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West Virginia WC wants to settle????

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  • West Virginia WC wants to settle????

    Brickstreet wants to settle claim West Virginia


    I was hurt on the job back in January. I injured my back and neck lifting a large patient.

    It happened over the holidays initially, but when I called to report it to my job, they said there was no one else to work. SO, over the week, I was constantly re-injured until I had no choice but to do something about it. I had even verbally reported the incident at the office between Xmas and New Years. They didn't even give me the form to report an injury, they said they would have to get one for me later but never did.

    I called work and when she said I had to go, I said the only place I'm going is the ER and I did.

    I was treated by an ER doctor for my back pain because at that moment, it was what was causing me so much pain. I did not mention my neck at that time.

    Within two days, I saw a chiropractor (no one else would see me) and when I filled out the forms I marked and "X" on my neck as well as 2 places on my back when I filled out the initial forms. I only mentioned my back pain on the report because at this point, it was still the main source. It was so bad I could barely function even to drive there or fill out the forms.

    This doctor treated my back and my neck during two appointments, but he did not make any notations about my neck. (I just found this out.) I don't know why, but I know his notations are not very detailed.

    I have never returned to work to that job. They treated me very bad after having the injury and said all they had was 12 hour shifts for me. I couldn't do 12 hours at that point.

    I changed jobs to one where I didn't have to lift at all for a few months. Then when I started contracting through the state to work for better pay, I had to take a client that involves lifting. This was in June. My neck and back now hurts me on a daily basis. I went to another doctor to be treated.

    Brickstreet, (WV Worker's Comp) sent me to an independent MD for an exam. He would not even look at my neck. He said it was not in the report. The claim was only for my back. Then I received a letter saying I have a 6% partial permanent disability.

    I went back to the chiropractor to get a copy of the form where I marked my neck and a copy of his notes, no mention of treating the neck. His office says they will give me a letter with this information stating that he did treat my neck.

    Part of the problem is that I had a sore throat and shoulder problem in the past (in my medical records and testing) and they are trying to say my neck was pre-existing. But, it wasn't. I never had THIS kind of problem before this.

    Yesterday, I got a letter from Brickstreet saying they want to settle the claim. (for my back only, of course) They want to give me $3700. I am confused. What is this for?

    If it's to pay for my disability, like auto insurance pays for a wrecked car, this doesn't seem right. I am 34 and have many years of hard work ahead of me. Is $3700 what they think this injury will cost me in wages? I am having to modify my whole life. Not just work. I have taken on other clients that involve no lifting, but also provide me with less hours because I can't keep lifting.

    I am not sure what I am supposed to do. I really don't want to get a lawyer, but I'm afraid not to. Does settling the claim end medical payments for treatment? Will I never be able to get my neck treated by them?

    I know there is an appeals process, but they are so difficult to deal with. I mean, they still deny I was off work for more than 4 days even though I have the written proof and they have never even compensated my wages.

    I feel like they think I am trying to fraud them. I have never had a work related injury before. I just want them to treat the problems. Isn't that what worker's comp is for? Or are they really just insurance who wants to get rid of me as a liability? That's how it feels to me.

    I am just very confused, frustrated and don't know where to take it from here. I used to be a very strong person. I have altered my whole life because of this injury. I don't want millions, just real acknowledgement and treatment.

    Any ideas on what I should do?

  • #2
    Step one. Hire a lawyer. I can give you general guidance but you really need someone to sit down with you and review all of the medicals and details of your case to advise you what you should do. I certainly would not settle a claim without having a lawyer review the document. Without reading the document, I can't comment on whether it is a full and final settlement or what it may be.

    Bottom line, if you didn't declare the neck as injured in the initial report and your doctor doesn't have a record of treatment for the neck as a result of this incident, then you are really going to have an uphill battle to have it included as part of the claim now.

    Whether the June incident is considered a reaggravation of your prior injury or a separate injury is a toss up. If you haven't treated for the back in months, and were able to work without difficulty between the end of treatment and the June incident, it will probably be considered a separa te injury. This is especially true if there is an actual incident that triggered the symptoms as opposed to just a gradual worsening of your condition overall. Did you report that incident as a WC claim?

    Settlements in WC are not like settlements in tort claims. You aren't going to get millions. How much you can collect depends upon what type of "settlement" you receive. You would have to ask the carrier or better, your lawyer, what the $3700 entails. It may be what is offered to close out the claim for good or it may just be the permanent partial disability award which would stil allow you to seek future medical treatment. You really need a lawyer to help you with that part and determine what is in your best interest.
    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.


    • #3
      Award Granted

      The letter says:

      You are being granted this award for permanent impairment resulting from your back injury.

      You will receive monthly payments until your award is paid in full. The breakdown of your award is as follows:

      Current Award: $3720.02 Total Overpaid $0
      Deductions Balance $3720.02
      NAP Non-Award partial Ba;ance $0 Monthly Rate $673.52
      Child Advocate balance $0
      Overpaid this claim $0
      Overpaid other claims $0

      The range of motion impairment falls within the ranges for this catergory.
      Therefore, no further adjustment is required for tthe final impairment.

      The granting of this award closes your claim for Permanent Partial Disability benefits.

      It also says I have 30 days to protest the decision.

      My questions about this letter:
      Does this stop any further medical payments for the treatment for my back?
      Is this the end of this claim PERIOD?
      I never received any payments for my time off of work due to this injury, 8 days.

      Also in response to your letter:

      I wasn't re-injured in June. I worked after this injury at another job with no lifting. When I took a job that involves lifting (for better money) in June, my back and neck became more aggrevated. It continued to cause me discomfort from the date of the injury forward but it became very bothersome when I began lifting again in June. That's why I sought out a doctor for treatment again.

      The only reason I didn't continue treatment until then is that WC continuously sent me letters saying the claim was still being processed. ANd other letters saying I would not receive any benefits for lack of income because according to them, I was not off work more than 4 days. But I actually WAS.

      I've never dealt with WC before. I wasn't sure what to do.

      I am still trying to get them to pay for my lost wages for the 8 days. They have the documentation, they've just denied it.

      However, sincnce the injury, I have lost wages also due to the fact that I had to find another job without any lifting. That cut my income in more than half. WHat do I do about that? I read somewhere that I should be receiving payments for up to 300 weeks. I am having a terrible time finding any information on the WC rules and processes and such.

      Does this help to clarify the details so you can answer my questions? DO you know where I can find real information to help me?
      Thank you!


      • #4
        I won't lie to you, yor state's WC site is among the worst I've encountered. Being as I'm from MD, I could make a comment on this but I'll be nice and refrain. (Ours isn't much better)

        The award you received is not a settlement. PPD is monetary compensation for the 6% disability rating you received. The amount is figured using a formula set by law. This does not prevent you from seeking related medical treatment in the future.

        If you wish to appeal, you will need to contact an attorney. You or the attorney would file issues to challenge it. You would need to have a doctor rate you and if it were higher than 6%, appeal.

        It is still iffy whether the June reoccurance is a separate accident or whether it is a part of the initial claim. Since you were lifting when it flared up, the odds are greatly in favor ot it being a separate accident. If you do retain and attorney, I would ask them about this but months later performing specific duties indicates a new accident.

        You mention that you left employment with this employer after the accident. When was this? Was this before or during the the 8 days you were out? Do you have medical documentation from a doctor that places you on leave during this time?

        You would not receive direct compensation for the time you spent looking for another job. The only time WC pays for job placement assistance is if there is a formal vocational rehabilitation program that has been authorized. That does not apply here.

        No, you would not get an automatic 300 weeks. The maximum you could ever receive PPD for is 336 weeks in your state if your rating is less than 84%. As you have a 6% rating, you would not be entitled to the maximum or even close to it. The 6% rating would have taken into account what is called "industrial loss of use" or "you no longer can do what you once did because of the injury". There is no separate payment for industrial loss.
        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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