Back Injury Settlement

[N8_Bee]

My name is N8,
I injured my back at work in June 09, performing a task that was not in my job description as IT instructor. I was ordered by a VP to inventory all of the equipment (cable boxes, modems and the like), even though the warehouse supervisor who was perfectly capable of performing the task (it was also his responsibility) was present. The problem was the the warehouse computer was down and I had the expertise and know-how to fix it and after doing so I was instructed to complete the inventory which consisted of over 25,000 pieces of equipment, I was advised that I would have help but it never materialized.
While conducting the inventory, which took about 6 hours, I picked up a box of equipment and while carrying it to the computer to scan it into the inventory, I felt and heard a 'Pop' in my back (like knuckles cracking). I continued to complete the entire inventory although I knew that I'd hurt my back. By the time I was done, all management personnel was gone for the evening so the next morning, I advised my VP that I'd injured my back conducting the inventory, he documented it but did not send me to the doctor to be seen. I continue to work that day (Friday) and was asked to come in on Sunday (my normal day off) to perform other mundane tasks so I didn't get to rest my sore and aching back.
On Monday, I couldn't even raise myself out of the bed so my wife made me stay home and call my PCP. I did so and went in for treatment and she immediately sent me for an MRI that revealed damage to my L4, L5 & S1 discs. When my doctor got the report, she immediately advised me that I needed to get and complete FMLA paperwork with my employer. She also started me on a regimen of prescriptions that continue to increase in strength and quantity (hydrocodone, oxycodone, skelaxin, dalaudid, methylprednison, clarisoprodol, darvocet, morphine and the list goes on and on, including a host of pain meds that the doctor knew I was allergic when he prescribed them to me.
I saw an Orhopaedic surgeon who started me on physical therapy wich did me no good and had to be stopped because it was causing me more pain. One thing I noted was during my PT eval, I was advised that I'd most likely have to choose a new profession as the demands of my job as an IT instructor (lifting and carry 100 lb. ladders, 50 lb. reels of cable, tools and the rigors of being suspended high in the air from a linesman's belt would be too much for my back to handle in the future). Because I was getting worse (couldn't hold my bladder, pain in my right leg and groin), I was referred to a Neurosurgeon who set me up for and gave me an epidural to help relieve the pain or so he and I hoped. He advised me that if it didn't work, he wouldn't do a second as it could cause further damage to my back. Because it didn't help relieve my pain, I was set up for surgery that consisted of the following (laminectomy, discectomy, fusion and foraminotomy of my L4-L5-S1).
Funny thing is, the IC (AIG or whatever name they're going by these days) refused to authorize my surgery because their "Board Certified Occupational Surgery Doctor" disagreed with my doctor so I had to continue to live in pain for another month. The even funnier things is that the IC sent me for an independent examination by a doctor of their choosing, and in his medical report, he also stated that he believed I needed surgery. Because of the contradiction between both of the IC's doctors, my surgery was authorized adn performed by my NS.
I started surgery again and needless to say the pain continued to increase exponentially despite the increased pain meds and strength and my PT's best efforts. Now I can't lift my right leg when in a prone position at all, it hurts to stand, sit, walk, lie down, you name it.
I had a Myelogram because the NS believes there is still nerve damage in my spine, my Physical Therapist has already contacted the NS and advised him that he doesn't believe that further sessions will be of any benefit to me.
I haven't worked since June 14, 2009 as I've been on TTD which stops and the most inconvenient of times I'm receiving $1446 every 2 weeks id TTD payments which translates to $723/week. My regular weekly wage was $1100, so you can imagine that my family is in a serious financial crunch. I was 38 when I got hurt and it's been nearly a year that I've been on disability. I was supposed to start work hardening but because of the pain that I'm in, that was cancelled.
I'm wondering now, how the "powers that be" are talking about a $100,000 settlement when I'm still under medical care. Is this a fair amount and does it include a provision for future medical care which I'm certain that there will be.
I'm fighting off depression because I just don't feel like my best interests are being looked out for. More than that, I was planning to buy a house for my family as we've been apartment living for almost 10 years. I can't do that now because my savings are all but gone due to my injury at work. I hate the fact that it comes down to dollars and cents but I hate more than anything that I can't provide for my family as I used to be able to.
I need help, answers and advice and I appreciate any and all responses. I'm glad to be here, part of this forum and I'm glad to meet all of you.

Thanks,

N8

[Christopher]

Sorry about your injury/

It is my understanding that each settlement process differs from one case to another, to state your settlement amount range would be an injustice to you.

Sorry I could not be of help.

[N8_Bee]

I understand Chris, and I thank you because through all that I've been through in the past year, you've probably given me something that none of the doctors, lawyers or insurance adjustors have even attempted to. . . Honesty.

Thanks again,

~N8

[daddyslittleroo]

I understand Chris, and I thank you because through all that I've been through in the past year, you've probably given me something that none of the doctors, lawyers or insurance adjustors have even attempted to. . . Honesty.

Thanks again,

~N8

Hi there
I understand what ur.going through cause I been out of work since 09 too. I did manage to go back to work however my injury has now put.me on STD ..short term disability through my work that I actually only work this job for 3 months. So I injury my.back in 09 like you kept working cause boss said to and worked the next day in pain told him again and he wanted me to make a appt with my Doctor so I did paid my copay in which he should of paid.for all of this. After several docs therapht finally a surgery thinking this will fix it..NOT...still can't do want I want to do on a regular basis like bend reach lift sit.there is more sex hurts cause I can't simply do it without the pain of course I have pain.pills they just put a bandaid on it..so come to find out I can no longer do the job I been doing since I came out of school 20 yrs ago. After many more struggling with wc and following the rules I could a lame job make almost a couple bucks more on min wages. My family lost out on alot including food for the house electric shut off cause after making $1200 a week then go to $345 a week is like nothing. And.this is all pre tax. But anyway we met the wc doc now meeting ours the end of this month. So I assume it will go quickly after that. At this point we just want it over with and all these people telling us what we can and can't do. I live in MARYLAND...tell me what is going on with you? Any updates?...our issue and questions is what does the attorney gets as in pay fees etc? Everyone seems to want to settle it out of court. What does that mean? Less for mu family? Also.with the new rules can we.take.the. ash settlement with out paying taxes and still have future medical bills paid for??...what happens next once our doctor report is done? Gyz keep me posted on updates....
daddyslittleroo@comcast.net

[BvIA]

if it's not too late, you should delete your email address... this board is annoymous for a reason, to protect your privacy.

can we.take.the. ash settlement with out paying taxes and still have future medical bills paid for??...

The entitlement to these services Medical care for the injury)may continue indefinitely or for whatever period is required by the nature of the accidental injury, compensable hernia or occupational disease if there is evidence to establish that the need for these services is reasonable, necessary and causally related to the accidental injury or occupational disease.

(added by me)

There are no taxes on a WC settlement. Just as you don't pay taxes on your weekly wage replacement benefits/TTD.

At this point we just want it over with and all these people telling us what we can and can't do.

You are free to do what you like, always. The reason medical care is controlled by the ER/IC is becuase they are paying the bills. You are entitled to medical care, for life, that is "reasonable and necessary, intended to cure and relieve from the effects of your injury or illness/disease".
Medical is provided to a point you are thought to be stable, or MMI/Max Med Improvement has been reached... basically that you are capable of at least sedentary employment. Being MMI does not stop your access to medical care.

take.the. ash settlement with out paying taxes and still have future medical bills paid for??... No... when you take a cash lump sum payment, you are releasing the ER/IC from all liability for your injury, including medical care, and agreeing to never come back for more. You are also agreeing to accept full liability for any additional medical care out of your pocket, with the cash you get for medical reimbursement, if any. Cash for future medical is negotiated item, not a entitlement in a settlement as the PPD indemnity would be.

Something many IW's may not be aware of is Wage Reimbursement...

Wage Reimbursement Benefits
In addition to any other compensation paid to a covered employee entitled to compensation under the Workers' Compensation Act, the employer or its insurer is required to reimburse the covered employee for lost wages due to time spent being examined by a physician or other examiner at the request of the employer or its insurer and time spent attending and traveling to and from a Commission hearing scheduled as a result of a continuance caused by action of the employer or its insurer, if the claimant is otherwise entitled to compensation benefits.

When/if you are required to attend a required evaluation by an "examiner", as you say your are scheduled for, OR a hearing, you are entiled to "wage replacement", not "disability", you are to be paid "wages" at the full rate as your pre injury AWW/Average Weekly Wages. Could be a significant difference for many IWs. Not all states provide for this benefit.

Everyone seems to want to settle it out of court. What does that mean? Less for mu family?

The WC system encourages informal resolution of a claim. That means the parties agree on the % of impairment/PPD.
PPD is paid weekly/bi weekly just as your TTD was paid. Benefit payments for permanent partial disability continue for a period of weeks established by the statute;

Permanent Partial Disability Benefits
Injuries that are not so serious as to leave a worker permanently, totally disabled may nonetheless result in some permanent impairment. This is called permanent partial disability.

There is more info on WC in MD here http://www.wcc.state.md.us/Gen_Info/WCC_Benefits.html

You should have signed a "Consent to Pay Attorney Doctor Fees" http://www.wcc.state.md.us/pdf/pdf_forms/h44_fill.pdf when you retained your atty. Including an explanation of how those fees are awarded/paid. The MD statute COMAR 14.09.01.25, governs atty fees.

(3) Permanent Partial Disability.

(a) General. Except as otherwise provided in §B(3)(b), in a case in which a final award of compensation is made for permanent partial disability, the Commission may approve an attorney's fee in a total amount not exceeding 20 times the State average weekly wage and computed as follows:

(i) Up to 20 percent of the amount due for the first 75 weeks of an award of compensation awarded;

(ii) Up to 15 percent of the amount due for the next 120 weeks of an award of compensation; and

(iii) Up to 10 percent of the amount due for an award of compensation in excess of 195 weeks.

In any claim where a C&R/Compromise and Release is negotiated, (e) The total amount of an attorney's fee in a case in which an agreement of final compromise and settlement is approved may not exceed 20 times the State average weekly wage.

The code for atty fees is here http://www.dsd.state.md.us/comar/com...4.09.01.25.htm
There may be other factors that affect your atty fees.

[daddyslittleroo]

if it's not too late, you should delete your email address... this board is annoymous for a reason, to protect your privacy.

(added by me)

There are no taxes on a WC settlement. Just as you don't pay taxes on your weekly wage replacement benefits/TTD.
You are free to do what you like, always. The reason medical care is controlled by the ER/IC is becuase they are paying the bills. You are entitled to medical care, for life, that is "reasonable and necessary, intended to cure and relieve from the effects of your injury or illness/disease".
Medical is provided to a point you are thought to be stable, or MMI/Max Med Improvement has been reached... basically that you are capable of at least sedentary employment. Being MMI does not stop your access to medical care.

take.the. ash settlement with out paying taxes and still have future medical bills paid for??... No... when you take a cash lump sum payment, you are releasing the ER/IC from all liability for your injury, including medical care, and agreeing to never come back for more. You are also agreeing to accept full liability for any additional medical care out of your pocket, with the cash you get for medical reimbursement, if any. Cash for future medical is negotiated item, not a entitlement in a settlement as the PPD indemnity would be.

Something many IW's may not be aware of is Wage Reimbursement... When/if you are required to attend a required evaluation by an "examiner", as you say your are scheduled for, OR a hearing, you are entiled to "wage replacement", not "disability", you are to be paid "wages" at the full rate as your pre injury AWW/Average Weekly Wages. Could be a significant difference for many IWs. Not all states provide for this benefit.


The WC system encourages informal resolution of a claim. That means the parties agree on the % of impairment/PPD.
PPD is paid weekly/bi weekly just as your TTD was paid. Benefit payments for permanent partial disability continue for a period of weeks established by the statute;
There is more info on WC in MD here http://www.wcc.state.md.us/Gen_Info/WCC_Benefits.html

You should have signed a "Consent to Pay Attorney Doctor Fees" http://www.wcc.state.md.us/pdf/pdf_forms/h44_fill.pdf when you retained your atty. Including an explanation of how those fees are awarded/paid. The MD statute COMAR 14.09.01.25, governs atty fees.
In any claim where a C&R/Compromise and Release is negotiated, (e) The total amount of an attorney's fee in a case in which an agreement of final compromise and settlement is approved may not exceed 20 times the State average weekly wage.

The code for atty fees is here http://www.dsd.state.md.us/comar/com...4.09.01.25.htm
There may be other factors that affect your atty fees.

Thank you for ALL the well needed information, we appreciate it very much. NOW, he is saying that even if we take the Cash settlement that ALL future medical will be covered. Our attorney is a second one after we left the first one go/release of his services. These WC attorneis are not very good with the information or should I say they dont give details or explain this all process. Its always a rush to get in get out or on the phone and off in 30 secs or less and this is how we feel when it comes to attornies that their speaciality is WC cases. And you would think since this guy is the second one we would of picked much better but his intervoew with us was better then our experience with him for the last 2 yrs. So that is why we are looking for any information that we can gaither on our own so we are not lost in the dark. So with all that said I just want to get this right, with the New rules that came in effect this year they still DO NOT change the fact that if we take the cash settlement we are still liabile for ALL future medical out of our pocket once we take cash settlement in hand? After we see our doc what happen next please?
Thanks

[BvIA]

I'd have to read those "new rules" you mention.
But think about it... Why would the ER/IC pay out a bunch of cash and not want to close the claim completely ?
There are times, and some states that permit, a commutation or lump sum payment on the indemnity due, that's the money based on a PD/Permenant Disability rating, and leave the med open.

But... as a rule, you agree to a negotiated settlement, that includes all outstanding issues in a claim, including medical care.
When you do that, cash payment, you agree to accept full liability for any further treatment. Otherwise, what's is the benefit to the ER/IC ?

Attys take 100's of claims to rep IWs. You are not experiencing anything different that the rest. When your/IW input is necessary, you're the first to know. Attys don't have time to educate IW's on the process or how WC moves... you retain an attys services because they know the laws, how your claim is affected and how to deal with the ER/IC adversity to paying benefits. Atty handle going to hearings for the IW, and dealing with a CA without emotion... IW's who think they can do a better job... study those laws and rules, and rep themselves. That's how the legal end of WC works.

[daddyslittleroo]

Well here it is the end of July 2011 another year older and this whole nightmare still isnt settled. Finally been seen by my doc to give a o% of how much im injured. Came back with 50% the WC attorny doc gave me 20% so big difference. WC attorney wanted to settle on $40kand this was before I was seen by my doctor. My attorney counter with 75k. We did not get a answer as yet and it has been over 2 mos so my attorney filed for a court date last month the end of June we should have a court date any day now. I reside in MD. My questions are what happens next? Like I said this been going on since 09. Will I have to go to court only if the WC attorney does not agree with the amount correct? And if an agreement has been reached between both parties then no court and the commissioner signs off on it?
Just trying to get a idea how much longer this could be dragged out or is there a statue of limitations? I mean if every party involved is given a month to respond with a answer this could go on another year and lord knows I cant make it struggling with no income and still keep my house. All readt let my car go back cant pickof my meds cause I cant afford the $2 - $3 co-pay from the state of Maryland insurance. I have no food and the list goes on including maxing out my cards to stay a float. So if anyone could tell me what to expect the next couple weeks and if anyone thinks this may be getting closer to the end of the road I would appreciate anyones input of info please and thank you!

[queenbee]

Info about court date Im in maryland also and my attorney requested a hearing at the beginning of June he said it would be at least 3 months before we got a scheduled date they are so back logged good luck

[daddyslittleroo]

Hi Queenbee
Thanks for giving me the info nice to talk to.people that is going through this or had been through it. I just want to be clear in what you are saying. Do you mean that it will take at least three months to get a date from the court or three months before we are seen? Meaning that they are so backed logged that the schedule court date is three months out? I know the court has 30days to apply to our request. We just want a date to show WC that we are serious. Thanks again and if anyone else out there that lives in Maryland please share with.