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yet another question, sorry to be a pest.. Georgia

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  • yet another question, sorry to be a pest.. Georgia

    In expanding on a previous question..

    While I am looking for this new job, the TTD benefits are still to be paid to me?

    What happens if we ask for a settlement? do the benefits continue while we haggle? or do they stop the minute talk of a settlement is mentioned?

    Doesn't a settlement take several months, and have to be approved by the state board?

    Thanks again

  • #2
    It is easier if you follow up on the same thread as your previous question as after a while, all the posts blend together and it is hard to recall the details of yours.

    Once you reach MMI, you are not eligible for TTD benefits. If you are released with restrictions you *may* be eligible for reduced benefits. Ar eyou enrolled in a voc rehab program? If so, that would provide TTD while you are in the program until you secure other work.

    There are many types of settlements. All require the approval of the state board. If you are talking about a full and final settlement which releases future medicals, then it must also be approved by CMS, and yes, that can take a few months depending upon how backed up they are (and they are always backed up). I highly recommend a lawyer if you are thinking about settling.
    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
      Sorry, my mind is going a mile a second and I forgot to post under the previous question.

      No, I am not at MMI. I saw the dr. today and he said that he had been receiving faxes from the IC(I got a copy) asking why is it taking so long to return me to work. They said in the fax quote,
      "There is a position for her that is strictly administrative and would only require office work, sitting most of the time." (I didn't read the fax until after I had left the dr. office.)

      I had been fired from the employer I got hurt at, so where is this position for me? I know the IC doesn't find me a job, I am not on voc-rehab, that is why I asked about the looking for work question.

      Regardless, the dr released me to work with restrictions.
      My attny. said I need to start looking for a job. That is when we discussed a possible settlement, thus my questions for the settlement part.

      Comment


      • #4
        I would be asking the employer about this admin job. Or, have your attorney call the IC and ask about it. If there is a legitimate offer and you turn it down, you risk losing benefits.
        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
          The employer fired me last year in July.
          I don't think they missed me that much to offer me a different job now,when one of the reasons they fired me was that they had no "light duty" jobs in the company, and couldn't hold my position open.


          What are the limits to my having to take a job offered by the IC?
          Distance? hours/shift?

          If I understand you correctly, since I have been released to "light"duty, I can no longer get benefits even though I have no job to go back to?
          (whipping the dead horse...)The IC stops paying the moment I am released to light duty?(whip, whap..)
          I am now without any form of income because I am released to light duty?

          Comment


          • #6
            No, that is not what I said. Since you have an attorney though, you really should be asking him or her how to proceed. I can give you the general info but that is who should be advising you what to do as they have all the info. What is considered "reasonable" is not cut and dry.

            If you are still healing and there is no light duty, then TTD continues. If you are at MMI, a light duty offer is made, you have a non-catastrophic case and it has been 400 weeks or you find a new job, the game changes.
            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
              No, that is not what I said. Since you have an attorney though, you really should be asking him or her how to proceed. I can give you the general info but that is who should be advising you what to do as they have all the info. What is considered "reasonable" is not cut and dry.

              If you are still healing and there is no light duty, then TTD continues. If you are at MMI, a light duty offer is made, you have a non-catastrophic case and it has been 400 weeks or you find a new job, the game changes.
              The OP has been fired - probably because of injury (or being unable to be present for work because of injury - same thing):

              1) TTD continues to be paid, up to 400 weeks total, after being fired for injury as long as there are still restrictions;

              2) MMI doesn't cut off anything (imagine a quadreplegic who reaches MMI - that's as good as he gets, but he certainly may be fully restricted from any employment)

              3) as OP was terminated from employment, employer has lost the option to offer light duty employment

              4) OP - get a lawyer if you don't already have one and work on a settlement before looking for a job.

              Full disclosure: I'm a lawyer with a 99% incliniation to the employee. Some others who have been giving some fairly specific (incorrect or inadequate) advice to you so far on these posts have been Human Resources reps with a very, very strong inclination to the employer.
              Any advice provided does not create an attorney-client relationship. This is a public forum and therefore no confidentiality is assured. Attorney Joel Grist does not enter into an attorney-client relationship without a written representation agreement.

              Comment


              • #8
                I have a lawyer, it was after hours when I asked most of the questions, and I am a need to know yesterday type.
                I also ask to verify the info the atty gives me.

                I was fired because I ran over the 12 weeks FMLA time and becuse the employer couldn't hold the position because I was out because of the injury... Yes, I agree same thing.

                Thanks on the TTD info. It verifies the atty. info.

                The fax the dr. got saying there was a position for me came from the IC, so I didn't think they could "offer" me a job...Personally I think it was their form of pressure on the dr to release me.

                After the dr visit yesterday, I spoke to the lawyer this AM, and they are drafting a settlement letter,
                wish me luck!!
                Thanks for all the info everyone.!!

                Comment


                • #9
                  Originally posted by GaOvertimeLawyer View Post
                  2) MMI doesn't cut off anything (imagine a quadreplegic who reaches MMI - that's as good as he gets, but he certainly may be fully restricted from any employment)
                  A quadreplegic would be a catastrophic claim which is a very different ballgame.

                  Most often MMI is necessary before it is in either party's best interest (particularly the injured worker) to settle the claim. It is definitely required before PPD can be considered. Obviously guidance from the lawyer handling the claim and with all the details about it is best. I would still discuss with the lawyer why he is advising settling now as opposed to accepting this blindly. Make are that you understand what is being proposed and that you can live with those terms. A good lawyer will make sure you understand all the options available to you and the benefits and drawbacks of each.
                  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


                  • #10
                    Originally posted by ElleMD View Post
                    A quadreplegic would be a catastrophic claim which is a very different ballgame.
                    Incorrect. Quadraplegia itself does not necessarily mean unable to perform any occupation, which is what is required for catastrophic designation.

                    It is sometimes easier to see why a policy is such a way when an extreme example is given. But I'll take it down a notch - imagine a machine operator has one arm cut off - when he reaches MMI, he may not be able to do his own job - TTD does not cut off then. At 400 weeks, if he's unable to do any job, he can get catastrophic designation. In the meantime, if the employer insurer take no further action, the employee can continue to draw TTD as long as he cannot return to prior work, even if he can do other jobs.
                    Any advice provided does not create an attorney-client relationship. This is a public forum and therefore no confidentiality is assured. Attorney Joel Grist does not enter into an attorney-client relationship without a written representation agreement.

                    Comment


                    • #11
                      I'm not trying to be argumentative but do you know this for a fact? Have you actually had cases that did not hold the injury to be catastrophic when there was a lost limb or paralysis? I ask as the plain language of the statue lists both limb amputations and paralysis as catastrophic injuries.
                      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
                        ElleMD:

                        I'm trying to give you an example. You're missing the point and going off on a tangent.

                        MMI means maximum medical improvement - in other words, the doctors have done all they can do. It does not mean a person gets cut off of Temporary Total Disability (TTD) - they may not be able to return to their job even after achieving MMI. You had made the correlation to MMI and TTD being cut off, and the two are not correlated. And, catastrophic designation is not a completely different animal - it makes the cap of 400 weeks go away.

                        Use brain injury instead or whatever else - pick something major that may keep someone from doing their own job but wouldn't prevent performing other jobs.
                        Any advice provided does not create an attorney-client relationship. This is a public forum and therefore no confidentiality is assured. Attorney Joel Grist does not enter into an attorney-client relationship without a written representation agreement.

                        Comment


                        • #13
                          I'm agreeing with you on the TTD issue but once MMI is reached, generally the claim does settle, go to PPD or voc begins. Since it wasn't clear how long ago this injury occured or at what point in the process the claim was at, I asked. TTD does not just continue indefinitely until the 400 week mark has been reached if the person has reached MMI.

                          The rest I agree has nothing to do with the OP's question so there is no point in arguing about it.
                          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


                          • #14
                            I have asked the atty why she thinks we should ask for a settlement now,

                            her response makes sense to me:
                            The future of my knee lies in a knee replacement. A procedure that WC will not cover(in her case experience). Being that I am still paid while I seek employment to fit the dr.'s restrictions the settlement process may take many months. During which I continue to see the dr for my knee issues and if the knee worsens I will still be covered by WC. I can also refuse any settlement if in my opinion it is not adequate. The dr. can also say that he will not give me a rating at this time and we can still wait.

                            I have very little income pressure at this time(home nearly paid for, no credit card bills, car note etc. Only basic living expenses.) We live very cheap, in fact the WC checks cover all the bills so if the case or settlement drags on for months I will still be ok.

                            Comment


                            • #15
                              Originally posted by injuredonthejob
                              it looks to me after reading a lot of your responses to injured people that you are almost always argumentative with them, especially when you are so wrong abought so much other than what a H.R. person would do for the employer...not the employee. my two-cents worth as a see it. And i am glad that there is someone like GaOvertimeLawyer to set you straight and help us that are injured on the job
                              By all means, if you have something that shows that this information I posted is incorrect, share it. I'm open to finding out if there are differences between the letter of the law and the application of the law. I can only go with what I have experienced so far and what my sources state. If someone has something that contradicts them, by all means share it.

                              None of my claims are one this board so it really makes no difference to me what so ever whether there is a claim or not. I have no vested interest in detering a legitimate claim or giving wrong advice. I can't change what my background is and I can only answer based on the information given. The OP has a lawyer so I'm advising them to discuss the details with that lawyer as I don't have all the facts of the case.
                              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

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