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  1. #11
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,941

    Default Re: New Here. Few Questions

    There is never any guarantee of a cash settlement in a comp claim.
    WC is all about paying benefits, including those associated with your 5% PD rating.
    Permanent partial disabilities. Compensation for permanent partial disability shall begin at the termination of the healing period provided in subsection 1. The compensation shall be in addition to the benefits provided by sections 85.27 and 85.28. The compensation shall be based upon the extent of the disability and upon the basis of eighty percent per week of the employee's average spendable weekly earnings, but not more than a weekly benefit amount, rounded to the nearest dollar, equal to one hundred eighty-four percent of the statewide average weekly wage paid employees as determined by the department of workforce development under section 96.19, subsection 36, and in effect at the time of the injury. The minimum weekly benefit amount shall be equal to the weekly benefit amount of a person whose gross weekly earnings are thirty-five percent of the statewide average weekly wage.
    Where are you getting 500 weeks?
    What is your body part/injury ?
    Are you rated for scheduled loss, or whole person ?
    The PD indemnity rate may be the same as your TTD weekly rate, or more/less... depends on your specific numbers...the basis of eighty percent per week of the employee's average spendable weekly earnings, but not more than a weekly benefit amount,. As you can see...average "spendable" is different than "average weekly wage"... TTD is calculated as a rule on gross wages... "spendable" may be considered after tax income, or net wages.

    While the indemnity is predetermined based on the rating, there is no law that requires you to be paid for future medical care. If you require additional treatment, you should not C&R the claim, and take the indemnity benefits weekly, that leaves the medical open for you. You are not going to be paid for future medical near what the potential cost may be out of your pocket. They just don't pay that kind of money, and don't have to.
    ... so the time has elapsed that he plans to send me a check for around $11,000 which is nothing compared to lost wages, future medical bills etc.
    No reason for him to lie to you... you are not due more than the indemnity associate with your PD rating. And there is no law that says it must be lump sum. There are no monies for lost wages, past or future, your TTD wage replacement was the benefits there...PD indemnity...that's it.
    I just received mmi rating of 5%. Which is a bunch of crap.
    Actually, MMI is Max Medical Improvement...a status where you have reached a stable condition.
    The rating is PD/Permenant Disability, and done by your Dr based on your condition post recovery to MMI.

    You can read about PD ratings and guides here 876—2.4(85,86) Guides to evaluation of permanent impairment. http://web.legis.state.ia.us/ACO/IAC...m#rule_876_2_4
    If you dispute the PD rating, there is a process to resolve that... info is also in the link above...look for "Dispute Resolution"
    Anyone have any idea? I dont think it is too much to ask to throw an extra $5000.00 on to cover future medical bills. Am I out of luck? Anyone?
    If you don't have an atty, may be a good time for consult, no fee for talking. Attys can negotiate a settlement better than you can... attys know how the statutes may apply to your claim...better than you or anyone here.

  2. #12
    Join Date
    Apr 2011
    Posts
    1

    Default Re: New Here. Few Questions

    Quote Quoting sparky1975 View Post
    I just received mmi rating of 5%. Which is a bunch of crap. anyway, is the 25 weeks (5% of 500 weeks) all I am entitled to? And is it prorated at 60% or whatever, the same as when i was receiving weekly checks? I asked the adjuster to cushion the 25 week - check, to cover a handful of trigger point injections etc, and he said that all they are on the hook for is the 25 weeks worth of disability. I quit my job and returned to college last september, so the time has elapsed that he plans to send me a check for around $11,000 which is nothing compared to lost wages, future medical bills etc. But he claims that they never ever give more than the weekly required amount from mmi rating. I am sure he is lying to me. Anyone have any idea? I dont think it is too much to ask to throw an extra $5000.00 on to cover future medical bills. Am I out of luck? Anyone?

    I was reading your entire story, and I agree with what others stated about what you should do. I am in the same situation that you are in. I was injured on the job back in 08, with a back injury. I've been on workers comp since October 2008. You should have gotten an attorney when you first started having problems, because there are some things that the adjuster can tell you and you'll actually believe them because you think that they are on your side. In reality they aren't. But an attorney can help and get what benefits that are rightfully yours. Just recently my adjuster stopped sending me my benefits in March 2011, but I never received any notice, and my lawyer also stated that it should have never happened. But They will try whatever they can because they don't really want to pay out money. They are in the business to make money and not pay out.

    But the fact that you said that you quit your job,BIG MISTAKE! That will terminate your claim, you should allow them to lay you off, or let them suggest to offer you job retraining. Back in March 2010 I went through the same thing where they stopped my checks, but now it's even worst where them stopping without notice had really affected my life where I'm on the verge of loosing everything. But having a lawyer can help you take the correct steps to stay on top. They insurance adjuster will bully you because you don't know the law. But as far as payment to a lawyer, they are paid when you settle.
    Hope this helps, but I do hope that the decision you made works out for you.

  3. #13
    Join Date
    Jan 2013
    Posts
    7

    Default Re: New Here. Few Questions

    Just in case anyone follows this story to the end... why didn't sparky get an attorney? The adjuster, IC and ER made out good on that one. Shame. He had a great idea though. I started taking courses while at the job where the injury occurred, in hopes of furthering my career there. HA! I continued with all online courses (yes it is possible) writing papers and reading and homework laying on my back, standing or laying on my stomach. (Back injury)

    It can be done!

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