feel like throwing in the towel and settling but I know they would love that!!!! any suggestions would be helpful. I have a 42% whole body and have 9 allowed claims thanks

from what i read, and understand here. you should never settle, the amounts they give, will not cover your medical bills for a year. then you are on your own with the bills.

[Sherry Lou]

hubert,

Also, it may very well be that the medical expense amounts projected in the future for the purpose of settling a case are based on a current WC fee schedule. No COLA adjustment assumed. As such, once settled, one could very well feel that WC is "still in your life" long after settlement, especially if one is unable to "afford" better than lousy licensed excuses for lazy, greedy medical "professionals" who can't make it at UCR or better. Or, no access to those docs who know they're good and opt out of insurance games. Or, treatment from highly trained but poorly "educated" networked docs who, perhaps innocently (ethics ed. not a part of med school) agree to laying their moral character down so as to "fit" the schemes imposed on their agreeableness...

One sleazy comment that seems to be highly biased legal advice/commentary runs something like, "Wouldn't you like to have WC out of your life?" Oh, sure! If it would be guaranteed, for real! (Maybe, just maybe, the lawyer is eager to settle, a little too eager perhaps???)

Everyone's "life on WC" is unique and different, despite a rather widely shared experience of wrong-doing going down. Settlement will serve some at least adequately in their personal circumstances, and they might never realize the favor they do for the greedy insurer, the employer's good deal, and the system that insults, demeans, destroys and disenfranchises American workers. Every case settled off the insurer list frees up "their" money, which was really your money, but some here won't ever acknowledge that... Careful negotiation with a stellar lawyer has about the same odds as the slots in Vegas.

If this was a war game I might consider the strategy of no one ever settling -- and burdening the system into spending the money on swift, high quality, effective injury care and administration INSTEAD of using the money to hire any number of company adjusters and non-treating docs and PIs ($600 a day!!?) and, of course, lawyers to make the whole plan one simple mismatched adversarial game of who else could join in (get paid) to bully and beat down injured workers... injured American workers with no right to sue for justice, no privacy protection under HIPPA, no functional appeal, no checks and balances on deadbeat insurers and IW abusers... There are solutions, just apparently not enough folks genuinely interested in or aware of potentially reasonable plans for the reason to expect injuries on the job and reasonable risk for expense to be involved... Psychology comes from the human interest in the "study of the soul:" We've all been bamboozled into the study of one value -- the study of money -- to the detriment and diminishment of every other previously respected human value. (Herbert Marcuse was a prophet, and "Radical Left" is not the same as socialism, communism, and other currently misapplied media sound bites delivered by attractive, young, highly-trained/poorly "educated" college journalism graduates who had no critical thinking skills taught or required for graduation......!))

[hubert]

sherry, very well said.