Vermont Workers Comp Questions-Help!

[anumbnut]

I am currently on WC in Vermont, for the past 10 months, for a broken wrist in 2 places (which required surgery and PT), and a still unknown shoulder injury. I am scheduled for a Drs visit made by WC in 2 wks. I am unsure of the WC procedure from the point that their Dr determines that I may be able to return to work, which at this time I feel is premature, considering the line of work I'm in. My current Dr has said that my wrist will not get better than this, and I should consider another form of employment. My job pays very well for this area, and I have invested time and money to become trained and certified and this doesn't seem fair to me. Would I have an opportunity to appeal their decision? Would I immediately be cut off from receiving checks, which I rely on to support my family? At what point is a settlement made, and what is the process? About how long do you wait for a settlement? Do we have to go to trial? Should I find another Dr for 2nd opinion now or wait for the Comp board's decision? Thank you in advance for your help.

Tony

[ElleMD]

Sending you for a second opinion once your doctor has said you have reached MMI (as good as you are getting), if routine. 10 months is a long time to be out for a break.

No one here can guess what their doctor will say or recommend and what your carrier will ultimately decide to do. There are many options available but paying you to be out indefinitely won't be among them. You may be offered a settlement or offered vocational rehabilitation to learn to do a new job. It is really too soon to speculate on what might be as you have not had the other exam yet.

If you do not have one, you should look into getting a lawyer to help you sort through the options and determine what would be in your best interest.

[anumbnut]

I understand its premature to know whats going to happen until the doctors exam. I was just asking what is the procedure of comp? If the doctor clears me for work what happens next with comp to finalize payments? I heard there is a point or percentage system they use to determine how much permanent loss I have in my hand? Is this correct? How long after I am cleared to go back to work can I expect to receive this settlement? As far as the length of time I've been out, 10 months may be long for a simple break - cast on, cast off. I shattered my wrist and had multiple fractures and went through surgery to place pins in my wrist. Recovery was very painful and in my opinion is not completed. PT helped but ended after 6 weeks, so I keep trying at home. Furthermore there is a secondary injury in my shoulder from the fall which I am still waiting for comp to allow treatment. I know every case is different, I was trying to get an idea from someone whos been in a similar situation as me. BTW, I went to an attorney, they said I am doing everything I can and they will basically charge me 1/3 of any award I receive, to do the same as I am doing right now. Thanks

[ElleMD]

I would check with another lawyer. What lawyers may charge under WC is set by law and 1/3 is extremely high even for a civil case. I say this as you are really going to want to have a lawyer on your side when it comes to reviewing any settlement offers.

In the normal course of a WC claim, what generally happens is after treatment, if there is a permanent impairment, your doctor and an independent doctor would "rate" you and come up with a % of disablement. Your state undoutedly has a formula for turning those numbers into a $ award. This award is not the same as a settlement. Receiving it is not a bar to receiving future medical treatment or even voc rehab, though usually the award follows any voc rehab you may recceive.

There are any number of ways that a settlement figure can be reached based on those results. Bear in mind that if you outright settle your claim, it will be for more money, but you will probably not qualify for future medicals or vac rehab. The terms of the agreement are whatever you and the WC carrier make them, but there is no benefit to settling without closing out these future expenses. This would be a legally binding contract and they are very very hard to overturn, which is why you really need to have the advice of a lawyer to help you determine whether this is in your best interest, and if it is, what is a fair amount. While the lawyer gets a % of the settlement, that is usually figured into any negotiation. You won't find that written anywhere, but in my experience, that is how it happens.