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  1. #1
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    Aug 2013
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    Lightbulb Impairment Ratings and Multipliers

    I know in the State of Tennessee that once MMI (Maximum Medical Improvement) has been reached that an impairment rating is given by the treating physician. This rating is a percentage (ie. 25%). If you have a knee injury like myself, then you are limited to 200 weeks of TTD (Temporary Total Disability).
    TTD is the payment you receive from your employer's Workers Comp insurance company while your treating physician says you are unable to return to work.
    TTD Is calculated thusly: weekly pay averaged over the last 52 weeks or back to date of hire.

    Example: you make $350.00/ week you have been employed for 52 weeks. $350.00x52 weeks=$18200.00. $18200.00/ 52 weeks=$350.00. TTD is 66.67% of the weekly average.

    Therefore your TTD payment will be $233.35.

    This relates back to MMI because the insurance company has to pay you a settlement once you reach the end of your treatment, also known as MMI.
    This settlement is calculated based on your TTD ( in this case $233.35).

    Lets say you receive an impairment rating of 10%.

    An impairment rating of 100% entitles you to a settlement amount of: 200 weeks x 233.35= $46669.00.
    Your impairment rating is 10%, therefore you are entitled to a settlement of : 200 weeks x10% = 20 weeks. 20 weeks x 233.35 =$9333.80
    Be aware that there are multipliers involved and this complicates the process.
    This is where I am not sure of the law and have questions.
    I know that if you are able to return to work without restrictions the multiplier is 1.5.
    Under the current scenario the math would work thusly:
    200 weeks x Impairment Rating(10%)= 20 weeks
    20 weeks x TTD(233.35 in this case)=9333.80.
    9333.80 Multiplier(1.5 in this case)=$14000.70 (Final Settlement)
    This is in addition to any previous TTD payments and medical bills paid by the employers workers comp insurance company.

    My question is :
    What other conditions are provide for in the multipliers and what are the multipliers for those conditions?
    Please understand that I am not looking for anything that is not legally justified.

    My 1st priority is to get back to work.

    But there is a possibility that I may not be able to go back to my job and I want to know what I am entitled to if that happens.

    I hope the info I posted here was helpful

  2. #2
    Join Date
    Oct 1971
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    5,045

    Default Re: Multipliers

    KneeInjury
    This relates back to MMI because the insurance company has to pay you a settlement once you reach the end of your treatment, also known as MMI.
    This settlement is calculated based on your TTD ( in this case $233.35).
    That's not true, where did you get that from?
    I have no idea of where you getting your facts but you are totally misguided, that's not even close to how the system works.
    This is why I require people to post sources when making statements of fact or quoting rules.

    Once you reach MMI your TTD ends, you are then eligible for PTD or PPD.
    The insurance doesn't have to pay a settlement, they can pay you out in weekly payments or cash you out (settle) for a lesser amount if they choose.

    Benefits for Temporary Total Disability (TTD)
    The percentage of worker's wage paid is 66 2/3. For weekly payments, the minimum is $114.75 and the maximum is $841.50, 110% of SAWW. The maximum period of payments is 400 weeks. The maximum total amount payable is $300,800 (determined by PTD max).

    Benefits for Permanent Total Disability (PTD)
    The percentage of worker's wage paid is 66 2/3. For weekly payments, the minimum is $114.75 and the maximum is $765, 100% of SAWW. The maximum period of payments is 400 weeks. The maximum total amount payable is $300,800. If a worker is 100% disabled, maximum weekly payment can be received until age 65, and may be offset by OASDI.

    Benefits for Permanent Partial Disability (PPD)
    The percentage of worker's wage paid is 66 2/3. For weekly payments, the minimum is $114.75 and the maximum is $765, 100% of SAWW. For non-scheduled injuries, the maximum period of payments is 400 weeks, and the maximum amount payable is $306,000.

    http://www.state.tn.us/labor-wfd/wcomp.html
    The administrative rules of workers' compensation in Tennessee are available online from the Secretary of State's Web site at:
    http://www.state.tn.us/sos/rules/080...02/0800-02.htm
    Historical and current benefit rate information is available in PDF format (requires Adobe Acrobat Reader) online at:
    http://www.state.tn.us/labor-wfd/WCRATETB.pdf

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Mar 2011
    Location
    Tennessee
    Posts
    100

    Default Re: Multipliers

    Actually, the original poster is almost entirely correct in every part of what was posted, at least in substance, if not in actual terminology. I'd suggest that the weekly rate (used for either TTD or PPD benefits) should be called the weekly compensation rate (or "comp rate") as the professionals in this business call it. Calculation of this rate is 66 2/3% of the average weekly wage for the 52 week period prior to the date of injury.

    TTD paid from injury until MMI (or release to return to work, whether it be modified or full duty). On reaching MMI, if there is a rating, the employee IS entitled to get a settlement offer under the law, if the injury is compensable and there is a medical impairment rating. It's in the Administrative Regulations for the WC law:

    0800-2-14-.06 RESOLUTION PROCESS.
    (1) A medical impairment rating and date of maximum medical improvement by the treating physician,
    and information needed to settle a claim shall be documented in writing.
    (2) Insurers shall make an offer of settlement in writing within thirty (30) days of receipt of information
    specified above,Rule 0800-2-14-.06(a). The claimant shall sign the offer of settlement indicating
    approval or rejection of the offer.

    (3) An agreed settlement shall be finalized by order of a court or approval by the Division as required by
    TCA 50-6-206. A copy of the court order or division approval shall be filed with the Commissioner
    of Tennessee Department of Labor.
    (4) If settlement is not agreed upon, a Benefit Review Conference may be requested pursuant to TCA 50-
    6-237.

    As far as the original poster's questions concerning a multiplier to expect, there's no absolute, definite answer in any one case. The 1.5x limit doesn't require you to be returned to work with no restrictions, only that you return to work for your pre-injury employer making the same or greater rate of pay (per hour). If that cap doesn't apply, then the maximum cap is up to 6x the impairment rating, though that is exceedingly rare.

    A multiplier would depend on factors such as your age, education, work experience, transferable job skills, medical restrictions, and things of that sort. Basically, the worse off you seem on the factors, the more likely you'd be at the higher end of the multiplier spectrum. If you're over 50, without much education, and have some restrictions, probably the higher end. If you're younger (under 40) and have a decent education, not too many restrictions, probably at the lower end.

    In most cases, if the 1.5x limit doesn't apply, you should probably look at the middle of the overall range (about 3x impairment), and adjust up or down depending on your individual facts. There's no set amount/multiplier in any particular case, so this is just a general range to keep in mind.

    The way you're working out the math is correct, so you'd just need to put different multipliers in place to figure the possibilities.

  4. #4
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    Oct 1971
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    5,045

    Default Re: Multipliers

    WCGuru
    Actually, the original poster is almost entirely correct in every part of what was posted, at least in substance, if not in actual terminology.
    Settlements are not based on TTD rates, that's ridiculous.
    Many states have completely different rates for PPD and TTD - although the rates in your state are similar, you can't make that statement.
    That's just plain wrong terminology, that's what set my alarm off.

    You are correct, I misspoke in that you are entitled to a settlement.
    But I am correct that you are not entitled to a cash out settlement, which was what I was referring to when the poster said "the insurance company has to pay you a settlement" (I took it he meant cash out)
    If there is a cash out settlement offered, it would be for a lesser amount than the full value of the case.

    Thanks for the information, I didn't know they had to make an offer in 30 days, also I've never understood those multiplier rules.
    No, I'm not familiar with every states rules but I do try to respond when threads are left unanswered or when there are obvious misstatements of fact.
    That's why I include sources with my responses, it allows people to view the facts for themselves and draw their own conclusions.

    Also, are you a lawyer?
    If not, you must supply sources to support all statements of fact, I don't have the time to fact check all posts.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  5. #5
    Join Date
    Mar 2011
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    Tennessee
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    Default Re: Multipliers

    I am a lawyer. I am in Tennessee. I have done workers' compensation work in the state in some capacity or another almost exclusively for the bulk of the last 15 years.

    I know there are a lot of well-meaning folks on the forum, including the admins. I also recognize that there are a lot of people who don't know anything about the particular state they comment about. If you go back and look at my relatively limited posting history, I'm pretty sure you'll find that I've just posted in the Tennessee forum. It's the state I know. I know it exceedingly well.

    As far as this part of your response
    Settlements are not based on TTD rates, that's ridiculous.
    That's almost entirely not correct in Tennessee. The weekly benefit rate ("comp rate") is the basis of the calculation of any settlement amount on a compensable claim. Impairment rating x Multiplier x # of weeks for injured body part x Comp Rate=Settlement or Judgment total.

    Impairment depends on the doctor's opinion under the 6th Edition of the AMA Guides.
    Multiplier depends on those vocational related factors (age, education, restrictions, etc.).
    #of weeks depends on the body part injured (either 400 weeks for body as a whole, or something else for a scheduled member injury)
    Comp Rate depends on what 2/3 of the 52 week pre-injury wages are.

    The biggest opportunities for variance in the amount for any settlement or judgment depend on what the multiplier is/should be. As I mentioned in my original post, there is absolutely no set formula for setting that multiplier. In most cases where the 1.5x return to work cap doesn't apply, the middle of the range, or about 3x the rating is probably a reasonable estimate.

    As far as settlement offers per the administrative regulations I cited above, there is no specific statutory obligation or discount in Tennessee for paying benefits in a lump sum. As a practical matter, most every settlement is paid in a lump sum, except for some of the very largest of the settlements (depending on the IC or ER involved, that may vary). Most carriers want to pay the lump sum and just be done with it instead of setting up recurring periodic payments until the entire settlement/judgment is paid.

    I'd cite to authority on this for you, but the bulk of this information is from my practical experience handling cases throughout the state and how the legal requirements are actually put into effect. In general, if you want to read the entire workers' compensation statute, Tenn. Code Ann. Section 50-60-101, et seq, is available for free online by LEXIS. Going to http://www.lexisnexis.com/hottopics/tncode/ will allow anyone who wants to review it to do so at their leisure. The question of the values for benefits for Permanent Partial Disability is generally addressed at TCA 50-6-207.

  6. #6
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    Oct 1971
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    5,045

    Default Re: Multipliers

    WCGuru
    I am a lawyer. I am in Tennessee. I have done workers' compensation work in the state in some capacity or another almost exclusively for the bulk of the last 15 years.
    Then you need to make that clear in your signature. I'm not going to guess who's who and neither should the members.

    I know there are a lot of well-meaning folks on the forum, including the admins. I also recognize that there are a lot of people who don't know anything about the particular state they comment about.
    I know enough to bring this forum from nothing to what it is today, I can't be as stupid as you're painting.
    If it wasn't for my ignorance, you wouldn't have this place to play in.
    I know what TTD is and what settlements are based on, figured that out back in ........... I think it was 1999 if I'm not mistaken.
    I gave relevant sources to support my statements, anyone can easily look at the rules for themselves, I'm not a servant.

    As far as the admin, do you know who you're talking about?
    He's probably forgotten more than you know.

    As far as this part of your response

    Settlements are not based on TTD rates, that's ridiculous. That's almost entirely not correct in Tennessee.
    Again, I understand your position that PPD and TTD have the same rates.
    I'm saying it's a misstatement to say settlements are based on TTD, that's 100% false.
    It may be based on the same calculation but it's not based on TTD.

    there is no specific statutory obligation or discount in Tennessee for paying benefits in a lump sum. As a practical matter, most every settlement is paid in a lump sum, except for some of the very largest of the settlements
    That makes no sense from an economic stand point.
    Why would they pay lump sum for the full value when they can make payments and draw interest on the money?
    Also, they use the lump sum payment as leverage to settle for a lesser amount.
    I've never heard of a carrier settling a case for the full value at lump sum, why would they?

    I said, carriers will usually settle a case at a lump for a lesser amount but there's no law mandating a lump sum settlement.
    Are you saying I'm wrong? What's your point?

    I'd cite to authority on this for you, but the bulk of this information is from my practical experience
    Cite the regulation that says "settlements are based on TTD" as you and the poster claim.
    Also cite the regulation that says "the carrier must settle for a lump sum"

    You're pouncing on me over these two statements and claiming I don't know what I'm talking about - prove what you're attacking me over.
    I'll be anxiously awaiting those regulations, let's settle this debate once and for all.
    Also, update your signature or source your info.

    Be careful of attacking myself or the admin, I have a zero tolerance for that garbage.
    Don't be in here playing "gotch ya" you'll lose every time.

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  7. #7
    Join Date
    Mar 2011
    Location
    Tennessee
    Posts
    100

    Default Re: Multipliers

    Tony,

    I'm not playing gotcha or any other game with you. I certainly don't mean to come across as anything other than trying to provide genuinely helpful info about TN WC claims. I don't post by my name, my practice, or anything to identify myself, and I don't intend to do so. If you don't think what I've had to offer is beneficial to the people who come here looking for Tennessee answers, there's really no way I can stop you from banning me.

    I get the idea that some other folks have tried to argue, etc. with you on the forum, which is the furthest thing from what I'm trying to do. I didn't say that you or any other person in Admin/Mod is stupid, ignorant, or otherwise unversed in the general world of workers' comp issues. What I was saying was simply that WC law is a creature of each individual state, and advice/information that applies in one place probably doesn't in another. That's why I limit myself to this spot on Tennessee issues. It's what I know. I don't have a clue about any other state, so I don't offer any suggestions or information there.

    As far as the lump sum settlement amounts are concerned, certainly the ICs keep in mind the value of a case in the time-value of money for lump sum vs periodic payments. In almost all cases where there is a return to work, where the 1.5x cap applies, if there's an agreed impairment rating, I'd expect that 90+% of settlements are for both a lump sum total equal to the full 1.5x medical impairment. No discount for lump sum, etc. Like I said, there's not a statutory table of lump sum discount percentages as with some jurisdictions. On higher value settlements, the IC may take something of a discounted value in setting where they'll offer settlement. It's still almost without fail, done as a lump sum. No authority to cite to, as again, it's not in the statute, the administrative regulations, or case law. I know that the TN Dept of Labor keeps statistics on all WC settlements/judgments (there's a statutorily required form called a SD-1 to compile the data), and I'm sure they'd provide you with data about settlements upon request.

    The reason I responded regarding the importance of the TTD rate issue that you mentioned was simply because your response was about the "rate" not the TTD payments alone. TTD/PPD is going to be paid at the same rate in almost all cases (subject to maximum rates, which are different for each), but the fact that TTD was paid is not really relevant to the PPD that might be due. It's the rate, not the TTD, that's important. That's why I prefer to call it the "comp rate" instead of the TTD or PPD rate, as I think it avoids confusion. Again, I'm not trying to beat up on you or attack you in any way. I just wanted to point out what's practically important. I don't think we disagree on the substance of this point; it just looks like a miscommunication.

    I'm not going to get into some kind of flame war with you here, but I never said
    Cite the regulation that says "settlements are based on TTD" as you and the poster claim.
    Also cite the regulation that says "the carrier must settle for a lump sum"
    If you look back at my two posts on this thread, they're substantive, with information that is relevant to the original poster's questions on range of settlement/calculation, etc. There is no regulation that says that "settlements are based on TTD" and I never said that it was. Again, that's why I said the OP was correct on substance, if not actual terminology. Likewise, the administrative regulations that I posted (text and citation, where you had previously posted a link to the URL for the full set of admin regs) regarding offering settlement does not compel or require anyone to offer settlement as a lump sum. There is no law that compels it, though it is permissible, and as I've mentioned, most frequently the way settlements are done.

    As far as reasons why an insurer would want to pay something as a lump sum instead of in periodic payments, I'd direct your attention to TCA 50-6-231:

    50-6-231. Lump sum payments final -- Modification of periodic payments for more than six months.

    All amounts paid by the employer and received by the employee or the employee's dependents, by lump sum payments, shall be final, but the amount of any award payable periodically for more than six (6) months may be modified as follows:

    (1) At any time by agreement of the parties and approval by the court; or

    (2) If the parties cannot agree, then at any time after six (6) months from the date of the award an application may be made to the courts by either party, on the ground of increase or decrease of incapacity due solely to the injury. In those cases, the same procedure shall be followed as in 50-6-225 in case of a disputed claim for compensation.

    In other words, when you pay in a lump sum, as an employer/carrier, you get finality. Periodic payments can be subject to being reconsidered. That, beyond the simple efficiency of not having to make ongoing periodic payments, is a reason why lump sums get done in almost every case.

    I hope the original poster has gotten a satisfactory answer to the questions asked.

  8. #8
    Join Date
    Oct 1971
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    Default Re: Multipliers

    WCGuru
    There is no regulation that says that "settlements are based on TTD" and I never said that it was.
    You insinuated I was wrong when I corrected that statement.
    You said the poster is "entirely correct in every part of what was posted, at least in substance, if not in actual terminology"
    I tried to explain my position and you still argued the point you said:
    "As far as this part of your response Settlements are not based on TTD rates, that's ridiculous. That's almost entirely not correct in Tennessee."
    You argued the point not once but twice, now your trying to say that's not what you meant?

    I didn't say that you or any other person in Admin/Mod is stupid, ignorant, or otherwise unversed in the general world of workers' comp issues.
    You said "I know there are a lot of well-meaning folks on the forum, including the admins. I also recognize that there are a lot of people who don't know anything about the particular state they comment about."
    "Not knowing anything" means ignorant in my book.
    I'm the only person responding to this thread and we have only one admin, who where you talking about?

    I'll put it this way.
    For starters, the OP failed to source his info as required by forum rules, this thread should've been promptly deleted, that's my error for responding.
    Secondly, This isn't a legal forum.
    If you want to have technical legal debates and nit pick words, there are plenty of forums to accommodate you, this isn't the one.
    I'm not going to enter into debates on interpretations of statutes with professionals, I am at a disadvantage if you know what I mean.

    This is an injured worker forum, it's a place for laymen to share stories, offer moral support and have fun.
    I give general responses to general questions and call out bull when I see it.
    I do give state specific info but also source my statements with the relevant sources so the posters can review the facts for themselves.

    The poster or yourself could have easily explained as I did that he misspoke, he meant that settlements are based on the same rates as TTD, not based on TTD.
    He could've have easily said he didn't mean they must pay a lump sum but a settlement should be offered in 30 days and post the source.

    There is no regulation that says that "settlements are based on TTD"
    regarding offering settlement does not compel or require anyone to offer settlement as a lump sum. There is no law that compels it,
    Great! thanks for sourcing my statements.
    Settlements are not based on TTD.
    The carrier isn't mandated to pay a lump sum after MMI.

    Unless someone can post regulations stating otherwise these statements still hold credible in this forum.
    I was correct all along, the poster did misstate the facts and you are mistaken when you said:
    " the poster is "entirely correct in every part of what was posted, at least in substance, if not in actual terminology"

    I didn't say post your name. I said identify the fact you're a lawyer or source your info.
    We've had too many people in here claiming to be authorities and posting misinformation without sources.
    We have to have a way to identify who's who, I won't assume anything based on a posters responses.

    I have no intention of banning you, you haven't broken any forum rules, don't know why you would say that.
    Don't get me wrong, I do appreciate the information you've shared with the forum, very informative - I've learned a lot.
    Thanks for sharing.

    I'm trying to restore some credibility to this war zone, misstatements will be called out - they won't be left unchallenged.

    Peace
    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  9. #9
    Join Date
    Sep 2013
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    1

    Default Re: Multipliers

    WCGuru I need to ask about the multipliers and how they work when the impairment rating is as high as 27% such as mine.. My lawyer tells me that I couldn't get a 4 X because it would put me over a 100% rating. I can't believe that is true since it would penalize those with more severe injuries if it is. Can you please help me out here.. I'm 27% to the body as a whole my comp rate is $482.50 per week. I wasn't allowed to return to work and this injury took place in 2010 so the 6X multiplier applies. Help me with this I'm not at all confident in what I'm being told..

    - - - Updated - - -

    HELP! I need someone that's 100% positive about how the multiplier works in the state of Tennessee. My attorney is giving me the feeling they are lost. I know that sounds bad but she keeps saying because my impairment rating is 27% (and I was NOT allowed to return to work) she keeps implying that I can't get 6X on the multiplier because that would equal more that 100%. So my problem with that is ....... A person with a greater impairment rating gets penalized because they are hurt worse? That simply doesn't make sense to me. To me the math should be as follows... And please understand I do not understand all the means to the abbreviated names so I'm going to call it what it is.

    In my case my weekly 66 2/3 of my pay equals $482 week. So the way I understand the formula is as follows. My impairment rating is 27% and I wasn't allowed to return to work. So take $482 and multiply it by 400 weeks and I get this number $192,800.... Now since I'm 27% impaired I take the $192,800 and multiply it by .27 = $52,056 <--------- This number is my settlement WITHOUT any multipliers RIGHT???? Then according to all the factors the Judge has to consider I can get up to 6 times that amount RIGHT??? So the max would be $52,056 X 6 = $312,336 <----------- Please someone tell me this is how to figure this number because my attorney is out in left field with some strange formula... There's a couple of ways to arrive at the same number.. You could take 400 weeks and multiply that by .27 and come up with 108 weeks of pay... 108 X $482 = $52,056 EXACTLY as the number above and the multipliers apply the same way....

    Someone that knows the law in Tennessee please help me out here because I'm starting to think I'm being sold out or misled for some reason..And I can't wrap my brain around people with greater injuries are limited to less of a multiplier...

  10. #10
    Join Date
    Sep 2018
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    1

    Default Re: Multipliers

    Hello all,

    I do not know if this thread is still active but I am looking for some help. I do not understand WC claims at all. In Jan I tripped over a pallet and tore my Patellar Tendon. I ended up having surgery on my left knee. I had an arthroscopy, lateral release and chondroplasty done. I also had a piece of broken cartilage removed. Fast forward to now and I just had a second opinion done today. First doctor wanted to do another scope on my knee since I am having continuous pain and still need a cane to walk. Second doctor states another scope wouldn't be beneficial for my knee. What he says is that I had arthritis in my knee prior to the injury and that after having surgery that the trauma issued to my knee has cause the arthritis to worsen. They have started steroid injections on my knee to see if this will help with the pain. I can not walk up stairs using my left knee first because the pain is to intense. I also still can not bend or extend my knee fully. Both doctors have agreed and said that I have lost range of motion in my knee and that I will have to find work outside of my field I am currently working in. I work in a factory. They told me I would have to have sit down job only. I had ABSOLUTELY ZERO issues before falling and injuring my knee.

    Well I haven't reached MMI as of yet and haven't been given a rating. What I would like to understand is the Loss of Use Award and also say if the doctors tell me I am 25% disabled, how do they payments work? Do they subtract the payments from what I was receiving before going back to work? ( Since I can not return to work at my previous employment, my job contracted out to VocWorks to get me a Modified Off Duty Site job with a non profit organization. I get paid by my employer to sit at a desk.) So say I have been receiving workers comp for 28-30 weeks already, then I am back to work at this other place. What would be the amount of weeks for my knee? Do they subtract those weeks from the amount of weeks I would get paid for my knee? Would I also receive a Loss of Award? I made $360-$400 a week prior to injury and I received $266.03 during the time WC was paying me. Please explain it like I am completely stupid, because in all honesty I need layman's terms. I am in Tennessee.

    Thank you all!

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