Settlement

[Caddarik]

Hi, Nancy!

After more than 6 years with a very poorly managed case, i reached a point where I took charge of my care, paying out of pocket for Jedi atop sand treatments. I explained this to my adjuster in a very frank conversation and she suggested that adjust come you settlement, close the case, and part ways. With complete subjectivity, the adjuster determined a 5% whole body impairment and a compromise & release amount of$25,000. I do not have an attorney, as there are very few WC specialists in my area and none of them felt my case was worth their time). However, I am aware that insurance companies rarely act in the best interest of the injured party. So, I network the Work Comp Board's Information Liaison- herself a former WC adjuster- who strongly advised me to have a QME before agreeing to a settlement. I just received a copy of the QME's report, and he determined a 20% whole body impairment... 4 times higher than my adjuster estimated. I find it hard to believe that the insurer will come back with a new offer that is four times higher than the original $25,000, but I'd appreciate it if you could provide some estimate of what I should reasonably expect. I was a 40 year old executive assistant at the time of my injury. The doctor also recommended vocational retraining, as performing tasks common to my previous occupation are the cause of my injury, which is further aggravated by those tasks. Thank you for any assistance you might be able to provide. Best regards,

Lisa

[Dabbah]

You have extremely limited negotiating power because you won't say, "Ok, we're going to trial" if the adjuster doesn't increase the demand substantially.

There is no more 'job retraining.'   Since 2004, there is only a "job displacement voucher' for a few thousand payable solely to a school, no cash to you.

That $25,000 was largely to close out future medical treatment and issues like your out-of-pocket expenditures and prescriptions and mileage.   

Know that you will need the same future medical whether you have a 5% or a 20% permanent disability award(at trial).

I cannot discern from all this which body part was injured, so I couldn't do a rating of your whole person impairment.    

So I can't get a dollar value for you.

An 'exective assistant' comes out as a secretary in the rating calculator, and that gets marked WAY DOWN(=less money).  If you have a 20% Whole Person Impairment on a Shoulder injury, that goes down to 16% Permanent Disability Indemnity for a 40-yr-old executive Assistant.

So you should think about a job description that includes the more physical aspects of your job assignments... e.g., if you had to clean the bathroom as part of your duties, then you should say you are a Janitor instead of an Executive Assistant.     If you had to pack and ship 50-lb boxes of records, you should say you are a Packer.

A 5% whole person impairment for a 40-yr-old secretary/Executive Assistant with a shoulder disability comes out to about 3% Permanent Disability, only $2070.   A 20% WPI for the same comes out to $12,765.

You could 'insist on that $25,000 plus the extra $10,000 for a $35,000 Compromise & RElease Agreement(the 'divorce' in workers Comp), but the adjuster has no reason to add on $10,000.   She isn't bound by what the QME wrote.  

Attorneys often 'split' the liability, a split between $2070 and $12765 is so a judge might suggest a settlement based on $7,400 in Permanent Disability plus $22,000 for future medical rights(just dollars so you don't have to run to court for an order for each treatment suggested, NOT the estimate of what the actual costs will be for life), so around $30,000.

But if I were the adjuster, I don't know if i'd budge from the $25,000...she knows you have no lawyer and you have zero plans to get a lawyer, and she knows you'll wrestle at trial because you can't know if the QME report is 'substantial evidence' or not.

If there's an attorney who can poke holes in your QME findings and persuade the judge the 5% report is the best evidence, you'll be done(presuming you've already received most of that $2,070 in PPD Advance payments already).

I'll be out of town for about a week so don't ask a follow up for at least one week.