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continuing case, GA Georgia Hawaii Idaho

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  • continuing case, GA Georgia Hawaii Idaho

    I have posted here before regarding my case so I won't go into many details.
    Tripped at work Jan.06, out since then due to knee injury and surgery. No light duty policy at employer, so no work until termination in July. Lawyer is on retainer, with little to do as Ins. co paying as required, but for a few hiccups with hospital bill.
    Recent Dr. and MRI visit shows more damage and future surgery needed. I am waiting for a custom fit brace, but the Dr. says the damage won't heal on it's own so a brace is only a stop gap step to delay future total knee replacement.
    I am really tired of the waiting around for my leg to heal. I want to go back to work, in fact have had nibbles of a job offer from a prospective employer who is aware of knee injury and physical limitations. The problem is the insurance with the prospective employer has a pre-existing condition rider that will not cover my knee and future surgeries.
    My question: "How, or should" I ask the lawyer to approach the ins. co about a settlement now, so I can get back to work, or should I wait until MMI and/ or time limit runs out?

  • #2
    sorry, only in Ga., not other states.


    • #3
      You need to discuss settlement with your lawyer. That I won't get involved with.

      If I understand you correctly, you had the injury and then wre terminated in July as you were unable to return to work. You are currently receiving TTD and want to go work elsewhere but are concerned that the new insurance will exclude your knee as pre-existing. Do I have that right?

      First of all, your claim continues even if you do go work elsewhere. The medical portion would still be paid. You could still settle the claim later. Nothing changes except you do not receive TTD as you will have a paycheck coming in.

      As for the knee at some point being considered pre-existing if you later settle the claim, there are limits on how long a condition can be excluded assuming the new insurance even has a pre-existing clause and you otherwise would be subject to it. Rather than confuse you with the "what ifs", I'll point you in the direction of your lawyer to explain the realities based on the actual plans at issue. Even if there is an exclusion for some period of time, there are ways to structure a settlement to deal with that but talk to your lawyer.
      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.