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  1. #1
    Join Date
    Aug 2010
    Posts
    56

    Default Compromise and Release

    I signed a C&R over a week ago, how long does it take to get in front of a judge, approved and finally the check ? this whole work comp thing has ruined me financially.

    How anyone can commit W/C fraud is beyond me.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Comprmise and Release

    Once you have signed off, the documents to back to the CA, the carrier approves though home office, then the documents are sent to the WCAB judge for review/approval. The documents can be walked though, takes just a day. If the docs are just sent to the judge, depends on the schedule each ALJ determines. Some address as they are rec'd....others set aside a specific time each week. Once the ALJ signs off on the C&R docs, they are sent back to CA to issue the check.

    WCAB' locations are subject to the furloughs just like the other state EE's. Closed on Fridays, that has the distinct possibility of prolonging things more. Expediated hearings/MSC, regular MSC, trials are going to be held before taking time to review/approve settlement docs.

    The ER/IC has 30 working days to issue the payment. After that, a self imposed 10% would be due. Plus interest at 7%/annum, from the date the ALJ signs off on the C&R.

  3. #3
    Join Date
    Aug 2010
    Posts
    56

    Default Re: Comprmise and Release

    Great, thanks for the reply...so I should get a check sometime in January one would think.

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Comprmise and Release

    Could be... maybe, possibly... any similar word you can apply ..may apply.
    While you are waiting, it would be a good idea to begin a job search. The sooner you RTW, the less in wage loss you'll suffer. Lost wages cannot be replaced.

  5. #5
    Join Date
    Aug 2010
    Posts
    56

    Default Re: Comprmise and Release

    Quote Quoting BvIA View Post
    Could be... maybe, possibly... any similar word you can apply ..may apply.
    While you are waiting, it would be a good idea to begin a job search. The sooner you RTW, the less in wage loss you'll suffer. Lost wages cannot be replaced.
    I'm not able to work, I have reached MMI and still in pain daily, I receive SDI still but I'm not injured enough for SSD, is there a possibility the IC could change their mind about the settlement ? or are they just dragging their feet ? my attorney doesn't answer my calls either.

    Is there a # I can call to find out whats going on with my case other then my dumb Attorney ???

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Comprmise and Release

    Go to the WCAB web site, you can find info on what actions are open in your claim. You need your claim number issued by the WCAB.http://www.dir.ca.gov/dwc/EAMS/EAMS_PublicSearch.htm
    It's not going to tell ya that much though. You could contact an I&A officer... but they won't speak to you as you have a 'dumb' attorney.
    I'm not able to work, I have reached MMI and still in pain daily, I receive SDI
    YOu're not going to like this...but you may as well get used to hearing it... "pain" is not enough to continue being ''disabled''. YOur SDI is going to run at 52 weeks. There are no extensions.
    Lots of people go to work every day with some degree of pain. I'm not saying your pain is more/less than others may suffer... only that at some point, you should be prepared for your benefits to stop.
    Even that C&R money isnt' going far... If your careful... what, Two years...? IF that long.
    is there a possibility the IC could change their mind about the settlement ?
    You bet they can.
    You didn't provide a lot of information here. Don't know what the details of your settlement are. Or what is included.
    I can tell ya though... you mentioned SSDI... IF you have applied for SSDI and been denied, though are appealing...then based on the figures/triggers of your settlement.... you may be required to address the MSA issues... even though you are not Medicare eligible yet. You haven't said anything about that... and you could face some ......well, "challenges".

  7. #7
    Join Date
    Aug 2010
    Posts
    56

    Default Re: Comprmise and Release

    I was denied SSD and didnt appeal with in the 60 days so I applied again, I'll drop the claim if I have to, I dont want any MSA. If me or the IC replenishes my SDI acconut I can go longer than the 52 weeks correct, if my DR still rates as not able to work.

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Comprmise and Release

    SDI is paid when your DR says you are 'disabled'.... due to injury/illness. This has nothing to do with being "disabled" for WC purposes of definition.

    In a C&R, the parties are agreeing, or resolving/settling all issues in the claim, and you are agreeing as well to accept full liability for further medical care...out of your pocket.
    If the SDI/TTD periods were not addressed in the documents, IE. that the EDD/SDI is to be reimbursed....then, no, you won't have additional weeks of SDI available to you. Not until/unless you RTW and replenish that account by paying the premiums/payroll deductions.
    I was denied SSD and didnt appeal with in the 60 days so I applied again, I'll drop the claim if I have to, I dont want any MSA.
    You cannot expect to apply, drop the claim, then apply again later with the intention of manipulating SSA. They are fully aware of those tactics...you have already applied, whereby you have declared you are "100% disabled" and unable to work. Your Dr's have provided medical evidence to support that opinion....only SSA has disputed that so far...according to their definition of "disabled". That doesn't mean you are no longer disabled, only to come back post settlement of your WC claim to declare your "disability" once more.

    Medicare eligibility due to age/normal retirement, receipt of SSDI, OR... application/appeal process is reason to address CMS/Medicare protection.

    Furthermore....with the MSPA/Medicare Secondary Payor Act changes a couple years ago... ALL personal injury/auto/liability and/or workers compensation claims that are settled where medical coverage is changed/closed MUST be reported to CMS/Medicare and are tracked. When you become Medicare eligible, regardless of the length of time, or Medicare status at that time, (whether or not Medicare actually exists as we know it) you will have to prove you have spent all of the money allocated to FMC/Future Medical Care before Medicare will pay for treatment to your injury.
    AND...if there is no allocation in the C&R documents, CMS can and will declare the ENTIRE amount of your settlement as reimbursement for FMC.
    It is in your best interests, and your AA/CA/DA to see that Medicare is addressed in any settlement you enter into.

    I doubt anyone 'wants' a WCMSA....but as you can see, it's not up to you, and you are not big enough to manipulate SSA/CMS/Medicare in this.
    If me or the IC replenishes my SDI account
    Not sure I follow your thought process on this... why would you reimburse/replenish your SDI account? If you have the money to do that, why give it to EDD only to continue being paid the weekly benefits? The only way you could do this otherwise is RTW. If you can do that...you aren't "disabled" to the point of qualifying for 'disability' benefits.

  9. #9
    Join Date
    Aug 2010
    Posts
    56

    Default Re: Comprmise and Release

    The DA wrote in the C&R
    Applicant is not a recipient of Medicare benefits and there for the interest of Medicare/ CMS have been considered
    Not sure I follow your thought process on this... why would you reimburse/replenish your SDI account? If you have the money to do that, why give it to EDD only to continue being paid the weekly benefits? The only way you could do this otherwise is RTW. If you can do that...you aren't "disabled" to the point of qualifying for 'disability' benefits.
    There is a lien on my settlement against the IC, its going to get some money back in it.

  10. #10
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,017

    Default Re: Comprmise and Release

    Applicant is not a recipient of Medicare benefits and there for the interest of Medicare/ CMS have been considered
    That doesn't matter. That is the DA opinion.
    To cover your ass, which is more important... you should sign a SSA release of information form, and GET your SSA/Medicare status..>IN WRITING<. That document should be included in the C&R documents.
    That is the ONLY way the parties will be protected against CMS and the ability to declare your ENTIRE amount as medical reimbursement.

    The penalties for failure to report the settlement to CMS/Medicare can be up to $1000/DAY. AA', DA's CA's, TPA's... they are not all that familiar with the new rules. So just because a defense attorney, or claims adjuster 'says" it's alright... well, how much have you trusted them so far?
    If it's not in writing... from a reliable source, it doesn't exist.
    There is a lien on my settlement against the IC, its going to get some money back in it.
    That's fine.
    You won't be seeing SDI though UNTIL those benefits are reimbursed to EDD. Lien doesn't mean a thing until it's satisfied.

    I'm not trying to discourage you here... but I am telling you that weekly checks are going to be few and far between... you shouldn't rely upon SDI to pick up the slack. That C&R money doesn't last long.
    A job search is in order. And the sooner you can do that...the less in wage loss you'll see. Lost wages cannot be recovered or made up.

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