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  1. #1
    Join Date
    Jul 2010
    Posts
    5

    Question L5 S1 Fusion, Disability Rating

    Hello

    My workers compensation claim was made in the State of New Mexico.

    I am searching for a while within this forum for a good answer but I could not find any, this is why I decided to register.
    I lost my faith because of a rude adjuster otherwise I would call them to ask my questions.

    I had a L5-S1 spin fusion, with a big uneven scar (6 inches) and still pain in my lower back. I still take pain-killers, sexual activity is almost ZERO, which makes feel that I am not more man enough which depresses me a lot. I could mention a few more reasons but I know I will never be the same as I was before my accident. My MMI date will be in the end of July 2010.
    I would like to mention that my accident was caused by a previous work injury as my knee gave up on me (never being fixed properly), I believe I got a 6% disability rating on that (it was app. $3600, which I consider to be lower than it should have been).

    Now to my questions,

    1. I would like to know what will be my approximate disability rating for my lower back including all the facts I mentioned above?

    2. Will the 6% for my knee taken in consideration?

    3. I also would like to know what kind of money I can expect after my MMI?

    4. For right now I get payed app. $416 (the 2/3's) a week and I need a approximate idea what a lump sum payout would be?

    I do not trust my adjuster they did many things wrong to me, I have many reasons to file a lawsuit against them, but I am not such person and I also do not like to share with lawyers what is already mine. Or should I consider a lawyer?
    Thank you for reading,
    BL

  2. #2
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: L5 S1 Fusion, Disability Rating

    ratings are done by a physician using the 6th edition of the AMA rating guide.
    ratings can't be done on a message board.
    the guide includes a formula for combining multiple body parts into a whole person impairment rating.
    you may be able to get some unbiased information from the state work comp agency
    http://www.workerscomp.state.nm.us/contact/index.php

  3. #3
    Join Date
    Jul 2010
    Posts
    5

    Default Re: L5 S1 Fusion, Disability Rating

    Hello,
    I understand that ratings can not be given over the internet, but please understand me that I would like to have some kind of an idea so that I can feel save because of the lost trust in WC.
    I would like to ask three more question.

    1. Is there a difference between a settlement and the check I will receive after my MMI when I take it as a lump sum?

    2. If yes, can I proceed with a settlement by myself, or do I need a lawyer?

    3. If yes, who I have to contact in order to work our a settlement by myself?

    Thank you again for reading and a Happy 4th July to everybody.
    BL

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: L5 S1 Fusion, Disability Rating

    1. Is there a difference between a settlement and the check I will receive after my MMI when I take it as a lump sum?

    There is no lump sum check after you are declared MMI... you would begin receiving payments on the indemnity due. That is the award or settlement for the resulting PPD due to the injuiry.
    It can be confusing...but WC pays benefits, not settlements. When you accept a lump sum to close the claim, you are agreeing to a % of partial disability/impairment, the predetermined indemnity due, and liability for any further medical care you may need.
    There are no ''settlements'' beyond what that money is for. A lump sum will generally not pay as much as if you let the indemnity pay out weekly. Never enough for future medical.


    2. If yes, can I proceed with a settlement by myself, or do I need a lawyer?

    You would be wise to consult with an attorney to determine the merits of your claim. Whether you would receive more money may or may not happen. But attorneys generally can increase a rating to the extent of covering the atty fees. At any rate, you would at least have valid legal advice...which you cannot get from a message board.

    3. If yes, who I have to contact in order to work our a settlement by myself

    As a rule, once you are declared MMI, and rated for PPD, you would be contacted by the CA. to discuss a settlement by Compromise and Release, If NM permits this kind of resolution to the claim.
    You'd have to read the WC statutes to determine how claims are resolved.

    SH is right, you can't get a estimate, no average, no way to tell what kind of rating you may have.

  5. #5
    Join Date
    Jul 2010
    Posts
    5

    Default Re: L5 S1 Fusion, Disability Rating

    Hello,
    Thank you guys for your quick response.
    I am now certain that I have to get a lawyer .
    I am very thankful full for the knowledge I got, I wish you
    and all who read that the best in there lives and good health.
    Thanks again,
    BL

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