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  1. #1
    Join Date
    May 2007
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    23

    Default Lump Sum Settlement or Installments

    I hate to posting qusetions but I need to know something. If you read my other post you will see that I have been in contact with insurance company and will probably be settling prety quick, but is it mandatory to take payments or a lump sum? Due to all the bills I have incurred in the last year I would opt for a lump sum and settle for less than have the payments. I'm getting the life time medicals so I feel good about that, any input would be great thanks

  2. #2
    Join Date
    Apr 2007
    Location
    cincinnati,ohio
    Posts
    761

    Default Re: 1 more question

    i advise not to settle the medical out. at least have an attorney look at their offer. you have to look out for your best interests, because they do not have yours in mind. good luck, take care of yourself, my prayers are with all injured workers.

  3. #3
    Join Date
    Mar 2007
    Location
    Georgia
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    1,923

    Default Re: 1 more question

    Quote Quoting hubert View Post
    i advise not to settle the medical out. at least have an attorney look at their offer. you have to look out for your best interests, because they do not have yours in mind. good luck, take care of yourself, my prayers are with all injured workers.
    Hubert although you gave good advise on the medical issue it appears that you failed to read the post prior to responding. Supertrucker has open medicals as he is in Tennesse and this is required for a minimum of 3 years. After the 3 years he and the IC can do a S&R if he chooses, but can not be forced to.

    His question was can he opt for a lump sum settlement rather than accepting payments over a period of time even though the total amount will be less?

    Supertrucker what has the insurance company offered by way of settlement? Have they given you the option for how you prefer to be paid for the ppd? It appears that you have yet to retain an attorney, which is okay so long as you are treated fairly by the IC. How are you going to determine what is a fair settlement? What does the Tn work comp law say as far as accepting lump sum rather than payments? Have you asked for a benefit review with a WC rep?

    As a side note it would appear advantageous for all states to adopt this type of program. No offense to any of the WC attorney's but this type of system could eliminate the need for legal representation with no charge to the IW or the IC. Kind of seems like a good way to make the regs be followed with out having to fight it out with an attorney in a court room. Maybe a little like it should be. I doubt however that other states without this service will follow suit any time soon.

    BENEFIT REVIEW

    The Workers' Compensation Division has representatives that can assist employers, employees, and insurance carriers. If you have questions or problems relating to a workers' compensation injury, call 1-800-332-2667 (within Tennessee) or 615/532-4812.

    If the representative cannot resolve the issues, a Workers' Compensation Specialist can assist in resolving disputes and settling claims at no cost to the employer or employee.

    The role of the Representative is:

    To be the "first line of assistance" in cases with problems and/or disputes.
    To examine claims to insure accurate processing of benefits to injured employees.
    To advise employees and employers of rights and requirements under workers' compensation laws.
    To visit and consult with employers to verify coverage and compliance with safety requirements and to insure posting of the Tennessee Workers' Compensation Insurance Notice.
    To explain to all interested parties the laws, rules, and policies governing workers' compensation.
    A Workers' Compensation Specialist will also conduct a benefit review conference for all injuries occurring on or after January 1, 1997, that do not reach a final settlement and where the parties do not waive this requirement. Some Tennessee court jurisdictions already have this requirement. A benefit review conference is a non-adversarial mediation that takes place with the Specialist mediating the case between the employee and the employer/insurance carrier.

    The role of the Specialist is:

    To resolve/arbitrate the question of compensability in disputed workers' compensation cases.
    To conduct benefit review conferences for the purpose of trying to resolve disputed issues through the process of mediation.
    To review and approve or reject proposed settlement agreements in disputed workers' compensation cases.
    The Reform Act of 1996 authorizes the Commissioner of Labor and Workforce Development, or his designee (workers' compensation specialist), to approve proposed settlements between the parties if:

    The settlement has been signed by the parties; and,
    The Commissioner of Labor and Workforce Development or a workers' compensation specialist has determined the employee is receiving, substantially, the benefits provided by law or is in the best interest of the employee; and,
    The settlement agreement is reviewed by a specialist not associated with the employee's case.

    A settlement approved by the Tennessee Department of Labor and Workforce Development shall be entitled to the same standing as a judgment of a court of record.

    http://www.michie.com/tennessee/lpex....htm&cp=tncode

    Supertrucker, from what I garner from the regs I don't see any reason you will not be allowed to take a lump sum payment in lieu of weekly or semi monthly payments. This is something that you and the IC must agree on but not reg stating that you can not.

    Good Luck to You and keep us up to date at to your progress.

    Steel
    Last edited by SteelMagnolia; 07-22-2007 at 11:42 AM.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  4. #4
    Join Date
    Apr 2007
    Location
    cincinnati,ohio
    Posts
    761

    Default Re: 1 more question

    steel, you are right, sense i been on the med.s so much, i do at times miss read. and i want to say, you do give very good advice. if you not an attorney, may be you should be. at least you would make a very good advocate, or a paralegal. if i had a team of advisers, i would want you on the team.

  5. #5
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: 1 more question

    Please take no offense to this, but Tennessee's system of administering workers' comp claims is hardly ideal, and even with the 2004 amendments to the statute, are still some of the most difficult to navigate.

    If you don't settle early with the IC, then you're going to wind up in the regular court system, alongside all of the other divorces, car wrecks, real estate disputes, and everything else. The judges don't have the level of knowledge on this specific area as an ALJ only handling workers' comp cases would.

    That being said, however, the Judges in Tennessee are quite liberal with regard to awarding benefits in workers' comp cases.

    Make absolutely no mistake about this--workers' comp in Tennessee is an adversarial process. The ICs have attorneys that go into cases, and they'll fight them tooth and nail. If you go into a mediation (BRC) without an attorney, or settle your complex, high impairment rating case without a lawyer, you will absolutely get less (probably by at least half) of what you'd otherwise get if you get a lawyer. Part of what the IC is trying to do by settling early on these cases is to avoid the case expenses for hiring their own lawyers, and they still want to pay you as little as they can get away with.

    To Supertrucker specifically, I have mentioned this on a number of occasions already, but given the potential value of your case, I think you are making a very large mistake to settle your case without the assistance of an attorney. Like I've said before also, while I would be happy to look at your case and help you, I also don't care if you hire me or someone else that works in this field.

    You may think you are saving money by not having to pay a lawyer's fee to represent you. In my opinion, that's penny wise, but pound foolish. Workers comp attorney fees are limited to only 20% of your award in the case. It's not like a car wreck case where you're going to pay 1/3. Any attorney worth his salt is going to be able to get you at least 20% more than the IC will give you voluntarily if you don't have a lawyer.

  6. #6
    Join Date
    Mar 2007
    Location
    Georgia
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    1,923

    Default Re: 1 more question

    Awwww thanks Hubert .. I really wasn't trying to flame you just wanted to make sure you know ST had the meds., covered.

    JLJ I mean no disrespect when I say this so please do NOT take offense. I am very much of the opinion that it is a crying shame that anyone would have the NEED to retain legal council in a WC case. Especially for a WC case where future medicals are left open and do not figure into the settlement. The laws in every state that I have read are written in plain english and not hard to understand. Payment of injuries, for the most part, are all scheduled and are dependent upon the percentage of PPD or PTD. None of which is hard to calculate and come up with the right answer for. Kind of seems as senseless as having to hire an attorney to get your private health insurance to pay for a trip to the doctor. The plan is clearly written. The fee schedule is lined out and the claim is paid for services rendered. The math is not hard to do in either case. So why do the WC IC's think they can do as they darn well please when the laws are perfectly clear as to what they are required to pay for a specific body injury? I might even understand if pain and suffering was taken into account as this can have huge variables but not a schduled body part. If an IW only realizes a 20% increase in the settlement and the attorney charges 20% for services how much additional money does the IW end up with?
    Last edited by SteelMagnolia; 07-22-2007 at 03:05 PM.
    "He who is his own lawyer has a fool for a client"
    Abraham Lincoln


    Take Care and Be Well.

  7. #7
    Join Date
    May 2007
    Posts
    23

    Unhappy Re: 1 more question

    Thanks for all the input, it looks like I will be retaining a lawyer here in the chattanooga/cleveland area. I got a letter today saying that I have a brnifits review for 9/23 so I guess like you said they wanna try and get this outta the way. I also spoke with the ins. company this morning and they wanted to know what I wanted since I have refused both of thier offers and my reply was whatever I am suppose to get. I will not be returning to my job since there is no light duty available and I have been told by my doctor all I can do is sedintary work {sorry for the spelling). So here I'm going from a $18 job to god knows what, and I guess the house that I wanted to buy before I got hurt for my family is now just a joke and won't never happen. I'm really worried about my family, as if you have read my previous post you will know that the last year has been about as bad as it can get. At this point I feel totally worthless and useless and feel that I'm just a joke. My kids can't figure out why they don't have their own home and don't relize that without me working my checks went from $1200 to $1400 a week take home to $526 a week. Everyone keeps telling me to hold my head up that when all is said and done it will all work out but honestly I just don't know. I know I gotta have my medicals left open but I'm scared that if I keep refuseing thier offers they are gonna make it tough for me at the review meeting next month.
    Listen I'm not trying to get rich or see how much I can take them for, I just want what's right for me and my family. My wife and kids have suffered just as much as I have, I have had to say no to all activities that cost any extra and they just can't understand. My family is looking to me for answers and I don't know what they are myself. JLJ if you are in this part of the state I probably need to talk with you, I'm sorry for the long post but I'm under alot of pressure at this point. You know I mentioned my dad had a minor surgery done last year at the age of 60 and died as a result, well to let you know how bad I'm having it since I had to buy grave plots, pay for a funeral I have'nt even been able to buy him a head stone . I feel like I'm failing my family, I should have done had that done but honestly my injury has drained my account. And what's even worse is my oldest daughter just got a full scholorship for vanderbilt and all I have to pay is housing and I don't even know how I'm gonna do that

  8. #8
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: 1 more question

    My practice is in Loudon, and I do work in just about all of East Tennessee (at least from Knoxville down to Chattanooga), and would be happy to meet with you in your area (either your home or some public place) at your convenience. If you want to set up a meeting as soon as possible, then we can go over the facts of your case, the details, and map out a plan of action for moving forward to get you a settlement as soon as we can.

    It's possible to get your case settled before the BRC date that is set, and I'd bet that as soon as you get an attorney, they'll start getting really reasonable. Then again, they could be difficult, but I know how to handle that too.

    If you want to email me through the board, I'll get back with you and give you a call asap).

  9. #9
    Join Date
    Jun 2007
    Location
    Tennessee
    Posts
    200

    Default Re: 1 more question

    Quote Quoting SteelMagnolia View Post
    Awwww thanks Hubert .. I really wasn't trying to flame you just wanted to make sure you know ST had the meds., covered.

    JLJ I mean no disrespect when I say this so please do NOT take offense. I am very much of the opinion that it is a crying shame that anyone would have the NEED to retain legal council in a WC case. Especially for a WC case where future medicals are left open and do not figure into the settlement. The laws in every state that I have read are written in plain english and not hard to understand. Payment of injuries, for the most part, are all scheduled and are dependent upon the percentage of PPD or PTD. None of which is hard to calculate and come up with the right answer for. Kind of seems as senseless as having to hire an attorney to get your private health insurance to pay for a trip to the doctor. The plan is clearly written. The fee schedule is lined out and the claim is paid for services rendered. The math is not hard to do in either case. So why do the WC IC's think they can do as they darn well please when the laws are perfectly clear as to what they are required to pay for a specific body injury? I might even understand if pain and suffering was taken into account as this can have huge variables but not a schduled body part. If an IW only realizes a 20% increase in the settlement and the attorney charges 20% for services how much additional money does the IW end up with?
    No offense taken, SteelMagnolia. There are many states where almost all claims can (and should) be handled without lawyers. Unfortunately, Tennessee (with the exception of all but the very simplest of claims) is not one of those.

    Tennessee's laws give the IW some relatively liberal treatment, and that's part of the reason a lawyer is almost always necessary. The ICs don't give up maximum benefits voluntarily, and because of the wide discretion that Judges have in cases where the employee cannot return to work, employees need the assistance of counsel to navigate through the system to get the benefits to which they are truly entitled. When you can get a wide range of benefits, you're almost certainly going to get more when you retain an attorney to be your advocate. We can accurately appraise what the value of a case is, and know whether or not someone is being treated appropriately or not by a proposed settlement offer.

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