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Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

RSD & Worker Comp Settlement Issues

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Unread 01-17-2009, 03:43 AM   #1
traevin
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Default RSD & Worker Comp Settlement Issues

I've had RSD for nearly three years. It's so debilitating and painful that I haven't been able to return to work and there's no telling when or if that day will ever arrive. My Worker's Comp people are getting fed up with me, mainly because I'm not responding to any treatments and it looks like I might have to get another operation on the same injured knee that led to the RSD in the first place. Long story short, they want to settle.

I haven't received a dollar amount from them yet but I'm thinking that it's right around the corner. My question to you is:

For you RSD sufferers who have received settlements through Worker's Comp, what's a reasonable ballpark figure? Some (or most) of you might not want to discuss this on a forum but perhaps you wouldn't mind emailing me privately.

I'm afraid the insurance company will give me a low-ball figure and because I wouldn't know a good settlement amount from a bad one, I'm hoping that with your help, I can respond to their proposition from a position of strength instead of ignorance.

Thanks in Advance,

Jennifer D.
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Unread 01-17-2009, 01:21 PM   #2
Dubious
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Quote:
Originally Posted by traevin View Post
I've had RSD for nearly three years. It's so debilitating and painful that I haven't been able to return to work and there's no telling when or if that day will ever arrive. My Worker's Comp people are getting fed up with me, mainly because I'm not responding to any treatments and it looks like I might have to get another operation on the same injured knee that led to the RSD in the first place. Long story short, they want to settle.

I haven't received a dollar amount from them yet but I'm thinking that it's right around the corner. My question to you is:

For you RSD sufferers who have received settlements through Worker's Comp, what's a reasonable ballpark figure? Some (or most) of you might not want to discuss this on a forum but perhaps you wouldn't mind emailing me privately.

I'm afraid the insurance company will give me a low-ball figure and because I wouldn't know a good settlement amount from a bad one, I'm hoping that with your help, I can respond to their proposition from a position of strength instead of ignorance.

Thanks in Advance,

Jennifer D.

If Oregon is anything like California, you will undergo an "impairment evaluation" first. That will establish an impairment rating to the whole person based on AMA Guidelines, that then goes to something like an Office of Benefit Determination who then pulls out a chart that is based upon your occupation, rate of pay and age, etc., and then will determine what the value of the case is. That then goes back to the adjustor who will "make you an offer. " Whatever you do, don't let them buy you out of "future medical" care. That has potentially far more value than any settlement. I am not into lawyers, but because of the far-reaching impact that this one settlement may have upon you for the rest of your life, you may want to sit down with one and hear them out.
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Unread 01-17-2009, 05:53 PM   #3
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I agree, for something that most likely will be a long term condition , you really need to look for a good wc atty to represent you.

interview with many before making a choice, look at their office, staff, and how they handle other cases, try to see them in action. and look them up online and the state site for as much info as possible.
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Unread 01-18-2009, 06:35 AM   #4
traevin
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Thanks. I haven't secured an attorney yet. My insurance company has been very good to me, which I'm aware is not the norm, but I believe it will probably in my best interest to get one unless the insurance company makes an offer that seems more than fair. But that's the problem.


What is fair? I'm disabled enough to have received SSD on my first try, which I've been told is rare. There's a good chance that I'll never be able to return to my prior occupation as a massage therapist.

I'm in constant pain, very limited, and the medication I'm taking doesn't do enough to provide any sort of quality of life. I haven't given up on a cure or at least getting better but from how I feel, the length of time I've had the condition, the lack of any breakthrough in treatment, and from what I've heard from people who've had the condition for several years, there's a good chance that I'll remain disabled for the rest of my life. And that's a hard thing to write.

That's why I'm wondering what to expect for settlement.

Any ideas?
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Unread 01-18-2009, 05:15 PM   #5
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Hi Jennifer,
I've sent message back by pm but not sure if you got it. gave you my ph. number. let me know if you got it or not and i'll try again. Loretta Jewell
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Unread 01-22-2009, 03:30 AM   #6
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My experience with wc was just one of the many horror stories of an injured worker. In Florida you can't hire an attorney just because you're on wc. A lawyer here will only take your case after you've been denied something. For instance, in my case they weren't paying me and were denying me physical therapy. I think in Arizona you can't hire a lawyer until wc closes your case. At that point you can get a lawyer and have your case re-opened. That one is the silliest thing I've ever heard of but that's the way they wrote their laws.

As for settlement, I'm sure just as each state has different rules, they also reach a figure for settlement differently as well. I've seen a lot of people say they had to go for an exam to determine the % of disability(impairment rating) so wc could throw a number for settlement out there based on whatever the % for a body part(s) is. I was never sent to a doc for a impairment rating. In my case, wc added up what they had spent on my care up until that point in time(a yr and a half), then came up with a number of what they might spend on me in the next yr.

Since wc doesn't pay for pain and suffering or lost wages, the settlement will never be enough. If you're lucky to live in a state with lifetime medical that's good. Florida has no lifetime medical so there was no reason for me to stay on wc and fight while they destroyed my life. I went to mediation, bantered back and forth for about 2 hours and settled on a $$ amount for settlement. The best I got was 40k, 10 of that went to my lawyer so I got a check for 30.

Each of our cases are unique, just as the laws are. I don't think anyone can say what a fair or reasonable amount may be because it depends on the state, the wc laws and whatever else they use to figure things out. They don't care that this is a lifelong condition and won't take that into account when tossing out a $$ amount to settle with you.

If you're unsure of what your wc laws are for your state, then your best bet would be to pick a wc lawyer and take advantage of the free consultation they have. Then you can ask them when you are able to hire a lawyer or if wc has lifetime medical in your state. WC lawyers are paid when your case is over and settlement is reached. You don't have to pay them any money up front to hire them or anything like that. I do know every state has a % that lawyers can take. Like here in florida, the Fee Schedule is 20% of the first $5,000.00, 15% of the next $5,000.00 of all benefits obtained and 10% of the benefits in excess of $10,000.00 during the first 10 years, and 5% of the benefits obtained after 10 years. We also get a lump sum settlement which means we get it all at once. I had a friend in california on wc. There, the settlement is given by annuity. When she settled she was mailed a check every month I think it was and that continues until all of the amount of her settlement is paid out. Out there they also take a portion of your settlement and put it into a separate account. That money is used only for paying for docs,pt and meds or docs and meds, whatever you have need of. Once that money is gone you have to self pay.

Sorry this is so long. I really hope this helps you somehow.

Hugs,

Karen
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Unread 07-18-2009, 09:29 PM   #7
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hi I am overcomer,
I just received w/c settlement and as has been said, it will never be enough when you have a disability w/not much chance to return to work - my injury was 5/2008, placed on ssd 10.2008 - as disability required lifetime care and I was looking at future surgery and insertion of neurotransmitter, w/c figured it was cheaper to settle - I also received a medicare set aside fund for the next 23 years for future care then after that fund runs out, medicare will pick up the cost as they indicated it was a w/c injury and w/c needed to pay - there is some sort of way they determine how many years w/c has to pay before medicare picks up - also, in the state of georgia, medicare does not start once you are on disability for 25 mos but even as I speak, medicare is evaluating my medicare set aside to see if it will be enough, if no, w/c will have to put more into the fund, if they say less, w/c cannot take anything away - it looks like they will have to put me in medicare before the 25 mos in order for me to use the fund because you have to prove you are on medicare to get medicare prices for treatment - you really need to find a lawyer who is aware of what rsd is are you will be short changed, my lawyer had specified on his site that he was familiar w/rsd and warned that all lawyers are not - what I did was went to the internet and looked up rsd lawyers, went on their sites as some will give you cases about rsd and othe conditions w/the amount that was won so that is how I knew about how much to expect - the sad part about this is you look at w/c cases on these lawyer sites and then you look at personal injury and the is succccccchhh a bigggg difference that you cry but that is how w/c is - my lawyer did tell me that the reason there is no pay for pain and suffering is that w/c considers paying your bill pain and suffering and personal injury cases are pvt iunsurance or if md is aware of personal injury/you have a lawyer they will treat you then get funds when you settle so you get money to also pay medical bill - hope this helps - I know each state is different and I live in the state of georgia and we do not have lifetime insurance -
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Unread 01-25-2010, 01:00 PM   #8
martra1025
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Default Rsd wc

Quote:
Originally Posted by traevin View Post
I've had RSD for nearly three years. It's so debilitating and painful that I haven't been able to return to work and there's no telling when or if that day will ever arrive. My Worker's Comp people are getting fed up with me, mainly because I'm not responding to any treatments and it looks like I might have to get another operation on the same injured knee that led to the RSD in the first place. Long story short, they want to settle.

I haven't received a dollar amount from them yet but I'm thinking that it's right around the corner. My question to you is:

For you RSD sufferers who have received settlements through Worker's Comp, what's a reasonable ballpark figure? Some (or most) of you might not want to discuss this on a forum but perhaps you wouldn't mind emailing me privately.

I'm afraid the insurance company will give me a low-ball figure and because I wouldn't know a good settlement amount from a bad one, I'm hoping that with your help, I can respond to their proposition from a position of strength instead of ignorance.

Thanks in Advance,

Jennifer D.
Hi Jennifer,

I can't tell you what a reasonable settlement is but I can tell you that the IC in my state, Pa. offered my husband who has had RSD for 4 years 150K. They did a life plan or something like that to figure future medical expenses for medicare set asideand estimated he would live to be 81. He is now 50 so that 150K is about 4800 bucks a year. That is crazy. We had our own impairment rating evaluation (IRE) and he is 63% impaired. The IC has yet to do an IRE but they have just filed a petition to modify/suspend benefits.



Good Luck.
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Unread 01-25-2010, 10:35 PM   #9
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Dear jennifer d,
I wanted to email you privately but can't find the stupid button to do so. If you want to do that it would be great. All I can say is it is a joke here in PA and from what I've heard over the years you are lucky if you get about 60K from them. Sometimes before they settle they will want you to do a 4 hour test or something. I am bedridden pretty much with full-body RSD and that was not an option I could do but had to settle. It was a joke for sure. The one thing I would have done differently is to have them give you monthly payments forever instead of a lump sum. Here in PA the social security disability considers that settlement as income and subtracts it for years from your monthly amount. So, there were months I only received $174.00 per month from SSD and had to dig into my savings to just live each month. It has been a mess.

The interesting info I have learned is that there are civilian cases where people ONLY have RSD in one part of their body and have received 15 million (yes, take yourself off the floor) and I want to cry each day cause I got peanuts for sure because it is workers comp. I don't know who made these rules up but they were either paid by workers comp or it was workers comp themselves. So not only are we in pain, lost our jobs, our families, friends, lives in general we now get the shaft for settlements too. All I can say (to rationalize this in my head) is that God has great plans for all of us for all the suffering we do each day. If you have any questions and feel like PMing me feel free to do so. Good luck. Stick to your guns and if they come in low tell them no way and make it higher.
kathy d





Quote:
Originally Posted by traevin View Post
I've had RSD for nearly three years. It's so debilitating and painful that I haven't been able to return to work and there's no telling when or if that day will ever arrive. My Worker's Comp people are getting fed up with me, mainly because I'm not responding to any treatments and it looks like I might have to get another operation on the same injured knee that led to the RSD in the first place. Long story short, they want to settle.

I haven't received a dollar amount from them yet but I'm thinking that it's right around the corner. My question to you is:

For you RSD sufferers who have received settlements through Worker's Comp, what's a reasonable ballpark figure? Some (or most) of you might not want to discuss this on a forum but perhaps you wouldn't mind emailing me privately.

I'm afraid the insurance company will give me a low-ball figure and because I wouldn't know a good settlement amount from a bad one, I'm hoping that with your help, I can respond to their proposition from a position of strength instead of ignorance.

Thanks in Advance,

Jennifer D.
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Unread 01-30-2010, 08:09 PM   #10
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Default Get a good wcom attorney

My friend has had RSD for almost 4 years (full body now) from a job related injury.

He finally got an attoney to take his case a year ago. and as it goes it is still on going:

The insurance company has been OK - but they are not your friend no matter how well they treat you - you are a long term liabilty on the books.

Never/ever settle your medical benefits.

If you take a lump sum settlement it could have effects on your current SSD benefits.

It has been rumored to his attorney that they are going to offer a settlement and it will be mulit million dollar ( he is currently 62 - 58 at time of accident).
He has no intention of ever settleing this case as the cost of just living expense, transportion, hiring someone to do what you can not is just too hard to determine.

Right now a million dollars may look good - but 5 yrs down the road you may ask why did I do that. The ploy of the insureace company is to be your friend and put a big dollar sign in front of you and say sign on the dotted line.

GET A GOOD ATTONEY on your side. Once settle you can not undo it.
Prayers and wishes for pain free days ahead.
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