California Worker's Compensation - Help For Injured California Workers

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  1. #1
    Join Date
    Apr 2011
    Posts
    2

    Default Permanent Disability Rated at 25%

    This is My first Time Being Involved In a Workers Compensation case.I just wanted to know what to expect Next.
    To make a long story short,I was Injured In 2009 On the Job As a Craegiver.
    My Ulnar nerve In My left arm was Damaged.The Insurance Company's Dr Released me for Full Duty a Month after My Injury Therefore stopping My TD Payments.
    I called My employer to ask if I could work,They then told me to feel free to look for another Job.I stopped seeing the insurance company's Dr after she told me that I was "Not Really Injured" After I asked her About Rating My Injury.
    I found My Attorney,He ste me Up with a Great Dr.
    In conclusion I was Just Rated Last week Having a PD Rated at 25% In My Non Dominant Arm. Servere Nerve Damage.
    A Represenative from My Attorney's Office said that the next step would be a Demand Payment letter and that The Insurance Company would have two weeks to respond.
    My questions are:
    Is The Insurance company Likely to respond,Or Would they most Likely settle It At the MSC?
    Also,would it seem that since My Payments were stopped By The Insurance Company's Dr Before I was declared P&S, That they would owe Me what was due?
    And Lastly,Would a Rating Of 25% Be a high enough rating for a decent compensation amount?
    I am not looking to get a Lump sum.So Can anyone Calculate a Ball park Figure of what I may receive?
    Thanks.
    All comments are welcome.

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Permanent Disability Rated at 25%

    A Represenative from My Attorney's Office said that the next step would be a Demand Payment letter and that The Insurance Company would have two weeks to respond.
    That is not true. They don't even have to respond to a demand letter.
    If the atty wants to move forward, s/he files for a MSC. At the MSC, you could receive a cash offer to close the claim...if you don't accept... they will determine if additional medical reports are necessary... and discovery will be closed if possible. If that is the case... you'll be set for trial.

    You should expect a dispute to the rating...and a AME/PQME will be necessary.
    I was Just Rated Last week Having a PD Rated at 25% In My Non Dominant Arm. Servere Nerve Damage.
    Doesn't matter, you are rated to WPI/Whole Person Impairment now, not body part.
    Also,would it seem that since My Payments were stopped By The Insurance Company's Dr Before I was declared P&S, That they would owe Me what was due?
    No...the Dr did P&S you. Your atty agreed to use that Dr, it's not the carriers choice. There is a statutory process for selecting an AME or PQME.
    And Lastly,Would a Rating Of 25% Be a high enough rating for a decent compensation amount?
    What do you consider a "decent amount" ?
    Ratings determine the number of weekly indemnity payments are due. That's all. 25% is 6 weeks for each one % or 150 weeks of indemnnity payments... average now is about $230/week. There are other considerations that may affect the total indemnity due, and other benefits.
    I called My employer to ask if I could work,They then told me to feel free to look for another Job.
    Well...that's not really how it works... but many ER/HR people are simply ignorant to the process.

  3. #3
    Join Date
    Apr 2011
    Posts
    2

    Default Re: Permanent Disability Rated at 25%

    Thank You. For giving your help and Knowledge.Your appreciated :-)

  4. #4
    Join Date
    Mar 2011
    Posts
    291

    Default Re: Permanent Disability Rated at 25%

    as you can see from the permanent disability tables 25% is only 100.75 weeks;
    so don't be disappointed when the true figure comes in.
    http://www.pdratings.com/2011pdchart.pdf

    since you have an atty they will likely negotiate a lump sum buyout of both medical and disability.
    your atty can demand they begin advance payments of your PD and file for a penalty if they don't.

  5. #5
    Join Date
    Dec 2009
    Location
    maryland
    Posts
    14

    Default Re: Permanent Disability Rated at 25%

    Hi there,
    I am at the same point you are with the workmans comp insurance. My attorney wants to settle out of court. and worksman comps attorneys is offering and additional amount due to my attorney says go by 1k on every % quoted say workmans comp ime doc said 20% my doc says 35% they will meet in the middle at 30% so that would be 30,000 and a little additional to settle it quickly without going to court. MY thing is how much the attorney gets if we settle out of court? Anyone have a answer? I know if we was going to court then they would be assigned amount from the judge but what happens if we dont go? Anyone knows???
    Thanks

  6. #6
    Join Date
    Mar 2011
    Posts
    291

    Default Re: Permanent Disability Rated at 25%

    Quote Quoting daddyslittleroo View Post
    Hi there,
    I am at the same point you are with the workmans comp insurance. My attorney wants to settle out of court. and worksman comps attorneys is offering and additional amount due to my attorney says go by 1k on every % quoted say workmans comp ime doc said 20% my doc says 35% they will meet in the middle at 30% so that would be 30,000 and a little additional to settle it quickly without going to court. MY thing is how much the attorney gets if we settle out of court? Anyone have a answer? I know if we was going to court then they would be assigned amount from the judge but what happens if we dont go? Anyone knows???
    Thanks
    12-15%
    if you don't go to court and don't settle, then the carrier pays whatever it wants and then everything stops.

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Permanent Disability Rated at 25%

    Quote Quoting daddyslittleroo View Post
    Hi there,
    I am at the same point you are with the workmans comp insurance. My attorney wants to settle out of court. and worksman comps attorneys is offering and additional amount due to my attorney says go by 1k on every % quoted say workmans comp ime doc said 20% my doc says 35% they will meet in the middle at 30% so that would be 30,000 and a little additional to settle it quickly without going to court. MY thing is how much the attorney gets if we settle out of court? Anyone have a answer? I know if we was going to court then they would be assigned amount from the judge but what happens if we dont go? Anyone knows???
    Thanks
    Whether you go to trial or not, the attys fees average from 9% to 12%, rarely over 15%, must be awarded by WCAB judge, and there is no statute on AA/Applicant Atty fees.

    The indemnity is not based on 1K/1%, your PD/WPI rating determines the number of weeks indemnity benefits are due.
    Any amount can be negotiated for your consideration to drop the claim. That "little extra", not for settlement out of court... it's for future medical reimbursement. Once you take a cash payment, you are going to pay for any further medical care out of your pocket.
    If there is no cash settlement, the indemnity will be paid out bi weekly, and medical remain open.
    The number of weeks indemnity would be paid will be reduced to commute the atty fees. Att gets a cash payment, regardless of how you settle the claim.

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