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  1. #1
    maw1953 Guest

    Default Settlement For A Back Injury

    I was injured at work in April, 2004. I had 3 ESI injections and 2 months of PT before my microdisectomy surgery in Sept, 05. After surgery I did PT for 13 weeks 3xper week, 2 more ESI injections, a trans-caudal injection, a trans-foraminal injection, facet nerve blocks, 3 mri's and finally a discogram that showed my 2 lower discs as severely degenerative with tears and leakage. My first surgery failed and my disc re-herniated. I am now scheduled for a 2 level anterior/posterior instrumented fusion. I applied for social security disabilty and was approved in 2 1/2 months to be reviewed in 5-7 years. I am presently on 60mg of morphine each day. I know that I am a long way off from settlement time but was curious if anyone with a case close to mine has settled. I am sure I will need a medicare set-aside fund for future medical and drugs. How do the attorneys come up with a settlement figure for a case like mine. I have been on work comp since Sept, 05 and will probably not be at mmi for 8-12 months. Will there be any cash settlement besides the money set a side for medicare? I have never gone through work comp before.

  2. #2 Guest


    MAW I am going to presume that you have an attorney, if you do not, then based on the severity of your injury & the complicated nature of your treatment & long term issues that your injury will have, I strongly recommend that you get one. Having said that, most workers' comp. insurers are against medical set-a-sides. They want finality. In other words, they desire to payout & close their files. So, if a medical set-a-side is your desire, then I would meet with your doctors and try to determine what the long range future medical costs might be & present the insurer with the estimated future costs as part of the entire settlement package. In essence you will be the one setting the money aside. Also be aware that once workers' comp. has settled your claim, all future medical can go thru your health insurer, if you have health insurance.

    As to calculating the actual value of a given case, the nature & extent of the injury must be examined, then compared to similar cases that went to trial. We then examine your Average Weekly Wage (AWW), 52 weeks prior to the loss, and use 60% of the gross, multiplied by a % Loss Of Use (L.O.U.) of the part of the body awarded in similar cases to come up to a basic case value. Then we, as attorneys, take many things into consideration that are not contained within the Workers' Compensation Act when determining the value range of a case.
    Some of the things we consider are: Whether the injured person is at a high or low rate. How much time was lost from work? What type of occupation was the injured party in, manual work or office work? Was there surgery? What kind of recovery did the injured employee make? If not a good recovery, less than 100% recovery, what are the residual problems and will further treatment later be needed (so perhaps a trial not a settlement would be better for the injured employee)? Is the case one that would be filled in a conservative or liberal jurisdiction? Is the employer insured or self insured? Who is the claim company or third party administrator? Do we know the adjuster or claim supervisor & get along with them? Do we know the assigned attorney & get along with them? Are there any disputed issues as to compensability or facts of the loss. Were wages, & in turn the permanency rate, properly calculated or was the employee not paid enough for weekly benefits?
    As you can see, there are many intangible things that we, as attorneys, take into consideration when evaluating a case.
    My advise would be see an attorney, in your area, knowledgeable in workers' compensation and retain them to settle you case for you... Remember, a man who represents himself has a fool for a client. Even lawyers hire lawyers. Good Luck.

  3. #3
    maw1953 Guest


    I do have an attorney. My sister is the para-legal handling my case and she has a good relationship with the claim adjuster and their attorney. From what I have been reading since I am on social security disability and will be eligible for medicare after being on disibility for 2 years that medicare will insist on a set aside fund for future medical. Have you done cases with set aside funds? Am I required to have a medicare set aside or not? Unless my doctors will state that I will most likely not need any future medical care in regards to my back injury I think medicare will require a set-aside fund. And what happens if I never use the money in this fund, who does the money belong to. Is the bulk of my settlement put into this fund that I can't touch? This is all new to me. Also my job as general manager of the company has been replaced which I don't blame them. I have been off almost a year already and possible another year before I reach MMI. Does not having a job to return to make any difference with work comp if I am put on light duty with no job to return to?

  4. #4 Guest


    Talk to your sister or your attorney....You obviously have a good relationship with them. They do not charge hourly. They should be the ones that address all your questions.

  5. #5
    Unregistered Guest

    Default Re: Settlement for back injury

    I was injured on 6-21-06, at first i was recieving me checks on-time, on 7-31-06, i went to the company doctor, i have a open MRI taken om8-10-2006, so my claim adjuster did not send me a letter until the 8-22-2006, said that the company doctor said i had recover from my injury, my last check was 8-18-2006, I went back to work like my adjust instructed me to do so, i also had restriction from my doctor, now i have a problem with my adjuster so is there i can do to get my workmen's compensation started back. i also had the shot in my back.

  6. #6

    Default old back injury with current problems

    It's a little difficult understanding what your issue is.
    -whether you are on light duty & have a cost differential owed;
    -whether your condition has worsened & you are now off work again & owed weekly benefits ('TTD'; or
    -whether you are having problems with the insurer authorizing or paying for continued treatment and care.

    Regardless of all of the above, because you have a permanency settlement due you, somewhere down the line, I would suggest that you contact a lawyer, locally, that is familiar with Illinois' workers' comp., sitting down with them & giving them a full history, advising them of your current issues & discussing that they 'step in' for you & resolve the current problems, get the matter back on track, & evaluate your case for a future settlement. Note: when I say 'locally' they need not be in the exact town or even county where you live.

    I am sorry to be so vague, but if you have more specifics as to your problems/issues, please repost. Good Luck.

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