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  • Hurt On Construction Job

    In September Of Last Year My Husband Was Hurt When A 350lb Steel A-frame Fell On Him. He Broke 2 Ribs And Did Some Damage To His Spine. He Has Been Out Of Work Since And Is Getting Workmans Comp Payments Weekly. The Doctors Are Sure He Has Nerve Damage And He Can't Walk Without Pain. He Has Fallen Down The Stairs Because His Leg Gives Out On Him. He Gets Pain Meds That Have Never Changed And Those Stopped Affecting Him Long Ago.

    I Am Worried Being That We Have 3 Kids And I Have Been Working 2 Full Time Jobs Because He Only Gets 2/3 Of His Pay Weekly. Someone Said He Will Get A Check When He Does Go Back To Work But Noone Has Even A Thought As To When That Will Be If He Ever Does. I Want To Talk To A Lawyer Because I Need Answers. The Doctors Who Have Been Seeing Him Have Scheduled His 3rd Mri And Now Some Type Of Electric Shock To See What Nerves Are Damaged. Surgurey Has Come Up In Office Visits But Thats A Chance To Take When Your Dealing With A Back Injury. Any Thoughts Out There? Thankx So Much. Kat

  • #2
    What is your question? Please don't capitolize the first letter of every word, It makes your post very hard to read.
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

    Comment


    • #3
      Reply

      I guess my questions are if he never goes back to work is he able to sue his employer? How long will he be able to stay on comp? If he does eventually go back to work will he get a check for the time he was out? Meaning he went from take home weelky $1200+ to 2/3's of his pay. Will they pay him the difference? He was hurt doing what his boss told him to do while the boss stood there next to him. It took 3 guys to remove the steel frame off of him. To date no doctor has even released him for light duty. I am afraid he never goes back to work. I don't know if he never does what do we do. What can we do? how long before the statute of limitations runs out if any in this case and why are the doctors dragging their feet?

      Comment


      • #4
        I highly suggest you read this http://wcc.state.ct.us/download/acrobat/Info-Packet.pdf It will answer most of your questions.

        No, you can not sue your employer as WC is the exclusive remedy. There are a few exceptions but they are very rare and require that the employer more or less purposely caused the accident with the intent to injure.

        There is no limit on how long he can receive TTD.

        He is only due what he receives from WC. If his employer voluntarily offers to supplement his pay they may do so but it is very rare. In any case, how and when and if they pay it is entirely up to his employer.

        If he can not return then he would be eligible for at least permanent partial disability benefits and possible voc rehab. I'd suggest reading those sections of the link above for details.

        Not being a doctor, not having read the medical reports and having no idea what your husband's injuries even are, let alone what treatment has been done or recommended, I can not possibly comment on why he hasn't been released for light duty or if the doctor is dragging his feet. That is something to discuss with the doctor.
        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

        Comment


        • #5
          He also should apply for Social Security Disability.

          http://www.ssa.gov/

          If approved it will pay in addition to WC up to the differnece of what he is currently drawing in WC and 80% of his average wages. Not a huge sum of money but every penny helps. Also it will already be in place if the time comes that he settles with WC. By the way if he settles with WC make sure they do a Medicare Set Aside. Your attorney can explain more of what this is about or you can go here and read about it.

          http://www.cms.hhs.gov/WorkersCompAg...wcsetaside.asp

          Good Luck to ya'll and I hope your husband is doing better soon.

          Comment


          • #6
            It is a bit premature to go the SSDI route and talk settlement at this point. I would never file for SSDI without the advice of an attorney ESPECIALLY if there is a WC claim out there. The number of possible pit falls and hang ups are too numerous to mention.

            Just for future reference, here is an article that explains how the SSDI offset work in the closest I've found to plain English. http://www.jjcelderlaw.com/SSDIOffsetMSABull.htm

            Medicare Set Asides are required by law and you can not get a settlement approved without one if it is called for. Again, this is well into the future.
            I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

            Comment


            • #7
              Originally posted by ElleMD View Post
              It is a bit premature to go the SSDI route and talk settlement at this point. I would never file for SSDI without the advice of an attorney ESPECIALLY if there is a WC claim out there. The number of possible pit falls and hang ups are too numerous to mention.

              I will strongly beg your differ on that on ElleMD. SSDI requires that a person expect to be disabled for 12 months or for the condition to result in death. The man has been out of work for 10 months with no end in sight. SSDI has a five month waiting period from when SSA determines that a claimant is disabled. It also takes many months and sometimes years to win an approval for award for SSDI. What filing now does is protects his future. It establishes a claim date which freezes his income level to that of which he is entitled to, waiting will only decrease his award amount as the longer it is from when he last worked to when he files the less income SSA will show him as making. Also these folks have 3 kids and if they are under age 16 and still in school they too will qualify for SSDI benefits over and above anything the father is entitled to. The SSDI benefit for the kids, and maybe even the wife depending on the kids ages, are paid at full value to them with no off set fot the WC as WC does not pay extra for dependents like SSD does. Further when/if he does get to the point of a WC settlement once he reaches Maximum Medical Improvement, MMI, all WC income will cesase, which can take months, while the settlement is approved and before it is actually disbursed. During this time SSDI continues and the family gets to have food on the table.

              So what pitfalls and hang ups are you refering to if awarded SSDI ESPECIALLY with a WC claim?

              The only one I can possibly think of is the one where it costs the WC insururance company more to settle the claim due to the MSA. Many WC IC's are trying to dodge this bullett and this does nothing but leave the injured worker holding the bag. Medicare can require the claimant to use up every penny of their WC settlelment for medical expenses before they pay the first penny on a WC injury. Insurance companies have gotten away with this shift of financial burden for years. Medicare has simply had enough cost shifting and have put these guidelines in place to protect the Medicare system. Without a MSA and regardless if the settlement was specified for loss of future earning based on the percentage of disability Medicare can refuse to pay for any treatment of the wC injury. That is the reason for the MSA and if it is not addressed in the WC settlement the worker is screwed if the WC IC has not accepted life time medical as part of any settlement.

              It is most definately NOT TOO SOON to get this underway, with or without an attorney that specializes in SSD law in tow. Some WC attorney's will discourgage the claimant from filing for SSDI as this might cut across the attorney's total take. Don't matter that the woker is left holding the bag. From what this lady has posted her husband has serious injuries and is not likely to return to work in the next two months, so why not file now?
              Last edited by BnThrDnTht; 07-12-2007, 06:44 AM.

              Comment


              • #8
                MSAs haven't upped the costs of most settlements, at least not that I've seen. It has decreased what the employee takes home in their pocket. The MSA must be expended before Medicare kicks in but not the entire settlement. It is no longer possible with the new regulations to have a settlement except of a very minor nature that does not include a MSA. Every single state requires that the state WC board or commission approve a settlement and they are not going to pass one that does not contain the MSA provisions if needed. I have never seen a settlement that left medicals open for life. There just isn't any point. The purpose of a settlement is to close out the claim for good. PPDs and stipulation agreements leave medicals open but settlements do not.

                At this point we don't know that the husband will never work again. He's been out less than a year with a back injury which is not that uncommon. If his wife is asking about light duty I assume he isn't totally incapacitated. He may with treatment be able to resume working. He may even qualify for voc rehab. I can promie you no employer or IC is going to extend voc to someone who is on SSDI. It also has the potential to cut off the TTD as TTD only covers temporary situations. If he is declaring for purposes of SSDI that he is permanently disabled as a result, that is counter to the intent and purpose of TTD. I've seen it happen far too many times. Employee files SSDI and TTD is cut off. At best it is a battle to get it restored. More often than not, it doesn't and my state is one of the more liberal in this area. There may also be protections under ADA that are "lost" when filing SSDI. It wouldn't be the first time an employee was overzealous in their application for SSDI and it came back to haunt them when they later sought an accommodation under ADA.

                The bottom line is we have very few details from the OP and we have no idea the extent of the injuries or the long term prognosis. A fear that someone may never work again is not uncommon and not indicative that it will come to pass. I'd highly suggest speaking with a lawyer before acting on any of this. It gets very complicated and even I who know the rules and pitfalls would never attempt to navigate this on my own without the advice of counsel. It is nearly impossible to stay objective when it is you or someone you care about and you want someone to help you see the big picture as opposed to the immediate act.
                I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                Comment


                • #9
                  Those who are disabaled for one year or longer likely qualify for SSDI. Contrary to popular belief by some very uninformed people SSDI does NOT mean one will NEVER work again. It means for a period of time, minimum of 12 months or longer, a person is unable to work at the SGA level, currently $900.00/mo. That is exactly what SSDI is for as well as for those who may never work again. Either way the process is very long to get approved.

                  As far as it having ANY bearing on WC and TTD? That's the first time I have ever had anyone even suggest such a thing. On what LEGAL grounds would the WC IC have to deny Temporary Total Disability Payments due to a claimant being paid under SSDI? I don't believe for one second that they would have any legal grounds what so ever. Fabricated yes, as so often is the case with WC cases that lasts for more than a few weeks. But certainly no legal grounds just based on the claimant being approved for SSDI.

                  I fully agree the OP needs a good attorney that specializes in workers comp law for the wC injury and one that specializes in SS law to help with the SSDI claim. It might even be one of the same but her husband most certainly needs at least one if not two good lawyers.

                  Comment


                  • #10
                    reply

                    Hi,
                    If the two of you were lawyers on opposing sides of a case the judge would have traded in his water pitcher for a bottle of scotch . I think I understand some of what you both are saying and I agree that we need a lawyer and am looking for a good one now. I am not happy that what Rob used to bring home a week he barely gets in a month now. I am not happy that he can't play and bike with the boys and I think that it is wrong for his life and that of my children to change for the worse because his boss wanted to cut a few corners to get out of work early to have a beer(s). I thank you all for your replies and will leet you know how it all goes.

                    ps- my honest opinion is that he will never return to work. light duty or not. he can't stand straight most days and is in pain daily.

                    Comment


                    • #11
                      Originally posted by BnThrDnTht View Post
                      Those who are disabaled for one year or longer likely qualify for SSDI. Contrary to popular belief by some very uninformed people SSDI does NOT mean one will NEVER work again. It means for a period of time, minimum of 12 months or longer, a person is unable to work at the SGA level, currently $900.00/mo. That is exactly what SSDI is for as well as for those who may never work again. Either way the process is very long to get approved.

                      As far as it having ANY bearing on WC and TTD? That's the first time I have ever had anyone even suggest such a thing. On what LEGAL grounds would the WC IC have to deny Temporary Total Disability Payments due to a claimant being paid under SSDI? I don't believe for one second that they would have any legal grounds what so ever. Fabricated yes, as so often is the case with WC cases that lasts for more than a few weeks. But certainly no legal grounds just based on the claimant being approved for SSDI.

                      I fully agree the OP needs a good attorney that specializes in workers comp law for the wC injury and one that specializes in SS law to help with the SSDI claim. It might even be one of the same but her husband most certainly needs at least one if not two good lawyers.
                      I don't know how many claims you deal with but I handle a lot as well as regularly attend hearings and keep up on the trends in claims. I've seen a LOT that have cut off TTD when SSDI is involved. Personally, I have not but then my employees rarely go the SSDI route as we have a pension system and a whole different set of rules. That doesn't mean I haven't seen and heard far too many cases where it has happened and been upheld. In many cases it has more to do with the way the application is completed than anything but that is why it is not a DIY project. While you can apply for SSDI if you are going to be off a year, in reality, especially when WC is paying, very very few do so. Those that typically do apply are those who are not planning to return to work ever. I would never just jump in and file for SSDI without consulting with a lawyer. There are just way too many issues here.
                      I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

                      Comment


                      • #12
                        And again I will ask for clarification as to what LEGAL grounds the IC used to suspend TTD because someone files SSDI? I agree about the lawyer bit, yes they need a good WC and SS lawyer to guied them in their decidsion makeing process. One that only takes the best interest of the worker and his family into account. An attorney that knows all the little tricks used by WC cariers to attempt to cut them/him short on what should be LEGALLY paid for what ever the injury and insuing disability amounts to, whatever that may be. So that you know Elle this poster has been posting on another board for some time so I suppose in all fairness I should tell you that I have read her posts on the other board. That is why I suggested that he go on and file for SSDI as it has been made very clear that he most likely will not ever be able to work again.
                        Last edited by BnThrDnTht; 07-14-2007, 05:45 PM.

                        Comment


                        • #13
                          What statute or regulation is invoked to challenge TTD varies in every state. The underlying premise is the same though; TTD is intended only for temporary situations. If the person is never ever going to return, then either voc rehab or Permanent Partial Disability benefits are appropriate, depending on maximum medical improvement. If more information is posted elsewhere then I can't comment on that. I can only go by what I read here. This is one of the frustrations when posters put parts of the story on multiple different boards and then expect anything that resembles sound advice. I'd reiterate my advice to see a lawyer. Advising someone with only part of the story is pointless.
                          I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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