Workers Comp Hearing

[russell50]

In Oct 2010 I had a displaced bucket handle tear of the lateral meniscus and a patellar tendinosis or partial-thickness tear. Arthroscopy which resulted with meniscus being partially removed.

The result was a development of Osteoarthritis in both compartments and all the pain and limitations that accompany a diagnosis of such as confirmed by three MRI and 3 X-ray.

My Dr.’s opinion is that I need a total knee replacement but at my age 44 He does not want to do it now and wants to wait until I am older due to the need for a (statically) second replacement later.

IC requested that my benefit be reduce from TTD to PPD. IC sent to an IME of their choice who agreed with my Dr. 100%. A conference was held and the judge keep me at TTD.

The IC is appealing and the Hearing is next week. The judge had me see by an IME who agrees that my injury happened at work but now claims that there is nothing wrong and that I am at MMI and 100%. My attorney has gotten the judge to agree to open up the medical records from the Dr.’s that have treated me as the reputation of the court chosen IME is suspect.

All conservative treatment efforts have had no improvement. My Dr. would like to a 2nd Arthroscopy for my knee for diagnostic purposes and to help improve my condition.

The Mass workers comp Utilization review came back with an approval for a right knee diagnostic arthroscopy and possible Partial Meniscetomy ( remove what’s left )and possible Chondroplasty for my knee.

The Insurance company requested that I go to another IME of their choosing who’s opinion was that the injury is work related, the 4 cortisone and 2 series viscosupplementation injections and that the treatment plan has been appropriate. But opines that she is unclear the goal of Arthroscopy would be now. She also goes on to adopted the work restrictions that my DR. has had in place of no kneeling, squatting , standing or walking for more than an hour and no climbing activities ie stairs, step stools or ladders all required for my type of work.

Yesterday my attorney called and said that IC wants to settle for 30,000.00. I want to have my knee fixed and return to the work I did before when I was making $1500.00 per week. I have only a HS education and no professional training and have work in the type of work since HS.


The question is can anyone please tell me what they think will happen at the Hearing ?

[.SH]

your atty will probably have you testify and the judge will take all the evidence under advisement and both parties will wait a few weeks for a written decision.
at which point either you or the employer will decide whether they wish to appeal.

[russell50]

Thanks

Does the Judge have to accept the opinion of the IME the he sent me to ( the one that claims that I have reached MMI ) or can he choose to adopt the opinion of my Dr. and my 1st IME that I need another Arthroscopy. Also my Dr. has work restrictions of no prolonged standing, walking, sitting, NO kneeling , No squatting, No stooping, No climbing, max weight to carry is 10 pounds,and max push or pull 25 and work must be limited to 6 hours per day. The 1st IME agreed with my Dr. and went on further to say that in his opinion " In a seated position only it would still be a great deal of difficulty getting him to a work place, functioning in a safe fashion." The last IME opined that I also had restrictions of, " no kneeling, squatting , standing or walking for more than an hour and no climbing activities ie stairs, step stools or ladders all required for work." " But with these restrictions in place , I feel he is capable of working full-time."

I would like to return to my job but this seems impossible at this time. With these restrictions I wonder what I could do for work.

Attorney explains there are risks to not accepting the IC settlement offer and letting the judge decide but attorney does not explain possible out come of his decision.

[BvIA]

Does the Judge have to accept the opinion of the IME the he sent me to ( the one that claims that I have reached MMI ) or can he choose to adopt the opinion of my Dr. and my 1st IME

I think .SH has answered this question...your atty will probably have you testify and the judge will take all the evidence under advisement and both parties will wait a few weeks for a written decision.

Yesterday my attorney called and said that IC wants to settle for 30,000.00. I want to have my knee fixed and return to the work I did before when I was making $1500.00 per week. I have only a HS education and no professional training and have work in the type of work since HS.

The cash settlement is for your consideration to drop the claim.
If you require any type of surgery for this injury, that 30K WILL NOT begin to cover the potential cost. There would be NO wage replacement. You cannot use your own health insurance. You'd be paying out of your pocket for additional medical care.

Attorney explains there are risks to not accepting the IC settlement offer and letting the judge decide but attorney does not explain possible out come of his decision.

Not your attorney, or any other has a crystal ball to predict what a judge will rule in your claim. ALL claims are unique to the individual. There are no averages, or norms.... it simply can't be answered the way you want.

You're going to have to let this play out...or counter offer and negotiate the settlement. That may or may not be in your best interests.
Not all injuries can be ''fixed''... there may not be any other treatment recommended for your injury at this time.

[complwyr]

As a general rule, judges can choose which evidence to believe and which to disregard. This includes the medical evidence from the treating docs and the IME docs. And it applies to your testimony too.