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  1. #1
    Join Date
    May 2012
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    6

    Default Payment for Percentage Lost

    My workers compensation claim was made in the State of: NC
    I was hurt at work in 2009 and have been out since. I have had 5 shoulder surgeries, including a tendon transfer. When I reach MMI, I know I will not be settling because I basically will be one armed. With the use of 2 hands so my chances of finding any work are pretty slim. My Question is this, does the insurance company have to pay me for my impairment (loss of shoulder) even though I will continue to collect my weekly wage. In other words, is the impairment rating paid seperate from everything else that would go into the settlement?

  2. #2
    Join Date
    Oct 2006
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    9,109

    Default Re: Payment for Percentage Lost

    Quote Quoting Dlsmith View Post
    My workers compensation claim was made in the State of: NC
    I was hurt at work in 2009 and have been out since. I have had 5 shoulder surgeries, including a tendon transfer. When I reach MMI, I know I will not be settling because I basically will be one armed. With the use of 2 hands so my chances of finding any work are pretty slim. My Question is this, does the insurance company have to pay me for my impairment (loss of shoulder) even though I will continue to collect my weekly wage. In other words, is the impairment rating paid seperate from everything else that would go into the settlement?
    I'm not sure how you are getting weekly wages if you "have been out since."?
    am I missing something?

    but generally yes impairment is paid in addition to other comp benefits or earnings from your job.

  3. #3
    Join Date
    May 2012
    Posts
    6

    Default Re: Payment for Percentage Lost

    I have been receiving my weekly ck because I have been on TTD since Dec 09. I know that impairment is paid in addition to others things. But, what I'm curious about, is whether they cut a ck seperate from the rest. Or, do you have to settle, to get any compensation outside of your weekly ck. I hope I'm making sense.

  4. #4
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    Oct 2006
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    9,109

    Default Re: Payment for Percentage Lost

    Quote Quoting Dlsmith View Post
    I have been receiving my weekly ck because I have been on TTD since Dec 09. I know that impairment is paid in addition to others things. But, what I'm curious about, is whether they cut a ck seperate from the rest. Or, do you have to settle, to get any compensation outside of your weekly ck. I hope I'm making sense.
    are you on a wage continuation plan and receive your regular paycheck from your employer while you are temporarily disabled from your job?

    what makes your think your weekly check from your employer will continue when you are no longer temporarily disabled?

    do you have some kind of special employment contract that specifies this?

    most workers under normal state workers comp law do not get their regular paycheck from their employer when they can no longer work.

    without knowing your special circumstances and employment conditions I cannot answer.
    Last edited by .SH; 05-15-2012 at 04:50 PM.

  5. #5
    Join Date
    May 2012
    Posts
    6

    Default Re: Payment for Percentage Lost

    I'm getting a weekly ck from worker's comp. I'm sorry if I confused anyone. I am about to reach MMI, I know I'm not going to settle, therefore I will continue to receive my weekly WC check. Which brings up another question. Since I will be MMI, I know I will have to look for a job under my restrictions. About how many times a week do I need to be applying in order to satisfy WC?

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: Payment for Percentage Lost

    I'm not going to settle, therefore I will continue to receive my weekly WC check.
    You need to consult with a attorney. Don't make any decisions about settlement of your claim without consult. You could be leaving valuable benefits...dollars on the table.
    You don't continue to receive WC disability benefits indefinately.

  7. #7
    Join Date
    Oct 2006
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    9,109

    Default Re: Payment for Percentage Lost

    Quote Quoting Dlsmith View Post
    I'm getting a weekly ck from worker's comp. I'm sorry if I confused anyone. I am about to reach MMI, I know I'm not going to settle, therefore I will continue to receive my weekly WC check. Which brings up another question. Since I will be MMI, I know I will have to look for a job under my restrictions. About how many times a week do I need to be applying in order to satisfy WC?
    workers compensation only pays disability not wages. a check from an insurance company is not wages unless you are working for them.
    disability is calculated as a set percentage based on your past earnings.
    the letter "D" in TD stands for DISABILITY.
    disability is not taxed and there are no deductions for SS or insurance, etc.

    temporary disability ends when maximum recovery is completed. it will not continue after you reach maximum medical improvement.
    and additional disability payments will be considered permanent disability.
    permanent disability payments will be paid even after you return to work. permanent disability payments are not wages.

    workers compensation disability is NOT unemployment.
    workers comp does not require you to look for work or return to your employer.
    TD ends when you are at MMI.


    more on North Carolina Disability here:
    http://www.ic.nc.gov/faqs.html#claimsfaq

    ---------- Post added at 09:32 AM ---------- Previous post was at 08:54 AM ----------

    Quote Quoting .SH View Post
    workers compensation only pays disability not wages. a check from an insurance company is not wages unless you are working for them.
    disability is calculated as a set percentage based on your past earnings.
    the letter "D" in TD stands for DISABILITY.
    disability is not taxed and there are no deductions for SS or insurance, etc.

    temporary disability ends when maximum recovery is completed. it will not continue after you reach maximum medical improvement.
    and additional disability payments will be considered permanent disability.
    permanent disability payments will be paid even after you return to work. permanent disability payments are not wages.

    workers compensation disability is NOT unemployment.
    workers comp does not require you to look for work or return to your employer.
    TD ends when you are at MMI.


    more on North Carolina Disability here:
    http://www.ic.nc.gov/faqs.html#claimsfaq

    if you can't return to work you will have to show that it is because of the injury in order to have TTD continue beyond MMI.
    Last edited by .SH; 05-16-2012 at 08:04 AM.

  8. #8
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    2,964

    Default Re: Payment for Percentage Lost

    Let me clarify the law for you.

    For a 2009 injury, you can draw the weekly TTD check for so long as you continue to be totally disabled by the injury, even for your lifetime if need be. You are required to prove that you are disabled.

    You can prove you are disabled in one of four ways--(1)with medical evidence of total disability (doctor says you cannot work); (2) with restrictions (doctor says you can work but not full duty) and an unsuccessful, reasonable, and diligent job search that is well documented; (3) your overall condition is such that looking for work is futile, or (4) by returning to work for less money than you made before your injury, and the pay loss is due to the injury and restrictions and impairments you have for the injury. This fourth method gets you permanent partial disability under NCGS 97-30 for up to 300 weeks from your date of accident, but the first three methods get you continuing TTD at the full rate until you either get back to earning wages or die of old age.

    I have a legal education paper posted on my law firm website that explains the process of proving disability. You are welcome to read it or download it/print it out, etc. It may help you to understand the process. Here is a link to the article:

    http://www.bollingerlawfirmnc.com/CM...Disability.asp

    MMI is really not relevant in NC under facts like yours. At MMI, the doctor will release you from treatment, and you will probably get permanent restrictions on what you can do with our hand. Those restrictions are what initially qualifies you for continued TTD checks. If you get released "Full Duty" then your TTD checks will stop whether you have a job or not. So you need a restriction, no matter how minor, to prevent your TTD from stopping. Then, you need to start doing a diligent and reasonable job search. Three to four job contacts a week, all carefully documented, is probably enough. At MMI, the doctor will usually give you a PPD rating which is a percentage of the body part. For example, "25% of the hand." But, if you are not back working, this rating is sort of irrelevant. It is almost always a bad deal for you to accept the rating in lieu of ongoing TTD payments, if you are eligible for TTD under the first 3 of the 4 methods of proving disability as set forth above.

    I would also suggest you start thinking about hiring a lawyer. You are likely to need one soon.

    Good luck. Bob
    Last edited by complwyr; 05-16-2012 at 03:38 PM.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

  9. #9
    Join Date
    May 2012
    Posts
    1

    Default Re: Payment for Percentage Lost

    you should have a lawyer....wcb sets their pay from your settlement or payments....never talk to the WCB as they can use anything you say at a hearing

  10. #10
    Join Date
    May 2012
    Posts
    6

    Default Re: Payment for Percentage Lost

    Quote Quoting complwyr View Post
    Let me clarify the law for you.

    For a 2009 injury, you can draw the weekly TTD check for so long as you continue to be totally disabled by the injury, even for your lifetime if need be. You are required to prove that you are disabled.

    You can prove you are disabled in one of four ways--(1)with medical evidence of total disability (doctor says you cannot work); (2) with restrictions (doctor says you can work but not full duty) and an unsuccessful, reasonable, and diligent job search that is well documented; (3) your overall condition is such that looking for work is futile, or (4) by returning to work for less money than you made before your injury, and the pay loss is due to the injury and restrictions and impairments you have for the injury. This fourth method gets you permanent partial disability under NCGS 97-30 for up to 300 weeks from your date of accident, but the first three methods get you continuing TTD at the full rate until you either get back to earning wages or die of old age.

    I have a legal education paper posted on my law firm website that explains the process of proving disability. You are welcome to read it or download it/print it out, etc. It may help you to understand the process. Here is a link to the article:

    http://www.bollingerlawfirmnc.com/CM...Disability.asp

    MMI is really not relevant in NC under facts like yours. At MMI, the doctor will release you from treatment, and you will probably get permanent restrictions on what you can do with our hand. Those restrictions are what initially qualifies you for continued TTD checks. If you get released "Full Duty" then your TTD checks will stop whether you have a job or not. So you need a restriction, no matter how minor, to prevent your TTD from stopping. Then, you need to start doing a diligent and reasonable job search. Three to four job contacts a week, all carefully documented, is probably enough. At MMI, the doctor will usually give you a PPD rating which is a percentage of the body part. For example, "25% of the hand." But, if you are not back working, this rating is sort of irrelevant. It is almost always a bad deal for you to accept the rating in lieu of ongoing TTD payments, if you are eligible for TTD under the first 3 of the 4 methods of proving disability as set forth above.

    I would also suggest you start thinking about hiring a lawyer. You are likely to need one soon.

    Good luck. Bob
    Thanks Bob, The percentage of loss will be on my shoulder and the Neurosurgeon has already told me it will be a very high percentage. However, I have done hard manual labor all my life with no further education than High School so finding another job at even $15/ hour (75% 0f $20/hr), will be pretty slim in this economy. I did talk with Todd Oxner yesterday, he told me the same thing about having to, not only look for a job under my retrictions, but also to document it very carefully. I am not to concerned with WC messing with me over my retrictions because my arm is physically unable to perform, it's not a matter of limitation. However, having said that, I am not naive enough to think, they may try anyway. As a matter of fact there was a lady out in the front of my house yesterday taking pictures of me out in the yard. So far I have had no issues with WC but I'm afraid the games are about to begin! Thanks for you help!!!!

    ---------- Post added at 07:16 AM ---------- Previous post was at 07:06 AM ----------

    Thanks for the input, but I have found out that WC will continue after MMI (in NC) and for my lifetime because, 1. I fall under the old law. 2. I will not be able to find "suitable" employment. (75% of my wage of $20.32hr or $15/hr). I have done manual labor all my life, with no education beyond HS. I do realise I will have to look for work and document very carefully. If I did in deed find a job at $15/hr. I would gladly take it. Being on WC means I have nothing going into my SS and or Retirement Savings (at least at this point and time). I'm not quit sure what one can do with one arm and two hands that will pay that kind of money. We shall see.....

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