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  1. #1
    ej Guest

    Default Is This Settlement Offer Okay

    I just got a call from lawyer and she said she settled my case and had dollar amounts available.
    I thought this was kind of funny because I had never even gone to court once for this. So here is my story. Had three separate back injuries,first was not w.c. however had surgery, second and third were separate w.c. cases which are being settled now together. I am permanantly disabled and considered unable to do any kind of work. My lawyer said she settled my first w.c. case with a lump sum payment of $61,000. She said she settled my 2nd w.c. case with a dollar amount which will be disbursed over 5 years in the amount of $157,000. After that is over I will get payments from the 2nd injury fund because my original problem was not w.c. related. However she said that my s.s. payments will be offset because of perm disability payments
    I asked if this was just a offer or is this a final settlement which is non-negotiable and my lawyer replied that this is not really negotiable because they are not arguing the fact that I am disabled and the ic is agreeing that I am 100% disabled so I could not possibly get any more money. Does this all sound ok to you guys.
    Or should my back injuries I've had be worth more than that. Anything sound funny to you?

  2. #2
    undercovrangel Guest

    Default

    EJ
    $218,000 for a permanent 100% disability ?? I think that your attorney is crazy. In no state, to my knowledge is an attorney able to settle a WC case without the permission of the IW.

    It sounds to me like your attorney is just wanting her share of the money so that she can dump your case. What about future medical. If you are 100% disabled, and still having/might have problems with your injuries, who is going to pay for future treatment and meds??

    If I were you, I would have the attorney put into writting just how they came about with the amounts of the 2 settlements. Something sounds very fishy to me.... and it isn't the deep fried catfish I had for supper last night!!!!!!!!!

    Angel ^i^

  3. #3
    kenneth Guest

    Default

    Your attorney has no power to close a case that you don't sign off on.

    In todays world I can't imagine what the real value of 200K is? But I do know that the likelyhood of further injuries above or below your initial injures is high, due to the hyper extension of those joints.

    My question then is; What will you do in five or ten years when you're all on your own and need another surgery?

    I agree...it sounds as if you're lawyer is looking at a new Mercedes and needs to settle up a few claims. Spend more time with her. get all the details.

    Don't let them say because the IC agrees you're injured (100%) that it's OK for them to short change you and make light of the fact this is something you have to deal with the rest of your life.

    And most definitly don't sign anything until all details have been explained clearly to you, and you are comfortable with the result. You've most likely been dealing with this for years, what is a matter of a few weeks or even months when it comes to getting a fair shake.

    If the attorney states this is a time sensitive offer and you need to make up your mind in the next week. Tell them all to forget it, as this is a offer that benefits only the IC. It's common practice to starve claiments, then try to shove lousy settlements down their throats.
    Have your attorney file an appeal if you are at that stage...although it sounds as if you're in the 11 th' hour before actually going to court and they want to try to settle up before it goes before the judge.

    Good luck.

  4. #4
    ejr Guest

    Default

    The case isn't final. My lawyer just called me and gave me those dollar amounts. She said I would have to go in front of the judge in may to make it final. She said that the case is basically settled and this is not an offer it is basically all I am entitled to because both the ins carrier and My doctors are saying I am 100% so there will be no negotiating. And although I am only getting approx 218,000, once they are finished paying me over the next five years the second injury fund will continue paying me for the rest of my life because the ic's liabilities are less than a normal case due to the pre-existing condition. So what do other people out there think about this?

  5. #5
    anon2600 Guest

    Default

    All states are different in how they value a case, especially when it comes to 100% rating.
    It may very will be that the $218 is what you are entitled to, buy the codes of your state.
    And after that is paid out, like you say, you will begin the life pension.
    I agree that you should have the terms of your future medical spelled out, exactly what they are going to cover.
    Medicare will not pick up the costs of your treatment until the FM money is exhausted. Also, be sure that CMS signs off on your settlement. As you are receiving SSDI/Medicare you MUST forward this to CMS for review before it can be presented to the judge for approval.

    Your SSDI benefits will be adjusted so that you don't go over the 80% rule. You are allowed 80% of what your average wages where at the time of your entitlement, usually your date of injury.
    As the IC has taken some apportionment due to the previous condition/injury, as long as you take into consideration the other issues, it sounds like you are where you belong.
    CMS/Medicare will go over your files and make the determination as to what should be set aside for your medical trust.
    This can take up to 9 months or so, so don't be too anxious if you don't hear from them right awary.

    You/your attorney can read about the CMS/Medicare requirements here...http://www.cms.hhs.gov/WorkersCompAgencyServices/
    It can get pretty detailed, be sure your atty understands the necessity of this.

  6. #6
    ejr Guest

    Default

    Is it possible that this monetary value was predetermined by the court or does it sound like a lowball offer that they have made to me. It dosn't sound to bad if I were to receive the 62k lump sum payment and approx 2,500 per month for the rest of my life plus whatever s.s. pays me.
    However although everything you are telling me is not quite clear It sounds like the money they are paying me would all go to future medical set aside, Plus the fact that my ss would be reduced to 80% I am not quite clear if that 80% would be calculated before the money for perm disability payments even made it to my pocket because I am setting them aside for future medical. Just how much money ends up in my wallet. Just sounds pretty confusing and crappy as now it sounds like all of my settlement will go to future medical. What should I do now I am so confused
    and don't know what you guys are telling me.Having a tough time supporting my family as now the bills still keep coming in and also I have to figure out what I am going to do for my families future medical coverage. I use to have excellent health coverage at my job and now I have to provide for very expensive coverage on my own.

  7. #7
    anon2600 Guest

    Default

    Your SSDI is not reduced to 80%. When you get SSDI you are entitled to 80% of your income when you stopped working...say you were earning $1000 per month...you would be entitled to $800.
    If your SSDI benefit is $800, and you get $300 from your WC pension, your SSDI would be reduced to $500 so your total would be $800, or 80% of your former earnings. IF you return to some type of work, you are entitled to a maximum amount monthly in earning before your SSDI will be affected. But you will get information from SSA if you haven't already.

    CMS/Medicare will tell you how much will need to go to the setaside trust. That's why you have to have them review your case. The IC will come up with a figure, but it still must be approved.
    Did you go to the web site and read the information there?

    As I said before, the amount of your award may or may not be determined by the laws/statutes of your state. Since you don't say where you live, I can't give you the web site, but you can find it and go there to read what it says about WC settlements.

    Also, you might consider a Structured Settlement for your award money. This would provide you with a tax free income for the rest of your life, and possibly provide money for your estate. You would end up getting more money in the long run. You can set this up any way that works best for you, and you can also make provisions in the trust for periodic lump sum payments. Like for your kids college tuition, every 5 or 7 years for down payment money for a car... etc.
    You can find out about Structured Settlements by doing a web search or going here for Medicare setasides...
    http://www.medivest.com/index.html
    there are others, this is just the one I have.
    And you can go here for WC trust examples..
    http://www.structured-settlements.com/index.html

    Before you sign any settlement papers you need to become more aware about what's going on here...start being a 'willing participant' in your case/life, this will affect you for a long time. No one is going to sit down and hold your hand to explain these things to you... not even your attorney. You must get involved and know what's going on. If you don't get what you are entitled to, it will be no ones fault but your own. And you cannot go back later and say I didn't know about that, or no one told me. That's your job, and since you are not working, you have the time to do this.

  8. #8
    ejr Guest

    Default

    I guess I sort of get what is going on but maybe I can rephrase my greatest concerns better.

    1st- Lets say my settlement with work comp is going to come to $2600 per month and s.s. disability is going to pay me the difference up to 80% of my salary. My previous salary was $4200
    per month. If my math is correct that would mean that s.s. would then pay me $760 per month which would be ok. However my concern is that cms is going to take $1000 a month out of my work comp settlement per month for set aside medical and social security will still only pay me $760 per month leaving me with a total income of $2360 per month. I don't know where I got the $1000 figure from but I just pulled a number out of air as I do not know how much cms will take. I know I may be confusing you however this would put a lot of stress on me because I would normally be working and earning $4200 per month and if my math is correct and the 80% rule does not take into account the money I am setting aside for future medical this would hurt pretty bad financially.

    2nd- I have been doing a lot of research on new jersey work comp laws and I just read something about permanent disability payments. It goes something like this. Wages earned after 450 weeks offset the weekly computation in proportion to the income at the time of the injury. Permanent Total benefits are paid weekly and are based upon 70% of the average weekly wage, not to exceed 75% of the Statewide Average Weekly Wage (SAWW) or fall below the minimum rate of 20% of the SAWW. What exactly do they mean when they say after 450 weeks wages offset the weekly computation? And what does the average perm total disability pay. Does it pay 70% of average weekly wage for the rest of your life calculated at the date of injury which would be ok for now but in ten years with inflation going up it would not amount to anything. Or do they normally recalculate that 70% every year to accomodate for cost of living increases.

    3rd and greatest concern- My lawyer has not said anything other than that when w.c. perm payments cease to exist I will continue getting the same amount of money per month that I got from the i.c. however now it will be paid by the 2nd injury fund because I had a pre-existing conditions. Well what happens if I settle my case and when the time comes for the 2nd inj fund to start paying me they decide that I am not qualified to receive that money. I know that I have already applied for 2nd inj fund but I did not receive a final decision from them. If I sign off on the ic's future liabilities and this happens I would have no income in the future. What should I do to ensure my future in respect to this concern?

  9. #9
    anon2600 Guest

    Default

    1)I keep giving you the answer to this, and even the web site for CMS/Medicare, yet you, for
    whatever reason want to keep rephrasing the same question... Medicare/SSA/SSDI, does NOT take money from you every month. The value of your future medical is determined, and "set aside" in a trust/account to be used for treatment that would normally be the responsiblity of Medicare. You do not "set aside" money each month out of your income.

    Your 80% is based on your income when you stopped working, but there is also a max to your SSDI benefit based on your wage history. You will not go over that amount, no matter what your income was previously. (say your max SSDI benefit is $600, but it takes $800 to make up the difference from the WC benefit, you can't get more than the $600 that is your max benefit)

    2) I don't know about the laws of your state. Or how they figure your AWW and benefits affected by this. I know it can be confusing.

    3)Don't sign any settlement papers until all the ducks are in a row, until you have your decision from the 2nd injury fund.
    whatever is agreed to in your final papers is the way it will be...that is your 'settlement'...


    Keep in mind that none of this is intended to replace what you would earn if you were working as before. All these 'benefits', 'entitlements' if you will, are intended to give you the minimum to live on. You don't get "retirement" from a WC injury. No one comes out ahead...so don't sign the papers on that new Mercedes yet either. (just kidding there...)
    If your state is like others, the only COLA you get is from SSA/SSDI. There may be a stipend COLA on your WC benefits, but even that will be minimal. As I said above, if you can swing it, your best bet is a Structured Settlement, you should talk to your attorney about this.

    What you are experiencing is a "life altering" situation...it is stressful, and difficult to accept at times, but this is the system we have and just have to get used to working within the perameters given.
    I hope the information regarding SSA/Medicare has helped you, I am not familiar with the other concerns enough to give you real, useable information.

  10. #10
    gonecrazyinky Guest

    Default

    I received a structured settlement of 222.00 per week and was receiving 580.00 per month SSDI. This happened in April of last year. In Dec. of 2005 I received a notice from SSDI that they were cutting my SSDI benefits from 580.00 a month to 39.00. I keep hearing you all talk about the 80% thing. I was making $2500.00 a month when I was injured. So can you tell me what my problem is. SSDI also drug their feet and now I owe 9000.00 in overpayment from SSDI. Even though they were contacted about the structured settlement...they waited almost a year before starting this stuff...

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