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  1. #1
    Join Date
    Oct 2006
    Location
    ga
    Posts
    103

    Default Settlement vs. Appeal

    I won at ALJ hearing, ER is appealing. My attorney feels we will win appeal, but ER is wanting to try to settle before getting too far into appeal. My Dr says surgery is the next step for me, call her when I'm ready. That is a last resort for me. My dad died during heart surgery and never came out of the anesthesia, my niece has been told that surgery for her is to great a risk due to dad's surgery outcome (anesthesia). I have not discussed this as yet with my doc. Anyways can a settlement be made when a rating has not been done? Also I have a piece of paper signed by my Dr stating I am permanently totally disabled and have been since accident date. Can this be of help to me? recieving SSDI as well.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Shed Some Light

    I have not discussed this as yet with my doc.
    Why... what are you waiting for?... If your treating physician is recommending surgery to ''cure and/or relieve from the effects of your industrial injury'', you should be discussing ALL of your medical issues that may prevent a appropriate treatment plan...and this could affect your claim status.
    Anyways can a settlement be made when a rating has not been done? Also I have a piece of paper signed by my Dr stating I am permanently totally disabled and have been since accident date. Can this be of help to me? recieving SSDI as well.
    A settlement can be negotiated ANY TIME the parties can come to an agreement. Regardless of the status of your claim, or physical condition. Whether that is in your best interest medically speaking... remains to be seen . When you accept a cash payment to drop your claim, YOU are accepting liability for any/ALL further treatment to your injury...maybe not something you want to do.

    Because you are 100% 'disabled' due to your work injury, may or may not be the same as being 'disabled' under SSA rules for that definition.

    WC and SSDI are TOTALLY seperate systems...and not dependant upon one another to qualifying or receiving an award.

  3. #3
    Join Date
    Oct 2006
    Location
    ga
    Posts
    103

    Default Re: Shed Some Light

    I have been paying for all medical visits myself for some time. ALJ has resarted benefits which of course were appealed. My neuro knows that I am not crazy about surgery and prefer it to be the last option taken. Although I listed my dads death on my intake form I never even thougt about discussing the details with my neuro. Actually my niece reminded me to bring this up. I have been having trouble with my knees which an orthopedic surgeon says is due to my back problem, should I now pursue this further? I want to make sure I do everything I need to but sometimes I am so overwhelmed it's difficult for me to see the forest for the trees. welcome all input as I know a lot of you have been there done that. Thanks for your time.

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Shed Some Light

    I want to make sure I do everything I need to but sometimes I am so overwhelmed it's difficult for me to see the forest for the trees.
    Why are you not, or reluctant to discuss this claim with an attorney ?
    That is where you get valid legal advice, not from a message board, all claims and injuries are different, and unique to the individual. Your niece, meaning well, is not the authority on a comp claim.

    WC ''insurance'' in not health coverage for the IW.
    That being said however, you should be discussing ALL of your health concerns with your treating physician. ANY issues you may have medically can and will affect your treatment plan.
    I have been having trouble with my knees which an orthopedic surgeon says is due to my back problem, should I now pursue this further?
    Yes, of course you should be discussing these issues with your Dr. If there is a compensable consequence to the org injury, your own health coverage won't pay for treatment... whenever there is a determination of industrial causation of any injury/illness, the private pay carriers will not cover the cost of treatment... and that's because YOU are not liable.

    Talk to an attorney who specializes in WC. That is your best bet with this claim.

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