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Reached MMI/Got Ratings/What's Next?

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  • Reached MMI/Got Ratings/What's Next?

    Original injuries (bad arm fracture with 2 surgeries) and fractured hip (no surgery, but had previous hip replacement), occurred 6/06. Last arm surgery was 12/06. Physical therapy is long done. Physicians say I have reached MMI and I was rated for PPD; 30% for arm. 55% for hip. I lost my job, as employer would not rehire me even though job was available. Employer is self-insured. In previous discussions with my attorney, he seems feel I should go for some type of settlement. I will need to set up a MSA. What should I expect to happen next? I am continuing to get WC pay, which is the same amount as TPD, but category is now PPD. Would appreciate any advice, suggestions or information. Thanks.

  • #2
    Follow your attorneys advice. That's what you have him for. I wish I could tell how much you'll receive but no one here can tell you that. Every state is different and every injured employee earns a different amount. I would go for a settlement and get it over with.... Good luck.

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    • #3
      If you just got PPD, then it is unlikely that settlement is right around the corner. However, you should discuss with your lawyer. They are in the best position to advise you.
      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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      • #4
        I did finally speak with my attorney today. I did get my MMI ratings from my two doctors, but the IC feels the one for my hip is too high. I am going to be sent to an IME for this. In CT it seems that when you reach MMI your WC payment category is changed from TPD to PPD. When you reach PPD is when the attorney starts collecting his 20%. There seems to be so much discrepancy about whether to go for a final settlement or whether to leave the medical open and not get a final settlement. In CT this also means that you get PPD for "X" number of weeks based on your ratings; then the PPD ends. In addition to the PPD award, it seems that my attorney wants my former employer to compensate me for my inbility to work in the future (have been approved for SSDI), and for future medical needs. Is the right way to go about deciding to see what kind of settlement is offered, and then figure out what you are left with? How negotiable are self-insured medical facillity employers?

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        • #5
          Every employer is different. There isn't a standard. Some self-funded employers are very willing to negotiate, and others not. I recommend discussing your settlement options with your lawyer. With SSDI involved, it can get very complex.
          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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          • #6
            Why would being on SSDI make it more complex?? I was told by my Social Security case worker that when you reach age 65, which is in 3 months for me, then there is no longer and offset between WC and SSDI. I don't know if this is just in CT. Until age 65, I was advised by Social Security to waive my SSDI benefit until age 65. This is what I have done. I will not have to reapply for medical approval.

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            • #7
              Actually it is just the opposite. Once you are on some sort of Social Security benefit, there absolutely is an offset. This is federal law, it has nothing to do with CT. CT can not decide to bypass federal law. Once you reach 65, you can't get SSDI. http://www.jjcelderlaw.com/SSDIOffsetMSABull.htm

              The offset only applies to indemnity benefits not future medical. MSAs always apply once you are receiving benefits from SSA.
              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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              • #8
                The Social Security offset applies to SSDI (disability) benefits, not to SSR (retirement). And the offset can be controlled if you settle your comp case by including SS offset language in the settlement agreement. But when you hit age 65 just convert your SSD to SSR and the offset issue should go away. The Medicare set aside issue will persist, however, if you settle your comp case and close out the medical coverage, you must consider Medicare's interest and probably will need to have an MSA allocation.
                Bob Bollinger, Attorney
                Board Certified Specialist in NC Workers' Compensation Law
                Charlotte, NC

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