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  • w/c question impairment rating process

    i have a nerve injury to my elbow and hand,also carpal tunnel syndrome. i have had several surgery's been off work for 6 months and will not be going back to same type of work again because of the injury.i was given 36%. now trying to figure or get an idea of how much will get in an offer.this is for south dakota.do i have to deduct money paid each week from final settlement?someone please explain this process to me if can be very appreciative and greatful. thanks eric..so confused

  • #2
    SD uses the AMA 4th edition for rating permenant disability.
    62-1-1.2. "Impairment" defined. For the purposes of this chapter, impairment shall be determined by a medical impairment rating, expressed as a percentage to the affected body part, using the Guides to the Evaluation of Permanent Impairment established by the American Medical Association, fourth edition, June 1993.
    Once you have reached MMI/Max Med Improvement, your Dr will rate you using those guides.

    SD also uses the ''scheduled loss'', or impairment to body part to calculate your indemnity benefits.
    (12) For the loss of a hand, or the permanent and complete loss of its use, one hundred fifty weeks of compensation;
    (13) For the loss of an arm, or the permanent and complete loss of its use, two hundred weeks of compensation;
    (24) For permanent disfigurement, or permanent disability resulting from injury to any part of the body not hereinbefore listed, compensation for that portion of three hundred twelve weeks which is represented by the percentage that such permanent partial disability or permanent disfigurement bears to the body as a whole.
    As it's not clear how your Dr has rated you... if you take your weekly rate, X 312 weeks, X 36%, that should give you approx amount of indemnity benefits due.

    You may be eligible for additional benefits, VR services, wage differential etc, as provided by the SD WC Act. http://legis.state.sd.us/statutes/Di...e&Statute=62-4. As you can see at the link, the Act is fairly complex, consultation with a WC attorney would be in your best interests.
    now trying to figure or get an idea of how much will get in an offer
    The employer/carrier doesn't have to offer you any money to close the claim.
    If it's in their best interests, which is generally the case, you will see some type of offer of cash payment.
    WC is about paying benefits, not cash settlements.
    If you are to be offered cash to close the claim, you could also be agreeing to accept liability for all future medical to your injury. Out of your pocket with any money you receive to close the medical portion of your claim.
    do i have to deduct money paid each week from final settlement?
    Don't understand that question ?
    Why would you deduct any money from any settlement.
    Weekly benefits are different than a final settlement. (?)

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    • #3
      help

      am confused, i still have use of my arm it is just not @ 100% i have loss of motion and feeling and grip.why can not return to the job was doing when injured,because requires 100% use of my hands.so why would i get 312 weeks for my hand and arm.i think what doctor say's is i have lossed about 36%use of my arm and hand and fingers combined not sure if that helps or explains it.as far as repayment someone told me that they would deduct the pay recieved thus far while off work each week is deducted from my final settlement.
      am trying to understand how many weeks x pay per week x % = poss settlement amount.i know my pay per week and i believe the 36% is correct,now just need to understand and find the weeks.i looked at a chart from sd w/c and they list 36% for a arm @ 112 weeks or so for hand @36% is 86 weeks or so would this be my weeks or just the arm or both and do the fingers also count. or do they just count it as a whole body.sorry to be such a pain am just trying to understand this and make sure that am getting what i deserve and is correct. part of the problem being my injury occured in sd where the company is also,but i live and another state over 1500 miles away.so getting a lawyer and going back in forth and other is time and money that i do not have to spend or can afford to lose.please help me understand this.i greatly appreciate the time and effort a person takes to read and respond to this question and for helping and giving advise.or direct me to a web site to find the needed info or poss info.and yes i have contacted an attorney was told do not need one at this time becuase insurance company is acting fair on my behalf,if we get an offer for settlement to contact them and would dicuss the said settlement and interven on my behalf if felt needed.but again being 1500 miles away does not help or make me feel very comfortable,not like can just show up in the office to discuss anytime feel the need.not being rude so hope understand my concerns and need for advise.

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      • #4
        The attorney you talked to is being very generous in the offer to review your claim.
        There is no fee for consultation, if there is any fee, it would be awarded by a comp court judge at the time your settlement is reviewed.

        WC is not a "DIY" project for many IW's. You would be well served to take that atty up on the offer to consult.

        Only the Dr who rated you knows how and what reference/guidelines were used. No one on a message board has that info, or access to your file.

        I gave you the link to the SD WC Act/sttutes.
        am confused, i still have use of my arm it is just not @ 100% i have loss of motion and feeling and grip.why can not return to the job was doing when injured,because requires 100% use of my hands.so why would i get 312 weeks for my hand and arm.i think what doctor say's is i have lossed about 36%use of my arm and hand and fingers combined not sure if that helps or explains it
        I understand what you're saying. IF you had an arm injury alone, you'd be rated to the arm. Same if you were injured only to hand....
        As you have mulitple injury to upper extremeties, I'd have to think you are rated to "whole person impairment' vs the scheduled body loss.
        If that is the fact, you are entitled to 312 weeks of indemnity benefits. 312 x 36% 112.32 weeks at your TTD rate.
        It would be rare that TTD would be decucted from an indemnity award. If you have already been paid indemnity benefits/weeks based on your rating, that amount would be taken as a credit by the employer/carrier.

        Who is the "someone" telling you there is a deduction to your settlement for the weeks/TTD you have rec'd ?. "Someone" rarely is correct when they don't know the statutes.
        am trying to understand how many weeks x pay per week x % = poss settlement amount.i know my pay per week and i believe the 36% is correct,now just need to understand and find the weeks
        That is the question you asked in the first post. And it's been answered, best possible based on the info you provided.

        IF you are offered a cash settlement to close the claim, you are not likely to see the full indemnity benefits due.
        A C&R/Compromise and Release is basically "new money" for your consideration to "compromise" on the outstanding issues, and "release" the employer/carrier from all futher liability for this injury.
        The indemnity is likely to be reduced to "todays dollars", so would be the future medical care estimate. You can deposit the money in an interest bearing account same as the carrier, over time, you'd receive the full amount as though you took the weekly payments.

        As I said, WC is about paying benefits, not cash settlement.
        If it's in the best interest of the employer/carrier, not the IW, they will offer you the cash to walk.

        You NEED to talk to that attorney. You can do that by phone. And it's not about 'losing' money... you don't have that money now. An attorney will generate more in benefits/settlement than you can do on your own.

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