What Happens After Two Years

[Ob3135]

It appears I have been made worse by major surgery and will require a second even more risky and major suregery. This will likely be just after the two year mark and will have me on the down hill swing to just getting better hopefully after the opp... So I will not be healed, or considered stable at the two year mark so now what do I do?

Will they stop paying my bi-weekly benifits at two years? Will it just cut off? As I have read it - it seems it seems to indicate that benifits stop dead at two years?

[tony]

Ob3135

I will not be healed, or considered stable at the two year mark so now what do I do?

Will they stop paying my bi-weekly benifits at two years?

I don't know where you get this two year mark as a limit for anything. You can collect TTD for the duration of the disability.

Here is a summary for Alaska:
Medical Benefits
Full medical benefits are provided with no time or monetary limitations.

Benefits for Temporary Total Disability (TTD)
The percentage of worker's wage paid is 80% of worker's spendable earnings. For weekly payments, the minimum is $110, or $234 (22% of maximum compensation rate) if employee shows proof of wages, or worker's spendable weekly wage if less. The maximum is $1,062, 120% of SAWW. The maximum period of payments is the duration of disability until date of medical stability. WC benefits are subject to offsets under Social Security.

Benefits for Permanent Total Disability (PTD)
The percentage of worker's wage paid is 80% of worker's spendable earnings. For weekly payments, the minimum is $110, or $234 (22% of maximum compensation rate) if employee shows proof of wages, or worker's spendable weekly wage if less. The maximum is $1,062, 120% of SAWW. The maximum period of payments is the duration of disability. WC benefits are subject to reduction by Social Security and any previously awarded PPD benefits.

Benefits for Permanent Partial Disability (PPD)
For weekly payments, the minimum is $110, or $234 (22% of maximum compensation rate) if employee shows proof of wages, or worker's spendable weekly wage if less. Ratings for compensation purposes are determined as a percentage of permanent total disability. Permanent partial disability benefits are determined by multiplying $177,000 times the employee's percentage of permanent partial impairment of the whole person and is payable in a single lump sum, unless the employee is enrolled in a vocational rehabilitation program. Compensation may not be discounted for any present value considerations.

Additional Information
Alaska Workers' Compensation Administrative Rules and Statutes are available online at:
http://labor.state.ak.us/wc/legaldir.htm
Compensation rate tables for current and previous years are available online at:
http://labor.state.ak.us/wc/rate.htm


I deleted your other post, it was a duplicate and would confuse the board.

Tony

[.SH]

no, they don't stop disability payments.

information clearly states that if medical benefits are denied after 2 years you can request it thru the comp board.

The insurer is obligated to pay medical expenses for up to two years following the injury. Medical expenses may be paid thereafter if ordered by the Board. Insurers usually pay for medical care beyond two years if necessary for the process of your recovery from the injury.
http://www.workerscompensationinsura...fter-Two-Years

what part is confusing?

what did the Information & Assistance Unit tell you?
http://labor.state.ak.us/wc/info-assist.htm

If the insurer/employer stops medical payments, and if you believe you need more treatment, you must make a written claim to request additional medical payments. The law permits the insurer/employer to stop medical payments two years after your injury date, but the AWCB can authorize additional medical payments if treatment is needed for the process of recovery.


when you wish to request treatment order by the comp board you file a claim form:
http://labor.state.ak.us/wc/forms/wc6106.pdf
and when you are ready for a hearing you file an affadavit:
http://labor.state.ak.us/wc/forms/wc6107.pdf


the board will send you a notice of when the hearing will be scheduled.
or
you can get an atty to represent you.

[Ob3135]

I deleted your other post, it was a duplicate and would confuse the board.

Tony

Didn’t realize the forum was so fast :-) I was hoping to increase chances of getting a answer... Evidently I under estimated how helpful and prompt you guy’s are with your help. It's impressive!

---------- Post added at 06:20 PM ---------- Previous post was at 06:13 PM ----------

what part is confusing?

or
you can get an atty to represent you.[/QUOTE]

The confusing part is that just like everything you pointed out here, it doesn’t say much about their requirement to pay me my pay check every two weeks. Just the medical expenses... The pay check is what would bankrupt me if it stopped. That’s my concern... I've read all the rules and it's just not very clear.

Also, I cant get an Attorney, I believe I need one for sure, I was even told by the board I should have had one long ago, yet there is no lawyer that will take my case because nothing has been contraverted :-( Everyone I've called says until something is contraverted they cant rep me... Disappointing, so I'm flying thru all this solo.. Scary :-(

however, Tony was pointing out as he reads it they must continue until I'm Stable... You agree? I guess the other scary part is their doc who is obviously bias could say I'm stable any time he wants rather I am or not, that said I have to admit he's had a couple chances to dispute if he was gonna and he didnt cause I'm legit, so I guess he isn't as bias as some have said he is. Maybe he is cool when you are for real and have a real serious injury... I dont know.

[.SH]

there is no objective way to tell whether your recovery has peaked except by medical opinion----neither you nor your employer's opinion will count.
there is no test, Xray, or special computer analysis that will know that about any patient.
so yes, one doctor can say you are stablized and another can say you're not--that'll always be the case about anything medical.
how it'll affect you comp benefits is what the comp board is for-----to resolve disputes/differences of opinion legally.

and you have to read all the information about each benefit (there are different rules for each)--see the links you were given--to get an correct understanding what happens with your workers comp benefits.

lawyers are good at filing forms and going to court but not so good at answering questions and explaining how the comp system works--they have too many cases to want to do that.
try the Information and Assistance--or come back here with your questions.