Colorado Worker's Compensation - Help For Injured Colorado Workers

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  1. #11
    Join Date
    Feb 2007
    Location
    Calif
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    18,011

    Default Re: Please I'm So Confused on Whats Next

    ......I take 75 (life expectancy) and subtract his age at time of accident (23) and multiply the months =600 months.....take that x his TTD x 19% and divide that in half (40-60% is what wc may offer...i found that on here....is that right???
    Where did you get 75/life expectancy, and where is that a factor in calculating PPD indemnity ?

    You also have to take into consideration this...
    8-42-107.5. Limits on temporary disability payments and permanent partial disability payments.
    No claimant whose impairment rating is twenty-five percent or less may receive more than seventy-five thousand dollars from combined temporary disability payments and permanent partial disability payments. No claimant whose impairment rating is greater than twenty-five percent may receive more than one hundred fifty thousand dollars from combined temporary disability payments and permanent partial disability payments. For the purposes of this section, any mental impairment rating shall be combined with the physical impairment rating to establish a claimant's impairment rating for determining the applicable cap. For injuries sustained on and after January 1, 2012, the director shall adjust these limits on the amount of compensation for combined temporary disability payments and permanent partial disability payments on July 1, 2011, and each July 1 thereafter, by the percentage of adjustment made by the director to the state average weekly wage pursuant to section 8-47-106.
    As the PPD rating is 19%, he cannot be paid more than 75K, when you combine any TTD/wage loss paid while treating/recovery... and indemnity due to the 19% PPD rating.

    Don't know what the 40% to 60% would be. If you mean the carrier would take that kind of 'discount', there is no formula for that. A C&R, or Compromise and Release is based on the estimated value of any indemnity due, the potential value of future medical care... but its actually ''new money'', or just a lump sum of cash for your consideration to drop the claim, and never darken their threashold/door again. No more benefits to this injury, from this claim.

    Apparently you/he is going to be evaluated by Dr/IME because the carrier wants to get another opinion on that PPD rating. Not unusual. And they have the right to IME evaluation. Those rules are here 8-42-107.2. Selection of independent medical examiner - procedure - time - applicability. http://www.colorado.gov/cs/Satellite...oximate_result

    You are going to continue in this confusion over how much money you may receive... it's a complicated formula to calculate, you don't actually have a final PPD rating. And even if you were to come up with some kind of number... not likely it would be accurate.

    Just for giggles... IF the rating stands at 19%, and it's for a scheduled loss/hip... the max would be 208 weeks.
    If it's paid at the TTD rate, take $704 X 208 X 19% X 1.74 = $48K +/-. I do not know that is the amount youd be paid. If it's close, and paid in lump sum, there could be a reduction, or commutation to ''todays dollars''. You could deposit the reduced amount in a interest bearing account, just like the IC does, and let it 'grow' vs taking the bi weekly payments.

    As I said, there are too many variables in any claim to predict what the dollars will be ....sorry. Can't suggest you run to the bank just yet. You'd be disappointed.

  2. #12
    Join Date
    Sep 2010
    Posts
    10

    Default Re: Please I'm So Confused on Whats Next

    Ya...I've read all of that stuff and even posted a question with the same information about the over and under 25% thing......wondering if he would be considered over 25 since his hip is 48% or under 25% since his whole person is 19. THe whole 75 year thing was something I found on this site......his hip injury...if he is rated to whole person is non scheduled injury so he will be compensated til his life expectancy age which I read is 75......My step dad got hurt at work and had a shoulder surgery and is completely healed....and he got all of his TTD pay and 65k for a 3% rating......so IDK I spoke to our attorneys and the appt on the 16th is a IME rating, but it was scheduled at the same time as the first rating so I am guessing they just want two opinions which is fine with me. The sooner we get done with this stuff the better b/c he is MMI but has not been released to go back to work...never in the coal mine or oil rigs like before.....but not even light duty until he can get another opinion on what he is able to do. Thanks for all of your help and information. Cant run to the bank til we get a check anyway lol
    Last edited by lionhunter; 09-10-2010 at 10:24 PM.

  3. #13
    Join Date
    Feb 2007
    Location
    Calif
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    18,011

    Default Re: Please I'm So Confused on Whats Next

    ......wondering if he would be considered over 25 since his hip is 48% or under 25% since his whole person is 19
    The 25% 'thing' would apply depending on how the rating is applied... IF there is scheduled loss, the 'hip' would be rated, if the 'whole person' impairment, then the hip would not be relative.

    All of your quesitons, and discussion in this tread go to show the reasons we don't generally like to discuss the dollar amounts in a claim/settlement. There are just too many variables to tell what the potential outcome may be.
    Nothing is final until a WC judge reviews for adequacy, and signs off on any settlement, whether there is Stipulation w/Award, or Finding/decision by judge post trial, or a C&R... keep in mind you cannot force a lump sum payment to resolve/close a comp claim... the defalut settlement is continuing weekly payments, and access to future medical care.

    Any cash payment to close a claim is always in the carriers best interests... the only good file is a close file... however, a C&R may not be in the best interests of the IW... regardless of how you may want out of the system.
    WC is about paying benefits due to industrial injury....not settlement cash.

  4. #14
    Join Date
    Sep 2010
    Posts
    10

    Default Re: Please I'm So Confused on Whats Next

    I guess this is why we have amazing attorneys huh.....Perhaps everyone should obtain attorneys instead of simply trying to find information from others who have been in similar situations. I wasn't looking for exact dollar amounts...just an idea from people who have been through similar situations. OBVIOUSLY W/C doesn't have the workers best interests in mind and dont really care what happens to anyone. Of corse they want a closed case, and so do we...no future surgeries will ever fix the damage that was done to him. This been an ongoing 'thing' for almost a year and came to this site for useful information...and only got the information that I have already read on the W/C site. You cant tell me that there aren't others that are curious to know a rough estimate of what a settlement can be...because I have seen tons of other ones on this site.

  5. #15
    Join Date
    Sep 2010
    Posts
    1

    Default Re: Please I'm So Confused on Whats Next

    Quote Quoting lionhunter View Post
    What is IME? We have another appt scheduled by the opposing counsel on the 16th of sept.....is that what u mean?
    imes are just rent a doctors that comp and insurance pay to say your fine so they don't have to pay you anymore, Has anyone EVER had a IME that did not come back that you are lying and just faking it? And Attorneys, please...I have been dealing with mine for three years and now he wants me to settle for nothing and I am still not able to return to work.

  6. #16
    Join Date
    Sep 2010
    Posts
    10

    Default Re: Please I'm So Confused on Whats Next

    Ya I have heard that the IME Dr. will be unfriendly lol....but thats ok.....I cant ever determine what is right on this site or wrong.....I have read that when someone is MMI they stop getting their ttd checks....but my husband was MMI over a month ago and we are still getting them and our attorneys say we will continue to get them until WC is satisfied with a rating and they will stop when he gets his PPD checks or settlemend.....so IDK what is right and wrong. I plan to just seek information from our attorneys and continue my homework. Thanks

  7. #17
    Join Date
    Feb 2007
    Location
    Calif
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    18,011

    Default Re: Please I'm So Confused on Whats Next

    .Perhaps everyone should obtain attorneys instead of simply trying to find information from others who have been in similar situations.
    Ok... based on your 16% PPD rating, (or whatever rating is finally agreed to) you are going to get about 25K. That's what everyone else in your 'similar situation'' gets.
    On the other hand... IF he can RTW, he would only get 10K... cuz that's what everyone else gets.

    But, because of the variables in your claim, you are gonna get 150K, and thats' ALL you're gonna get for ever. Cuz you chose to get out of the system, and do this on your own. Then when the money runs out, you're gonna pay out of your pocket cuz no other IC or Medicare is going to pay until you can prove you spent all of that 150K on treatment to this body part.

    Now, NONE of the above is true. None of that pertains to YOUR claim. ALL claims are unique, making comparisions with other IW's who think your injuries, income, recover, future medical care needs are even remotely close to being similar would be a gross disservice to you, and the other IW's who read these threads.

    If you read the other threads/posts here, you'd find even the moderator/Tony discourages discussion of ''how much can I get" questions. NO ONE can predict that. There is no information other than what the statutes provide.
    There is no one, not even your atty as you have found, that could accurately predict the dollar outcome in any comp claim. No one.
    If I say you get 50K and you get less, you scream foul, and 'liar'... If I say you get 50K and you get that 150K, you scream 'foul' and 'you don't know what you're talking about".

    OBVIOUSLY W/C doesn't have the workers best interests in mind and dont really care what happens to anyone.
    Ok.. WC is a system of statutes, as mandated by your state constitution. "WC" does not pay benefits, but for those states that have only state comp insurance funds where ER's pay for that coverage. Few, maybe two, or three, states have that kind of system.

    THe statues mandate the benefits available. Not guarantee.
    Your ER files a claim with their WC carrier, the carrier/IC becomes the 'employer', ER/IC, for the duration of the claim. The ER is the insured party, not the EE/Employee.
    As such, no, there is no one ''caring'' about the EE/IW... EE's who become IW's are but a liability while benefits are due. And yes, the only good file is a closed file.
    WC is not about 'caring', it's about paying benefits. Not even about paying 'settlements'. IW"s are simply a number on a manilla folder in a desk drawer. (now a number on a computer disk/file... that's all) IW's create jobs for claims adjusters.
    .....I have read that when someone is MMI they stop getting their ttd checks....but my husband was MMI over a month ago and we are still getting them and our attorneys say we will continue to get them until WC is satisfied with a rating and they will stop when he gets his PPD checks or settlemend.....
    ALL claims are unique to the IW. ALL benefits paid are unique to the IW and the facts surrounding the claim.
    TTD is "temporary TOTAL disability" benefits. Yes, TTD would generally stop at MMI, as you are no longer 'totally disabled'' by WC definition. Those wage replacement checks are identified by different letters...TTD/TPD/PPD/PTD, those are generally for ER/IC purpose and statutory identification. If TTD continues past MMI, there may be a credit taken against any indemnity due. Some states pay PPD at the same rate as TTD... it would be impossibly for anyone on a message board to identify exactly what benefits you are receiving, as no one has the claim file.

    So when you say "IDK", it's true from both sides of these monitors...no one ''knows'' what your facts are. The answers you receive from any message board are going to be generic...at best.

    YOUR attorney remains the best source for facts/answers in your claim.
    You are looking for somthing from a message board you simply cannot get, nor should be expected.

    Good luck to you... keep reading those statutes.

  8. #18
    Join Date
    Sep 2010
    Posts
    10

    Default Re: Please I'm So Confused on Whats Next

    Ya thanks again. Hopefully at his appt on the 16th he will get his rating and WC will be satisfied with it. I am so done with the appts, letters, calls and everything else that has been going on during this roller coaster ride with WC lol. I hope that our...especially my husbands...future is bright and he will be able to obtain a successful and fulfilling job like he had before....and if not then we will make it work. Cant get much worse than it is now right? Ill update on this and continue to browse the statutes and the forums. I guess I got in over my head trying to research all of this stuff that is chinese to me so I came here to get a little insight and help and I appreciate all of the input. Thanks again.

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