Results 1 to 9 of 9

Thread: C&R Settlement

  1. #1
    Join Date
    Aug 2010
    Posts
    24

    Default C&R Settlement

    My workers compensation claim was made in the State of: ca

    I am doing a c & r for only future medical with a disability rating of 0% the employers atty contacted me to settle and told me that I need to give him a dollar amt then he wil go to the wc ins with that number. I assumed the wc ins company would come to me with a dollar amt and I would agree or disagree. I am not comfortable giving a dollar amt the way this atty talked was that I had to otherwise the wc ins wouldnt even look at it.
    The Dr. report does say may need surgery so any ideas on dollar amt to settle for? Something similiar to carpel tunnel

    Thanks

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: C and R Settlement

    You aren't likely to get a settlement offer from them... why should they tip their hand on a number, when they can get a feeling from you of what you'd accept ?

    If you had an attorney... s/he would know approximately what the future medical is worth and send a demand letter.
    The Dr. report does say may need surgery so any ideas on dollar amt to settle for?
    You won't get near the potential cost of a surgery, regardless of the type.... nor wage replacement, PT, or other associated costs. And, IF you were paid for a surgery you may or may not get down the road... it would be paid according to the offical medical fee schedule, not the usual and customary fees you would pay out of pocket, and the amount would be discounted to "todays dollars" or present value, not the full amount 5 or 10 years from now.

    With out a comprehensive review of your claim, by an attorney, it's impossible to project a dollar amount on your future medical buyout.

  3. #3
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: C and R Settlement

    Quote Quoting JDE302 View Post
    My workers compensation claim was made in the State of: ca

    I am doing a c & r for only future medical with a disability rating of 0% the employers atty contacted me to settle and told me that I need to give him a dollar amt then he wil go to the wc ins with that number. I assumed the wc ins company would come to me with a dollar amt and I would agree or disagree. I am not comfortable giving a dollar amt the way this atty talked was that I had to otherwise the wc ins wouldnt even look at it.
    The Dr. report does say may need surgery so any ideas on dollar amt to settle for? Something similiar to carpel tunnel

    Thanks
    you shouldn't be negotiating with their atty; it's not an equal exchange. it's barely ethical that you deal with an experienced adjuster.

    rather then give them a number how about requesting a stipulation to the 0 PD and open medical?
    that way you have 5yrs to reopen the disability issue should you have surgery.

    don't deal with the atty. put any demand in writing to the carrier directly- with a cc to the atty.
    have you returned to work? you might be eligible for SJDB
    http://www.dir.ca.gov/dwc/SJDB/SJDB_FAQ.html

    unless you're using medical regularly or the chance for surgery is 50% or more there is little incentive for them to offer much.

  4. #4
    Join Date
    Aug 2010
    Posts
    24

    Default Re: C and R Settlement

    I no longer work for the company(I quit rather then drive 75 miles to a job). I have spent over a year trying to get info from the wc ins with no calls back no correspondence at all. I finally gave up, then I get a call from the employers atty wanting to settle. As I said the Dr. gave me a 0% rating, pretty much talked me into doing that. I understand why the wc ins would want to know from me a settlement amt. But I dont feel comfortable doing so, this is not a high dollar claim. But still dont want to low ball myself. The atty for the employer has given me a range but of course that is from the employers atty. The only options are medical or a C & R. I was under the assumtion that the ins co would come to me with a offer which I accepted or countered not me saying a dollar amt.

    Thanks much for all your advise and help

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: C and R Settlement

    It's common for them to ask how much you want... as I said, no reason for them to offer more than you may be willing to accept. Sure you see that reasoning.

    I have spent over a year trying to get info from the wc ins with no calls back no correspondence at all. I finally gave up,
    What info are you trying to get from the carrier? Did you put anything in writing and use USPS cert return receipt requested?

    Don't know what you mean by "employers attorney", vs the carriers attorney ? There is no reason your ER would have atty contact you for any settlement discussion. Once the IC accepts a claim... they handle and pay any benefits/settlement monies.
    As I said the Dr. gave me a 0% rating, pretty much talked me into doing that.
    Your PTP 'talked you into" a 0% PD/WPI... why? Why didn't you dispute that, and get a PQME... of course the ER/IC would accept and agree to a 0% rating... there would be no PD indemnity due.

    IMHO... you'd be luck to get 2K...maybe 3K for the future medical here.
    rather then give them a number how about requesting a stipulation to the 0 PD and open medical?
    that way you have 5yrs to reopen the disability issue should you have surgery.
    Agree with SH. The 5 yrs to reopen however is from the orginial DOI/Date Of Injury... if that is the case and you reopen for new and further disability... there could be PD indemnity benefits due based on a PD/WPI rating.

    Why haven't you consulted with a WC attorney on this claim.?

  6. #6
    Join Date
    Aug 2010
    Posts
    24

    Default Re: C and R Settlement

    Thanks for the info. I understand the the wc ins wanting a dollar amt. from me, I just assumed it would be an offer from them not just having a atty call me to settle. I talked to an atty early on and I guess not enough cash in it for them. So I guess I will go with a high number and see what happens.

    Thanks again

  7. #7
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,011

    Default Re: C and R Settlement

    Pulling a number out of thin air isn't going to move this forward...you don't know what the potential value is of your future medical... and you would be agreeing to pay out of YOUR pocket for any additional treatment, you cannot use your own health insurance, or Medicare.
    And... when you do become Medicare eligible, you will have to prove you have spent that money, including reasonable interest before Medicare will provide coverage for this body part.

  8. #8
    Join Date
    Aug 2010
    Posts
    24

    Default Re: C and R Settlement

    My understanding is if its under a certain dollar amt I think 250.000 medicare doesnt look into it. The atty that called gave me a dollar amt. I understand that I will be taking care of additional treatment when needed. I appreciate all your info

  9. #9
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,062

    Default Re: C and R Settlement

    Your understanding about Medicare and $250K is not correct. There is no "safe harbor" amount at this time.
    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

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
 


Find a Lawyer