Indiana Worker's Compensation - Help For Injured Indiana Workers

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  1. #1
    Join Date
    May 2010
    Posts
    11

    Default Retiring During Claim

    My workers compensation claim was made in the State of: Indiana. Because my injury seems to be going to prevent me from returning to a very physical job I am considering retirement @ 62. I was injured when 61 years old last October,20 2009.My last scheduled physical therapy treatment is May 13,2010. Back injury that I have had epidural injection and very little improvement. What complications would I cause if I decided to retire? Would I still be eligble for continuing treatments? I am also concerned about being able to afford health care/insurance because of this " pre-existing conditon" that I now have after my injury. Both physical therapy tech and orthapedic surgeon I was assigned to have "suggested" a different line of work. Might be the best advice,but is it the right way?

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

    Default Re: Retiring During Claim

    There wouldn't be any problem with your plan.
    But there is no reason to take early SSA normal retirement benefits at this time.
    You are being paid TTD, even though retirement doesn't necessarily remove you from the labor market, there really isn't any reason to take a reduced SSA entitlement now. The longer you wait to normal retirement age the less reduction you will see.

    The liability for treatment to your injury does not stop unless you cash out the medical in your comp claim. As you'll be Medicare eligible within 30 months of taking your retirement/SSA, you'll have to address the potential need for a setaside arrangement when the claim settles.
    A industrial injury isn't a 'pre exsisting' condition as your own health coverage, nor Medicare pay for that treatment anyway.

    The PT tech doesn't have any diagnosis/treatment plan weight in a injury, only your Dr has that. Whether or not you can return to your usual and customary job duties is a medical determination.
    IMHO.... you should leave things the way they are... your current status/TTD is not placing you in any jeapordy. I would wait to normal retirement age.

    IF you take the early SSA retirement, your monthly entitlement rate will not be affected by your comp benefits.

  3. #3
    Join Date
    May 2010
    Posts
    11

    Default Re: Retiring During Claim

    I did apply and am getting SS at early rate. I turned 62 Feb , 2010. I also applied for disability SS at same time. Not approved or denied at this time. My employer cancelled my health insurance 3 weeks after injury and I now had to get a short term policy at higher rate. Almost unaffordable. My concern is that if I lose my W/C I will be in a position where I can not afford insurance! Any insurance company I asked says that my back injury is a "pre-existing" condition and they will not even accept my application. So, if W/C drops me and I can not afford the high risk insurance that Indiana offers ( $700+ per M. ) where do I stand? The web is closing in on me...... Do I need a lawyer? I trusted the "system" and might be in line for a rude awakening.I have only 2 weeks to make my decision , by my advisors/ "experts"...

  4. #4
    Join Date
    May 2010
    Posts
    359

    Default Re: Retiring During Claim

    Quote Quoting 10w30dna View Post
    I did apply and am getting SS at early rate. I turned 62 Feb , 2010. I also applied for disability SS at same time. Not approved or denied at this time. My employer cancelled my health insurance 3 weeks after injury and I now had to get a short term policy at higher rate. Almost unaffordable. My concern is that if I lose my W/C I will be in a position where I can not afford insurance! Any insurance company I asked says that my back injury is a "pre-existing" condition and they will not even accept my application. So, if W/C drops me and I can not afford the high risk insurance that Indiana offers ( $700+ per M. ) where do I stand? The web is closing in on me...... Do I need a lawyer? I trusted the "system" and might be in line for a rude awakening.I have only 2 weeks to make my decision , by my advisors/ "experts"...
    ================================================== ====
    I am much younger than you, and was kinda forced to retire...With my union, my family is only covered for 30 months...So if I did not retired they would not be covered. Now I filed for SS and got it first time around. Now Im covered by medicare wich isnt nearly as good as my familys pollicy!..From what I know you need to be off one year to be eligable for medicare? thats what I was told......And as for a lawyer I think its a must!!!! I built multi-story buildings for a living, I would not trust someone who built wood houses, to construct a hirise! So my point is, if your background isnt law or WC law, its in your best intrest to get profesional advise from some one who was trained and works in that field!!!

    I hope everything works out for you, and PLEASE dont give up! It is a sloooow prosess and gets very confusing...Keep a smile on your face and just keep trying to move forward! There will be plenty of people trying to knock you down the whole time!!!!! Take care my friend, take care......

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

    Default Re: Retiring During Claim

    What complications would I cause if I decided to retire?

    I did apply and am getting SS at early rate. I turned 62 Feb , 2010.
    Gotta ask the question... If you already did this/retire, why ask about it now..?
    I also applied for disability SS at same time. Not approved or denied at this time.
    You can't get SSA retirement and SSDI at the same time. These are seperate benefits/entitlements but based on totally seperate causation. With SSA normal retirement, your comp benefits DO NOT affect the monthly benefit rate. SSDI would be affected by offset.
    My employer cancelled my health insurance 3 weeks after injury and I now had to get a short term policy at higher rate. Almost unaffordable.
    If you were/are eligible for leave under FMLA, that would protect your job, ER provided benefits too, up to 12 weeks/annum. By law.

    I asked says that my back injury is a "pre-existing" condition and they will not even accept my application.
    Not so much about pre exsisting condition, industrial injury is your ER liability, not yours. As such, your own health coveage, nor Medicare will pay for treatment. Don't know why they would decline your application though, riders are placed on policies all the time.

    So, if W/C drops me and I can not afford the high risk insurance that Indiana offers ( $700+ per M. ) where do I stand? The web is closing in on me......
    Web ?.
    Eventually the comp benefits are going to stop. Unless you are 100% PD due to the industrial injury, those wage loss benefits don't go on forever.
    Under Indiana statues, even those IW's with 100% total permenant disability can be limited to a max award and/or 500 weeks of payments.
    You should make yourself familiar to what those benefits/indemnity are http://www.in.gov/wcb/handbook/HANDB...onforLostWages

    have only 2 weeks to make my decision ,
    WC medical treatment benefits are just that... not health coverage for employees injured on the job. Medical treatment is open on as needed basis.

    Also...when you resign, retire...
    Effect of Employee’s Resignation
    The employee’s resignation from a job after an injury does not terminate the employer’s obligations to the employee, although the employee’s resignation may affect eligibility for Temporary Total Disability (TTD) and Temporary Partial Disability (TPD). In most cases the employee will still be entitled to medical care and compensation for any permanent impairment (PPI).(emphysis added)
    So if you are being paid TTD/TPD, those benefits could stop.

    I would say 'yes', you definately should be consulting with an attorney.
    As you are currently receiving your SSA/retirement benefits, and will be Medicare eligible at age 65, that's within 30 months of any settlement that affects your comp medical coverage, you must take Medicare interests into account when you settle the claim. That includes a WCMSA/setaside arrangement on money you receive for future medical care.

  6. #6

    Default Re: Retiring During Claim

    It is imperative that you consult an attorney. This system is complex and you need someone who will look out for your interest.

    This site is very helpful. Many members have been through similar situations and can offer advise. However, you must also be your own best advocate. Use the tools here to educate yourself. In addition, share what you learn.

    Eve

  7. #7
    Join Date
    May 2010
    Posts
    11

    Default Re: Retiring During Claim

    I filed for early SS benefits bacause I had no idea where this injury would lead in the way of W/C payments. Even if I went back to work I could collect early SS payments.I feel that I am still employed at the job until I notify them of leaving/retiring, correct? So, my real question is will it make a difference when I notify them of my retiring? Should I NOT notify my employer until W/C claim is settled, or medical decision made about my returning/not returning to same job? I was thinking I could do this w/o a lawyer,but I'm beginning to see that it can get tricky. Health insurance agents give me contradicting info all the time. Some say I can not buy insurance until my back injury is recovered and cleared by a Doctor.

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Retiring During Claim

    You can be paid normal retirement benefits and continue working, there woudn't be any offset, but a portion of your SSA retirement may be taxable.

    When you claim ''disability'' and are awarded SSDI, you are saying you cannot work due to your medical condition...not just the work injury. You can return to work with no effect on your SSDI until you are ''gainfully employed'' and earning the min wage to cause the SSDI benefits to cease.
    I feel that I am still employed at the job until I notify them of leaving/retiring, correct?
    Yes. Technically you are still an ''employee'' until you OR the employer change that status. And yes, your employer can terminate you or due to a business decision, or general layoff you could lose your job.
    There is only job/benefit protection under FMLA, up to 12 weeks/annum for qualified persons.
    I don't understand why you are wishing to quit your job ? Please re read the information here Effect of Employee’s Resignation
    at the link I provided.
    So, my real question is will it make a difference when I notify them of my retiring?
    It is not your employers business that you apply for early retirement. That has no effect on your comp claim, OR ability to return to your usual and customary employment. You don't have to tell them anything about this.
    Workers Compensation is not generally a DIY/Do It Yourself project. You should definately consult with an attorney.

    Insurance agents are not always the best source of information on all coverage.
    If your spouse has health coverage under a GHP/group health plan at work, you could go on that with a rider to the industrial injury. Pre exsisting conditions can't be excluded from a GHP. That's why I said your work injury isn't about being ''pre exsisting'' it's about who is liable for the cost of your injury/treatment. That would be your employer, not you. That's why GHP or private health coverage or Medicare won't pay...there is another party holding liability. WC is not health coverage.

  9. #9
    Join Date
    May 2010
    Posts
    11

    Default Re: Retiring During Claim

    Thanks for the info! I really appreciate it. The decision I make about returning to my job will be between myself and my wife and the soon to be hired lawyer. I agree that resigning would not be in my best interests. I was being pressured by my employer to answer his question about when I was returning to work OR if ever. I guess I was trying to help him make a decision about hiring a replacement. I am remaining an "employee" until he fires me.......my tools are still in the shop,like I left them in Oct'09. Best to look for a local WC lawyer I suppose.

  10. #10
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: Retiring During Claim

    I was being pressured by my employer to answer his question about when I was returning to work OR if ever.
    Tell him he should do what is in the best interests of his business. Your ER is free to replace you at any time. His business decisions should not revolve around what your intent may be. Your return to work issue will be addressed when your Dr releases you.
    The decision whether or not you 'may' return to work will be made by your doctor. If the doctor says you may/can return to your pre injury employment duties, then the decision will be yours/wife and employer.
    If the doctor says you cannot return to the pre injury job duties, you may be eligible for VR services. If you voluntarily remove yourself from the open labor market, those VR options may not be available to you.
    Your normal retirement has nothing to do with any of these options. Nor to your decision to RTW at the current ER or elsewhere.

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