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  1. #1
    Join Date
    Aug 2014
    Location
    Georgia
    Posts
    5

    Default On Settlement

    My workers compensation claim was made in the State of: Georgia

    I injured my shoulder about 3 years ago. The accident messed up my rotator cuff very badly, it tore the main vein coming out of my arm ( had to have angioplasty to repair) and caused traumatic lymphedema. I have nerve damage and they had to cut the bicep as well. I can raise the arm less than 90 degrees and have very little strength in it(left less then 5 lbs) They sent me to a FCE and their person said not able to do any work. I got SSDI on first try because of the accident. I go to a pain clinic to help with the constant pain, but the lymphedema requires that I wear a compression sleeve and glove. I also use a compression machine 3 hours a day and will have to the rest of my life.

    I had failed surgery on the cuff two times and they won't touch it now because of complications of the lymphedema. The WC insurance has offered to let medicare set a medical set aside amount and put $45,000 with that . Does this sound fair. The doctor put my arm at 18% rating which is crazy because I have very little use left.

    Now that I am on SSDI I would like a fair settlement and just get on with my life.

  2. #2
    Join Date
    Oct 1971
    Posts
    4,735

    Default Re: On Settlement

    kimdawg
    The WC insurance has offered to let medicare set a medical set aside amount and put $45,000 with that . Does this sound fair.
    Only someone with your entire medical history could answer that.
    Whether it's fair is irrelevant, that money is to protect Medicares interest only it has nothing to do with your monetary interest.
    After that money is exhausted, Medicare will pay from that point on, it doesn't matter if it's a dollar or a million.

    Sounds like they want to settle your case, the important part is the wage loss side and how it's worded.
    Don't agree to anything until you consult a lawyer, I 100% guarantee they will lowball you if you're unrepresented.
    For the cost of a lawyer, you'll be money head, protect your interest and save your sanity - hire a lawyer before proceeding further.

    Tony
    Moderator Responses are based on my personal bias, experience and research - they may not be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Aug 2014
    Location
    Georgia
    Posts
    5

    Default Re: On Settlement

    The $45,000 was to be separate from the medical and that would be what they offered me for my part. I know I need to make sure it has some type of wording to spread it out for SSDI. Now that I am getting TTD and SSDI I only get a couple of hundred from SSDI because of the offset. At first they offered 33,000 medical then they said they would have to get the amount from SSDI since I will be able to get medicare in June. I just want a fair amount and be able to put this behind me. It has caused a lot of mental stress getting used to having to deal with all that is required to keep the lymphedema under control and managing the pain. I just want to be be able to walk on the beach and find peace with my life again.

  4. #4
    Join Date
    Oct 1971
    Posts
    4,735

    Default Re: On Settlement

    Either they have no idea of what they're talking about or you're confused - what you're saying doesn't make sense.

    Again, if you're unrepresented, you won't get a fair deal - they'll cheat you out of thousands.
    You better have someone who knows what they're doing evaluate your case - hire a lawyer!
    You can dam well bet the carrier would never into a settlement blind, they know exactly what they're doing.

    Tony
    Moderator Responses are based on my personal bias, experience and research - they may not be accepted in the legal community, always consult an attorney.

  5. #5
    Join Date
    Aug 2014
    Location
    Georgia
    Posts
    5

    Default Re: On Settlement

    Ok, Let me see if I can explain better. So far they have agreed to give me a medical amount for $33,000 and $45,000 for me to use as I see fit. They realize that Medicare has to sign off on the medical set aside amount ($33,000) and we are waiting to see if that is approved.

    I have not signed anything yet. I know it has to have some type of language in there to spread the $45,000 over my life time, to help with the SSDI offset. I am just not sure how it should be worded.

    It is a non dominant arm but I will have to deal with the lymphedema and pain for the rest of my life. I can't reach above a straight out 90 degree angle and have no strength in the arm. The workers comp adjuster agrees that I will never return to work again. My age is 57 if this has anything to do with it.

    I admit I am very unfamiliar with any of this and wouldn't even begin to know how to find a lawyer. We just moved to this area and don't really know many people yet. Any help or thoughts about the fairness of this offer would be appreciated.

  6. #6
    Join Date
    Oct 1971
    Posts
    4,735

    Default Re: On Settlement

    Any help or thoughts about the fairness of this offer would be appreciated.
    Without knowing the details of your case, it's impossible to comment.
    The only way to know is to have your case evaluated by someone who knows what they're doing.

    I will say this, when people retain a lawyer - they get much more, sometimes double or triple of what the insurance offers.

    Tony
    Moderator Responses are based on my personal bias, experience and research - they may not be accepted in the legal community, always consult an attorney.

  7. #7
    Join Date
    Aug 2014
    Location
    Georgia
    Posts
    5

    Default Re: On Settlement

    Thanks for the comments. When you approach a lawyer what do you take. Do I need to get medical files or can I just take a record of accident, tests, surgeries, treatments, medicines, etc...

    Is it common to work a deal that excludes what you have already been offered from their percentage or is it considered rude to ask about that. Talking to a lawyer is something so far out side of my comfort zone and I would not want to offend anyone or say something that is stupid.

    Lastly does anyone know any good lawyers in Georgia that would take a case in this price range?

  8. #8
    Join Date
    Feb 2007
    Location
    Charlotte, NC
    Posts
    3,672

    Default Re: On Settlement

    Here in NC, I have settled cases like yours for over $200K for indemnity benefits, but state laws vary on the issue of ongoing disability benefits. In NC, if you cannot work, you are not limited to the rating.

    The 18% sounds awful low based on the symptoms you are describing. The Medicare Set Aside is for future medical care for the injury, and Medicare will typically tell the parties how much that needs to be.

    You need to be consulting with the best GA workers' comp lawyer you can get. Use the lawyer directory at WILG.org to get you started. They are all good lawyers for this kind of case.

    A good work comp lawyer would be willing to carve out your current offer from the fee agreement. I do that for people, and I know a lot of my colleagues do as well. Don't be nervous about talking to a lawyer, just pick up the phone and call. Tell them you already have an offer and that you think it is not fair, and ask what they think. The lawyer will need to know all the facts of your case to give you a good answer. If you are near Atlanta, I know of a couple of lawyers in that area that will do a good job for you, and they are nice people. Send me a PM and I will give you their names.
    Last edited by complwyr; 02-05-2017 at 09:33 AM.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

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