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2 shoulder surgeries & settlement Ca.

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  • 2 shoulder surgeries & settlement Ca.

    Hey all, had a bad injury at work back in January of 08. Had rotator cuff and bicep tendon repair in one in August of 08 and AC joint and labrum repair in the other in July of 09. The work comp agency EASIS offered me 10k to settle. He said I should be okay and that the doctor left some things out of his report but he will give me the benefit of doubt on some of the things and offered me 10k. Anyhow, not thinking I was going to get a penny this sounded great. I initialled all the paper work and sent it back. Now I got the full report back and it says alot of future medical issues come along with these types of surgeries. Is it too late to talk to an attorney since I initialled everything? Is 10k a good amount to settle for having both shoulders not 100% anymore?

  • #2
    Have you agreed to the settlement amount? If so, yes it is probably too late to retain an attorney.

    Is 10k enough? Only you can answer that for yourself. It is not enough for me.

    At this on a lawyer...MONDAY...let them decide if they can assist you or not.
    Not everything in America is actionable in a court of law. Please remember that attorneys are in business for profit, and they get paid regardless of whether or not you win or lose.

    I offer my knowledge and experience at no charge, I admit that I am NOT infallible, I am wrong sometimes, hopefully another responder will correct me if that is the case with the answer above, regardless, it is your responsibility to verify any and all information provided.


    • #3
      Yeah, I initialled everything already but the thing is, in my Doctors report he left alot out so I wasn't aware of the importance or future issues I will have with this type of repair. It was actually the attorney that reviews the offer for the comp place that put in his report that all the missing things were very important and had put me at a higher disability rate due to the severity of the repairs. I will contact and attorney for sure Monday.


      • #4
        You should also contact the CA/Claims Administrator, and the DA/Defense Atty you have been dealing with and notify them you do not intend to move forward with this C&R/settlement. And, you should memorialize this in writing, certified, return receipt requested, and/or overnight, not second day air... overnight!.... and, notify the I&A officer... Information and Assistance officer at the WCAB where your claim is filed for adjudication.

        You are not in receipt of the final PTP reports, and you also have the right to dispute any rating you may have now... you can use a Panel QME to do this... just notify the CA of your intention to dispute the rating.

        The 10K you have been offered is NOT sufficient for FMC/Future Medical Care for the type of injury you have described. The employer/carrier is liable for treatment to your injury for the rest of your life, OR until you close the medical by lump sum.

        There are other issues they have neglicted here... have you been requested to sign a release of information form for SSA/Medicare status ?
        Has there been a FMC work up done for your treatment anticipation ?
        The attys are not medical professionals...and no matter how many of these claims they deal with, they are out to settle/close the claim as cheaply as possible for the employer/carrier.

        Once you have been declared MMI, the employER has additonal mandates they are required to fufill... from what you describe here...those have not been you return to work issues.

        This claim is NO WHERE near ready to settle out... IMHO...I would do whatever necessary to STOP this settlement agreement... MONDAY.

        What is in your favor here is the WCAB judge must review all settlements for adequacy to the IW... as you have not received a PD/WPI rating, a judge will be very interested in that... as well as the PTP final report not being rec'd.... both very important before any negotiation should be completed... this DA/CA is doing everything to take advantage of you... based on what you provide here.

        Get the I&A officer first... that way they will be on the lookout for your paperwork and stop it before the ALJ gets involved.

        Please continue your thread in the Workers Compensation forum... this claim is not personal injury or auto accident issue.


        • #5
          Moving to WC forum.
          Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. Leo Buscaglia

          Live in peace with animals. Animals bring love to our hearts and warmth to our souls.


          • #6
            Judge suspended C&R

            Hey all, so the offer of 10k was suspended by the judge back in May. Since then the insurance company and their attorney have failed to respond to the judge or myself. I have called their attorney and the insurance company numerous times with no response.When I spoke to the workers compensation board they said I could ask to be compensated for the wait. Has anyone done this and if so what amount is reasonable? So far what I am rated at is 12% disabled that comes out to apx $8600 on the chart they use, plus 15% for there being no job offer equals apx $9900 which means I am settling future medical for $10.. What is usually a fair amount to settle on future medical?


            • #7
              There are as many answers to that as there are injured workers. And it varies by state.
              The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.


              • #8
                There is no 'average' or normal amount for FMC/Future Medical Care.
                You have to take into consideration what the PTP reports say, what the PQME reports says... there are too many variables to offer any dollar figure.

                WC is about paying benefits, not settlements.
                When you cash out the claim, you are agreeing to accept the liability for your injury, out of your pocket. Whether you are paid cash or not.

                When I spoke to the workers compensation board they said I could ask to be compensated for the wait.
                For what wait...?
                You are entitled to indemnity based on the rating. That's it.
                You can't force any cash payment. There are no compensaton dollars with waiting for anything, penalties are due on benefits that are ''unreasonably delayed'', settlement money is not subject to unreasonable delay.

                The FMC is not going to be paid for treatment you may or may not seek post settlement. There is no guarantee you'd- live long enough to exhaust any significant amount of money for FMC.

                By the way... the 15% is not on the full amount of your indemnity... the job offer must be made within 60 days of MMI. That would be TWO indemnity payments deducted from any 15% addon... may not be much, but you should be aware of this none the less.
                I have called their attorney and the insurance company numerous times with no response.
                The judge said no to the C&R, likely due to the amount or terms not being adequate to the IW.
                What was required as follow up...?
                Did the judge order any additional evaluation... review of the PD/WPI rating?

                As long as you are paid the indemnity/PDA's, you are in no jeapordy. You have continuing access to medical care, and the ability to petition the court to reopen the claim within 5 years of your DOI, for new and further PD.

                There is no ''delay'' here.


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