When will workers’ comp offer settlement?

This video reviews when workers’ compensation may offer settlement. If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.
In workers’ compensation, most every case will end with a settlement. The question then becomes, when? The bottom line is that settlement can occur at any time. It is more difficult to settle early on in the case as there are so many variables that you as an unrepresented injured worker may not want to come down to what insurance is offering, and insurance may not be willing to come up to what you are demanding. Plus, without an attorney, and early in the case, it can be very difficult to properly value a case. Is it worth $5,000 or $50,000? Depending on the facts, $5,000 may be a high value, or $50,000 may be too low. Plus, once you come to an agreement, you need to get it approved by a judge, and that judge will need to find adequacy in the settlement documents and the medical reporting.
Jeremy Lusk is a certified specialist in workers’ compensation with almost two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.
No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.
If you have any questions, let us know at [e-mail]

[@michaelwhite7739]

Praying for all my injured workers

[@Sxcuhan]

Thank you brother. Same for you. Case has been going for a year now lol

[@TownBoSs510]

Thank you I have 3 injuries my chest,back and pinky on the left hand. The qme gave me a bad report she game me 8% for each but said I have a permanent disability and shouldn’t pickup more than 40lbs so how can it be 8%? 🤦‍♂️

[@joseguadalupe6437]

Thank You

[@victoriamurphy7031]

Thank you ❤

[@Fony_turgeson]

@@Sxcuhan 7 years for me

[@survivalmode7032]

Went to my IME and they gave a 7.5% loss of use. My dr gave a 30% loss of use. Lawyer trying to work it out.

[@lazaroibarra8464]

Good morning. You repeat several times in your video, and thank you for making it, that if you don't have an attorney. I could not imagine any one doing that. Don't go it alone people. Your health, your benefits, your family, your well being, immediate and in the future is at stakes here. Get help!

[@myworkerscompguide]

I tend to agree. But for whatever reason, many people do it on their own. Some don't want an attorney to get 15% of the settlement. Some don't want to upset their employer. Some think the adjuster is nice so there's no need. Some think they are doing good enough on their own. There are many reasons out there. When I was a judge I couldn't force people to get an attorney, but I did strongly recommend it to many people. But for whatever their reason, many did not want to, or couldn't, get an attorney. That's why I make these videos.

[@lazaroibarra8464]

@@myworkerscompguide and I appreciate them. You're right. You can bring the horse to the river, but you can't force him to drink. On the long run the benefits outweigh all those reasons. To each his/her own.

[@myworkerscompguide]

@@lazaroibarra8464 Precisely.

[@Technotranceism]

Getting ready for deposition this week. Injured both knees causing meniscus tears, and may need surgery to correct. Will know soon, as I am scheduled to see an orthopedic specialist, the week after deposition. Generally they've been slow in setting up appointments, and getting me some physical therapy. I do have an attorney working my case, and they've been after them about scheduling appointments. Not sure how everything will go, but I do know that the attorney is trying to get me, some partial disability benefits. Work has placed me in another position, that they consider light duty, but it's anything but light duty. At least they are allowing me to maintain my hours and wages, even in the other position, but complain when not enough work is completed, despite my required restrictions. Gets annoying to hear, and it's not my fault that I have these restrictions, and they are short staffed.

[@myworkerscompguide]

It's good that you have an attorney to represent you at your deposition. He or she will get you prepared, and knows your case and strategy best. Best of luck to you.

[@bobocrina2643]

When an injured worker has severe issues, that require multiple surgeries, or life long medical care, Insurace will try to push the injured worker to settle. They will know the cost in long term will be dramatic for them. If the injured worker knows that the medical care its so important and is specified by the Qme that a lot of care is needed for long term. I talk about severe cases, not a sprain or scratch. then do not settle, exhaust all medical care possible. Usually when long therm medical care is involved, like surgeries, assistive devices ,etc.. the WPI rating will go higher at future revaluations. fight for youself

[@myworkerscompguide]

This is the bottom line - the insurance company will look out for it's best interest, so the injured worker either needs to look out for his or her own best interest, or hire an attorney to do it. The insurance company won't go to battle to fight for the injured worker.

[@Chopp0824]

This truly has been helpful!

[@myworkerscompguide]

Happy to help!

[@zerozilch]

Can you buy stock in workers comp on wall street ? Compensation is not a benifit

[@brianbui2460]

I just did my qme about a month ago and it shows my wpi to be at 18 percent and I just got a letter from the insurance company stating that my disability rating is only 9 percent. Does that seem correct?

[@edwardkareem6446]

That does sound interesting I do have an attorney I already got surgery I already did my 17 sessions of physical therapy and I already did my q&A today as I am typing I'm having my first deposition what to expect after this

[@blessedladyrobinson5674]

Enjoyed yr video, very helpful. Wanted to ask if a person has not reached MMI yet, at what point will a QME be done? Is a QME something that comes automatically after you reach MMI (back injury/surgery)

[@myworkerscompguide]

A QME can be done at most any time on an accepted case. Usually the insurance company will want one sooner if the PTP has the injured worker off work for a long time, as insurance wants to stop TD. An injured worker would usually want one sooner if insurance is denying some body parts and causation has to be addressed. There is no automatic time for a QME. In fact, many times insurance won't request one since they'll like the PTP findings or just hope the injured worker forgets all about it. Often times the injured worker will need to request a panel, and that is usually done when the PTP has released the worker to full duties or found the injury P&S.

[@oscarcuevas607]

Hello if the doctor tells me that I need surgery on my hand but i say I don’t want it. will the insurance company have to pay me the cost of the surgery when i settle my case?

[@myworkerscompguide]

@@oscarcuevas607 It depends on many things. For one, you may settle with a C&R in which case insurance would pay some money to cover future medical including the surgery, or you could settle with Stipulations and medical would remain open and insurance potentially liable for paying for the surgery later. Or, it may be a surgery that is recommended now, but that may not be recommended ten years down the road if you never had it, since it would be too late for the surgery to help. In that case, workers' comp might not pay you for the potential surgery. Or, if your doctor recommends surgery but utilization review denies authorization for it, then workers' comp will think the surgery isn't necessary and therefore will be less likely to pay you for it. The bottom line, though, is that whether you have surgery is up to you, and you should discuss what's best for you with your doctor.

[@tinkv192]

Will any insurance company try to make a settlement during a notice of proposed conciliation decision?

[@myworkerscompguide]

Honestly, I've been practicing in California workers' comp for nearly twenty years including my time as a judge with the WCAB. However, I have never heard of a Notice of Proposed Conciliation Decision. Doing a quick Google search it did turn up such a term in New York workers' comp cases. However, I will say that California has a very specific workers' comp system controlled generally by the Labor Code. If your injury was in New York, or being controlled by the New York system, my recommendation is to direct your question to New York practitioners. I have no knowledge as to the law in New York for workers' comp. If your injury was in California and is being adjudicated at the WCAB, expand perhaps on your question to see if I can help.

[@Guerro9219]

My hearing went OTOC settlement is In place already I signed paperwork and sent to judge what next well I get my check in 2-3 weeks 😊

[@myworkerscompguide]

Once the settlement goes to the judge, the judge will generally approve the settlement or suspend action on it needing further information/changes. If it is approved, then insurance generally has 30 days to issue timely payment.

[@bennyblanco5857]

Did you recieve your payment?

[@theGQX7]

I've had a torn rotator cuff injury since Dec 2021, two surgeries since, and 2 years+ of physical therapy in Texas. I have since exhausted Workman Comp for the statute limit, and my 3rd party doctor evaluated me at 2% MMI, I still cannot use my dominate arm with this shoulder and bicep tear still bothering me, and now have no benefits medically or financially, what should I do?

[@myworkerscompguide]

Every state has its own unique workers' comp system and unfortunately I am only familiar with California's. My only recommendation would be to reach out to a local attorney for a possible consultation. Best of luck to you.

[@lilwest9872]

what does it mean when i rieceve a letter saying "Before the workers compensation appeals board 0f the state of california" ? and says my name/attorney vs the company and i believe there attorney?

[@myworkerscompguide]

It sounds like there may have been a hearing, such as a MSC or Status Conference or even a trial, and the WCAB sent out the Minutes of Hearing. If that's what it is, then it should further explain what happened, and what happens next. However, if you have an attorney you should ask him or her what that is and what it means for your case. If you don't have an attorney, you can call the I&A Officer at your local WCAB office to ask what it is. They can look in the WCAB computer and be able to tell you.

[@danjones7046]

I have a rating of 7.5 out of a 9 maximum and I will need prescription meds for many years ro come. From a work comp concussion. Is there a reference book on this for indiana ?

[@myworkerscompguide]

I have no experience with Indiana’s system. You may want to reach out to the state bar association at www.inbar.org to see if you could get a consultation with a local attorney.

[@Downtoadventure25]

I broke my ankel while at work and workmans comp has paid my medical expense and wages up to date. (Only $8,640) I go to the doctor tomorrow and potentially return to work. So would that be MMI? Would i expect WC to make a settlement offer with more money or should i bring it up? Id think another 8-10k would be reasonable to cover future expense from the ankel injury. Any insight is very appreciated.

[@myworkerscompguide]

What workers' comp likely paid you so far was temporary disability. The doctor tomorrow may release you to work, and that often coincides with MMI but not necessarily required. The doctor may release to light duty for a few weeks or months before saying MMI. They won't generally settle with a buyout of future medical if you still work for the same employer. They may also owe permanent partial disability, but they will only pay that if a doctor finds it. The PTP may release you to work and find no WPI. If you disagreed, you would generally request a QME for an independent exam and opinion.

[@jayf8716]

Had a beam fall on my foot (broke 4 toes ) then it bounced into my leg (broke my leg) then I fell 30 ft in to a river. Was not tied off . Foman on site. No one was drug tested . Over all 3 surgeries including losing a 1/4 of my big toe . Should I be expecting a decent check ?

[@myworkerscompguide]

Tough to say. You'll get medical care, but those are checks to the doctors. You'll get temporary disability while you are off work due to the surgeries. You'll get permanent disability, but tough to say how much. Depending on how much of your big toe is gone, there may be some disability. Broken bones don't generally result in permanent disability because they heal and there is no lasting disability. Much will come down to what the panel QME finds.

[@GonzalezLawEmpower]

Jay, I think you might be confusing personal injury and workers' compensation. PI is all about whose fault is it and the case is valued when your injury is at its worst. Work comp is a no fault system and the case is valued when you have recovered the most. That is why if a bone heals so that you are back to normal, it does not have any permanent disability. It is kind of an awkward position to be in. You want to recover physically completely because that is your life, but the more you recover the less you are likely to recover financially. Even if you do recover completely, you would have been getting paid along the way if you are off work and would get other benefits too. Hope this helps, Naomi

[@yanceydavenport8657]

I'm an ironworker.. 28 years and no injury,, 17 damn months ago I was carbon arcing laying on my side ,,, a 3000 degree ball of hot molten lava fell right down into my ear ,, burned all of my eardrum,,, and inner ear ,, heard a loud pop,,, then loud ringing,,, loss of hearing in that ear ,, have terrible vertigo ,, balance issues ,, went to the hospital,,, referred me to a specialist ,, he said it was to messed up to try surgery ,, reffered me to another specialist,,, he said he would attempt to fix what he could ,,, now all along I would get medical records of hearing tests, ect ,,, i reported the injury ,,, it happened at work ... and they still tried to deny my claim ,,, I'm already been told my hearing is permanent damage , even with surgery,, I got a lawyer ,,,, they have stalled my case and continued it several times ,,, the safety man submitted fake safety sheets not even in my handwriting,, ive been an ironworker for 28 years,, balance is extremely important,,, oh and my severe tinitus,, ringing in my ear has made sleep almost impossible!!!! And to top it off .. since my claim was denied for no reason ,,, I had to use my insurance and NOOOO doctor was willing to simply write a note saying I couldnt work!!! Except one that covered a month out of the 17 I've been out!!!!,,, No doctor wanted to "get involved"... So i ended up calling a head dr.... I cant yake no more ... the ringing in my ear has ruined my life ,, cant sleep ... he said I have ptsd,,, finally went to court and I won lifetime medical,,, and that one month of pay ,,, I about wanted to just die!!! 17 months waiting ,, cant walk good ... cant work .. sold everything I worked for ,,, to get 1 month of pay .. I'm so fed up !! .. but my lawyer did some kind of motion with my head dr. saying I cant work anywhere until my ptsd gets right ... I still need surgery,,, my lawyer jist said ,, yea ,, I asked for them to provide a doctor but they wont call back !!! .. I'm not giving up ... and the way I see it is ,,, who the hell is gonna hire someone who is dizzy ,, has severe tinitus,,, cant thinl straight,,, severe hearing loss ,,, and has PTSD !!!.. SOMEDAY I WILL GET A DISABILITY RATING !!!! AND IM ALMOST 50 !!!.. it makes me sick they can do this shit !!!... I never asked anyone for shit !!!.. I loved my job .. this is what you get in america for building skyscrapers!!!!??? WHY BOTHER !!!!

[@josecantu3622]

Hey i was at work about 2 weeks ago and my coworker turned a machine on that crushed and broke my ankles bones in my right foot and cause nerve damage in my right foot to which i have no feeling in anymore. Ive had surgery to get metal plates and screws installed in both ankles. Im starting physical and occupational therapy tomorrow and im in a wheelchair.. i have severe pain everyday due to my surgery, could you please help me on how to go about this? Or if you have any tips? Thank you!

[@myworkerscompguide]

Foot and ankle injuries can be a real tough one, as the ankle has a lot of bones, range of motion, and impact on daily life. I would recommend reaching out to a local attorney for a consultation. You can search for certified specialists in workers' comp here by clicking on Advanced Search - apps.calbar.ca.gov/attorney/LicenseeSearch/QuickSearch#searchlink It will be important to see the best doctors in your area for treatment, and then also to maximize the level of impairment in your case.

[@MissDuke2012]

When he says WC, he means the insurance company/adjuster/atty.

[@TheAmerican101]

Hey I have a ? My work comp got settled with a compromise & release and got approved by the judge and settlement was supposed get check 30 days but it’s been two months and only got half. What happens now ?

[@myworkerscompguide]

The most common issue is that PDAs were deducted. It’s also possible they just plain made a mistake. To find out what happened in your case you would have to ask your attorney as he or she would know best.

[@pilarsalazar4353]

I really appreciate all this important information you are giving., What to expect after an FCE? Went to get mine done few weeks ago but until today I’m clueless of the results or what’s the next step, thank you.

[@myworkerscompguide]

It really depends on who requested it. Sometimes a PTP will request one to help determine return to work for light duty or permanent restrictions. Sometimes a QME will request one for help with addressing whole person impairment or addressing permanent work restrictions.

[@pilarsalazar4353]

@@myworkerscompguide Thank you for such a prompt response, WC request it, thank you again, new follower.

[@myworkerscompguide]

@@pilarsalazar4353 Happy to help inform.

[@46foryounger]

Interesting because my attorney said she reached out to the insurance company lawyer and they haven’t gotten back to her. So would an attorney be able to reach out to WCB to encourage settlement? And if yes why would an attorney not and prolong a settlement being reached?

[@myworkerscompguide]

An injured worker’s attorney can file a declaration of readiness to proceed and set the case for a hearing. However, when you do that you are declaring, under penalty of perjury, that you have completed discovery. I do not know what your attorney’s strategy is. You would have to ask her. I can say that I have had situations where I have tried to settle because I wanted to avoid further discovery for strategic purposes. However, at the same time that I wanted to settle, I did not necessarily want to close discovery if a settlement could not be reached. A lot of strategy can be involved.

[@46foryounger]

@@myworkerscompguide she makes it seem that way that it’s some kind of strategy but if you don’t educate your client as to what is going on and you are asking your client for documents that they’ve previously submitted 30-mins prior to a hearing it kind of blows your rationale out of the water and the client begins to question your integrity. This is the same attorney who did not assist in getting a completed MMI form that the doctor kept not completely filled out done and then proceeded to tell me it’s ok the judge will probably overlook it. I don’t have to be a professional to know that if you hand in a half completed form the judge is gonna spit it right back at you. She knows I am in terrible debt and she is purposely prolonging this. It’s bad enough that I had to settle with a lesser of the three injured areas due to my debt caused by not being able to return to my previous line of work.

[@46foryounger]

@@myworkerscompguide btw thank you 🙏🏻 for your prompt response. Probably the quickest response I have received on a KZbin post!

[@myworkerscompguide]

@@46foryounger Best of luck to you!

[@BearPapa49]

This was very good content . Can you add the same scenario with an injured worker with representation ?

[@myworkerscompguide]

Thanks! As you noted, the video was aimed at those injured workers without an attorney. For those with an attorney, in general, the same still holds true. The insurance company can make an offer at any time, and the applicant attorney can make a demand at any time. As to your case, and anyone with an attorney, the answer will always be the same - - - it's best to ask your attorney. He or she knows your case best, knows the strengths of your case, the weaknesses, and can best put together and follow a strategy to maximize your recovery. So if you have an attorney, I'd recommend you talk to him or her about a possible early settlement versus ongoing discovery.

[@BearPapa49]

Most helpful thank you

[@myworkerscompguide]

Glad we could help!

[@scc.1728]

@@myworkerscompguide What happens when you have an attorney who had dropped the ball so many times and has poor communication especially with important follow-ups? Where do you turn to for help?

[@myworkerscompguide]

@@scc.1728 I filmed another video on this channel that may answer your question. It's at kzbin.info/www/bejne/qJukcoelbNdonsk The bottom line is that you can dismiss your attorney and represent yourself, or you can find a new attorney to represent you, or you can stick with your current attorney and let him/her know you need better communication. It won't cost you any more money to get a new attorney, as the maximum fees awarded in workers' comp cases at this time is 15% of the settlement. So if you get a new attorney, then your new attorney and former attorney would split the fees. Watch that other video and let us know if that doesn't answer your question.

[@pt9261]

Hi, I was injured at work back in 2020 and needed surgery/physical therapy/pain meds. I went back to work in 2021 and I cannot contact my new adjuster. They do not answer my calls or emails me back. I don’t have a lawyer. I am disabled. I am unsure of what the next steps are? When Will they close my WC end? Will I get any compensation like stips/awards? Thanks

[@myworkerscompguide]

Often times claims adjusters seem to just ignore injured worker's phone calls or emails in the hopes that the injured worker just goes away. Then the adjuster can just close the file. You may want to reach out to your local Information and Assistance office at the WCAB, or reach out to an attorney. If you haven't seen a QME, and returned to work last year, then requesting a panel of QME's from the State of California is likely the next step for someone in your situation. That doctor will address your level of whole person impairment (disability) and then any settlement would likely be based on that report.

[@GonzalezLawEmpower]

PT, Jeremy is correct. It is a good idea to reach out to an I&A officer. Here is the link for more info on them and contact info. www.dir.ca.gov/dwc/ianda.html Honestly, you might have to file your claim with the WCAB. Here are instructions for that. www.dir.ca.gov/dwc/iwguides/IWGuide04.pdf If we have an unresponsive adjuster on medical treatment, we file a hearing on the issue. But to file a hearing, you need to have a case filed already. That is done with the above link. If you do not want to do all this yourself, it is time to consult with an attorney. Hope this helps, Naomi

[@ivan2jzbunny]

I need help . I was bitten by dog while working for Fed Ex Ground which is an independent contractor. I was delivering a package to the front door when the door when the customer open the door and her medium dog came out and bite me. Anyways I went to the Dr and got an MRI and they concluded that I have arthritis and the Dr suggested that I needed to see a knee specialist. I havnt been able to see a Dr due to my schedule only having Sunday off and work doesn’t want to give me days off to see a Dr so workers com offered me 25k to settle but I have to resign my job . I make 50k a year and that just seems like low ball number. What do you think I can get with a good attorney?

[@myworkerscompguide]

I would tend to agree that the offer is a low ball if you have to resign. But if you aren't going to the doctor, then it's going to be tough to prove the case is worth more. You may be able to settle for less money, but keep your job and also keep open medical care. It sounds like workers' comp is offering a C&R, but if you like FedEx, you may want to consider Stips. This video goes over the difference in the two ways of settling - kzbin.info/www/bejne/i2jUqmCdmbh1oLs

[@tinaramirez7217]

I was injured at work, slipped on grease. My attorney is push for MSA only. Shouldn't I have an opinion?

[@myworkerscompguide]

Often times what happens on the cases that I handle is that I will push for one or two potential settlement options. Then I go to my client and present options. So your attorney may be pushing for a C&R with a MSA, but the final choice is yours. You decide if you want to close out future medical or not, and your attorney will provide his or her recommendations. The bottom line - you bet you have an opinion. Your attorney can't settle your case without you. It could go to trial without you, or get dismissed without you, but it won't settle without you. My recommendation is to talk to your attorney as to what options you have, and what they recommend.

[@GonzalezLawEmpower]

Tina, Jeremy is right, you absolutely have a choice of refusal. MSA settlements can suck because you have restraints on your settlement money. But the one nice thing about them is you do get out of the work comp UR system and if you do not spend all the money, your heirs will get the money instead of the insurance company keeping it. But I totally get not wanting to mess with Medicare or the admin stuff with an MSA. Definite pros and cons. Your attorney should go over the pros and cons with you. Hope this helps, Naomi

[@gmonster467]

Is 45k a good settlement offer to accept for diagnosed Neck-stenosis Shoulder-tendinitis wrists torn ligaments- needed surgery back- bulk disk lumbar. Covid

[@myworkerscompguide]

I can't say if that's a good settlement or not without looking at your medical reports and talking to you about your goals. Here are a few thoughts - One, a judge will look at the settlement to determine if it is adequate. The judge will not opine on whether it's a good or generous settlement, but only if it is adequate. Two, you can reach out to your local Information and Assistance Officer at your WCAB office. They can't give legal advice, but they may be able to answer more specific questions. Three, with the conditions you are describing you would probably be best served by reaching out to an attorney or two for a free consultation. I've met with injured workers before and told them the offer they have is good and that I probably couldn't get more. I've also met with injured workers and told them the offer was far too low and then I've gone on to get them much more money. Four, if you had back surgery you may need further back surgeries in the future, so $45,000 might be too low with the other conditions as well. Much will depend on your date of injury, diagnosis, WPI, and apportionment. Five, if you haven't seen a QME and are settling on the PTP report, chances are you are settling at a lower amount than if you saw a panel QME (especially in chiropractic or related specialty). If you have more questions, let us know. Best of luck!

[@bey976]

😳

[@catalinamelnicov8728]

No

[@jtimagesartDivergentFRST]

My doctor recommended I go ahead and do more testing after the exam today, rather than closing my case. Any idea what this means? Work comp didn't get me a lot of tests I needed. My lawyers got chewed out to buy this man. He said, "they didn't do shit for this man". Memory loss, chronic headaches, pain when planting my left leg, sometimes with the right. Shooting pain to the left of my spine. Recovering from a fractured lumbar spine, bruised hip and concussion. 8 months into this grueling ass process.

[@myworkerscompguide]

California's workers' comp system is slow and frustrating, and for a serious injury eight months can be very early into the process. I wouldn't know what your doctor is thinking other than he or she thinks you should do more testing. You would have to ask your doctor what his or her thinking process is, and then discuss that with your attorney.

[@559FRESNOESF]

I have a question about my lower back work injury insurance offered 30k settlement and a voucher to get new job training but i have to resign and no future medical benefits paid for if i don’t accept this offer and wait until my next appointment where my doctor already said he doesn’t think im gonna be able to go back to my usual heavy lifting anymore at work could i risk the settlement offer going lower or being taken away all together or is waiting to see what percentage of ppd the doctor places me at?

[@myworkerscompguide]

I can't give you any legal advice as to what you should, or should not, do. I can say that you can certainly negotiate if they are offering a C&R at a certain sum. You can certainly go back with a counter demand. If the PD hasn't been established by a PTP or QME report, then the PD is just being estimated. Also, the value of future medical care and closure are both being estimated as well. So there can be a lot of room to negotiate a C&R as there are a number of variables. The value of the voucher is not negotiated, as that is simply a $6,000 voucher by law. Can they lower their offer or rescind it? Certainly. Nothing is final in C&R negotiations until both parties agree on all terms, both parties sign the C&R, and a judge approves it. You may want to call the I&A Officer at the local WCAB office and talk to that person about your options.

[@559FRESNOESF]

@@myworkerscompguide thank you so much for your advice i appreciate it

[@myworkerscompguide]

@@559FRESNOESF Happy to help educate. Best of luck to you.

[@brianbui2460]

Da sent an offer for around 50k after all advancement. Does that mean 50k after my previous ttd and ppd payments?

[@myworkerscompguide]

Generally a C&R offer is a lump sum, and the insurance company does deduct the permanent disability advances because those are "advances" on the final settlement. They generally do not deduct TD unless there was some sort of overpayment. However, each case is unique and those issues can all be negotiated, so you would need to confirm exactly what the settlement means and exactly what the settlement terms are in the C&R.

[@RRYYAANNK7]

Told my supervisor about faulty equipment. Someone came and checked it out. They said someone would fix it. Hadn’t been fixed in weeks. I now am getting surgery next week for a torn ligament in my biceps trying to muscle the equipment. Would the fact they were negligent affect payout?

[@myworkerscompguide]

Will it affect the routine workers' comp case/settlement? No. That's because workers' comp is a no-fault system, so it does not matter why an injured worker got hurt. The only thing (basically) is that the worker was hurt at work doing work for the employer so the worker gets benefits. The only time that fault generally comes into play is if it is a Serious & Willful injury, where the employer knowingly causes or ignores a dangerous condition which results in serious injury to the employee. It's a complicated area of the law with a lot of nuance, so I'd recommend talking to a local attorney about the possibility. That S&W Petition must be filed within one year of the injury generally.

[@RRYYAANNK7]

@@myworkerscompguide thank you for the informed response 👌🏼

[@myworkerscompguide]

@@RRYYAANNK7 Best of luck to you.

[@Tampertownmediagroup]

In Beacon NY if you buy sneakers people will gather together to stop you from receiving benefits

[@bennyblanco5857]

Mentally...are you ok?

[@Tampertownmediagroup]

@@bennyblanco5857 it’s true. In this sick town. If worker’s compensation caused you to loose a German Shepard, these sick people will play on your mental, and you will just so happened to see a German Shepard as soon as you step outside your home ever single day. And that why I have a deep rooted hatred for this area of the State

[@demarcustate8082]

Hey man i got hit by a tug driver while offloading planes at fedex express and the man was 100% at fault for the accident. so i broke my left leg and my right ankle now i have a metal rod in the left leg and screws in both legs also how much should i expect?

[@myworkerscompguide]

In workers' comp in California, the injury itself really doesn't matter much. What matters is how you are doing when you reach P&S status. So if you make a great recovery, have full strength, walk without a limp, have full range of motion, and don't need any future medical care, the case isn't worth much. The value in that case was getting all the medical paid and getting paid TD while you were recovering. If you don't make a full recovery, then it depends on how much whole person impairment the QME finds using the AMA Guides

[@joseRodriguez-pk9ld]

Will worker's comp call me to settle my claim after I'm back to normal? Or do I need to get an attorney

[@myworkerscompguide]

Good question, and unfortunately my answer is "it depends." Some insurance companies will try to settle once your condition is back to normal, or as we refer to it as permanent and stationary. If you completely return to normal, or pre-injury status, they likely won't offer much. If you still work for the employer, then insurance may offer Stipulations with Request for Award at 0% permanent disability. If you don't work there anymore, they may offer a Compromise and Release to close out liability for future medical care and a potential Petition to Reopen. While both of those may happen, a lot of insurance companies won't offer anything and just hope that you'll go away. Many injured workers get frustrated with the system and just give up, which is best for the insurance company as it costs no more money. So the bottom line is that it likely depends on A) Are you back to normal already? B) Do you still work at the same employer? C) Are you truly back to normal, or do you still have ongoing pain/treatment? D) What are your goals? To wrap it up, reaching out to an attorney is often free, as any attorney who represents injured workers will offer free consultations. If you have other questions, feel free to ask.

[@joseRodriguez-pk9ld]

@@myworkerscompguide I am currently waiting on surgery they still have me working but I'm on light duty and they cut my hours from 8 hrs a day to only 4.thank you so much for the information I really appreciate it.

[@myworkerscompguide]

@@joseRodriguez-pk9ld Something for you to consider is that in workers' comp the level of permanent partial disability is determined by your whole person impairment rating (WPI) and that comes from the AMA Guides. It can be very nuanced as to what level of WPI you have after (for example) back surgery, and it can greatly change the amount of money you get at settlement. For example, the doctor may use the DRE method or the ROM method to find the level of WPI, and if that is not the most accurate method, the doctor may go to other portions of the AMA Guides and use an Almaraz/Guzman approach. Obviously that last sentence probably only makes sense to people who do workers' comp all day, and because of that, my general recommendation is that if you are having surgery then you likely want to talk to an attorney. It will depend on what type of surgery. Surgery to remove a cyst on your wrist is very different from a three level lumbar fusion. But once you start talking surgery you are generally talking about higher levels of WPI and more complexity, so it is generally in your best interest to reach out to an attorney. If you have more questions, let us know.

[@countrees7977]

I was injured on the job in 2020 and my employer never reported my injury to workers comp. They basically tricked me into not mentioning my injury. Now this year injured my back in the same place and i ended up needing and getting back surgery in February. My question is if the insurance company is offering me 15000 for the injury in 2020 should i take it or should i wait until after my qme

[@myworkerscompguide]

That's a very difficult question to answer, and one that I couldn't do over this system. That settlement might be good, or it might be way too low. I'd recommend reaching out to your local WCAB office to speak to an Information and Assistance Officer. Or you can reach out to a local attorney who handles workers' comp cases for a free consultation. Then you can get an answer more specific to your case.

[@GonzalezLawEmpower]

Countrees, Jeremy is right. No attorney could answer that question with that information. If you want to settle prior to the QME then that is considered an early settlement. People should only do early settlements when it makes sense for their personal needs and/or for the case. If you want to make sure you get the full value of your injury, you should go to the QME. The risk you run in that is that IF the full value of your case is less than 15K, you might take less. The other thing is you stated your offer is for the 2020 injury. You should double check that. I highly doubt the insurance company would settle only one date of injury when you have two with the employer for the same body part. It is likely the 15K is for both dates of injury. Also, just in general, if you date of birth is 79 like your name, you have many years of future medical ahead of you. Make sure that is reflected in your settlement. Here is the link for info on the Information and Assistance Officer Jeremy was telling you about. www.dir.ca.gov/dwc/ianda.html Hope this helps, Naomi

[@countrees7977]

@@GonzalezLawEmpower thanks naomi. The thing is with this particular case my employer had a different insurance company for my 2020 injury and now they have a someone else. So im dealing with two insurance companies

[@GonzalezLawEmpower]

@@countrees7977 Oh, in that case them offering right now makes perfect sense. You have risks both ways in accepting now or waiting. If QME finds not much apportionment to 2020 doi then might be good move. If qme says like 90% of your injury is from 2020 then accepting may not be a good idea as your new date of injury will not be compensating you much. Problem is no crystal ball to know. If QME report, the 15k may be off the table. Could change up or down based on qme. Lots to think about. Good luck Naomi

[@countrees7977]

@@GonzalezLawEmpower also naomi. I had a L4L5 disc dysectomy laminectomy spinal fusion surgery

[@anthonywylie5771]

What type of settlement would I relieved for a failed laminectomy

[@myworkerscompguide]

There are a number of variables there. I created this channel to help people who don't have an attorney, either by choice or because they cannot find one to take a case. For someone with a failed back surgery, my recommendation would be to reach out to an attorney. You'll want to ensure that the permanent disability is accurate, and if you close out future medical, you'll want to ensure that you are protected. That said, you can still settle with either Stipulations or a C&R. As to the value of your settlement, that would take sitting down and going over the facts of your case. I will say it is not a run of the mill back strain or knee strain that is so often seen in workers' comp.

[@anthonywylie5771]

I have 21 percent rating Aww 1850.32

[@myworkerscompguide]

@@anthonywylie5771 The rating has a specific dollar amount for each date of injury. So an injury over the last few years that rated to 21% after apportionment has a value of $23,345. So you could settle with Stipulations with Request for Award at that amount, or enter into a Compromise and Release (if both parties agree) that would be based on that PD value plus future medical care plus closure value. I suspect the real question in your case is whether 21% is an accurate reflection of your condition, and a failed laminectomy can be a complicated matter with a number of variables. You could reach out to your Information and Assistance Officer at your local WCAB office for free answers. Or you can reach out to an attorney (ideally a certified specialist in workers' comp) for a free consult. My recommendation would be that you seek the advice of an attorney who can review the documents in your case and discuss it with you. You can go to the State Bar website at apps.calbar.ca.gov/attorney/LicenseeSearch/QuickSearch and do an advanced search for certified specialists in your area.

[@Spotty2Hotty1]

I’ve have 4 failed back surgeries, it’s the worst thing ever

[@anthonywylie5771]

@@Spotty2Hotty1 sorry it’s crazy my life has changed hope you get better one day

[@MoneyBagMafia258]

I got hurt at work I had over 500 pound worth of furniture fall on my back kinda of randomly while I was lifting sum other boxes and was not trained properly on how to do job now dealing with spinal contusions and not able to bend or walk for long currently .all this was caught on camera to and got multiple statements from employees how much you think I could get for my injury?

[@myworkerscompguide]

In workers' comp cases it doesn't matter much how the injury occurred or whether it was caught on tape when it comes to case value. What matters is the injured worker's condition once P&S. Early in a case with a back injury it is very difficult to tell how it will work out after treatment. Once the injured worker is P&S, then the level of disability is determined. Someone could have a back injury and fully recover, and there would be no disability at all - just future medical value. Or the injured worker could have 8% WPI, or end up needing surgery and have 20% WPI, or could end up walking with a limp so the QME has to rate by analogy. There are many variables. This video gives a more detailed discussion - kzbin.info/www/bejne/nqmQdH9_mreZo5I

[@MoneyBagMafia258]

@@myworkerscompguide ok thanks when does the p&s take place ?

[@myworkerscompguide]

@@MoneyBagMafia258 Either the primary treating physician or the QME will determine that, and it's generally once your condition has hit a plateau, and isn't likely to get better or worse over the next year with or without treatment. With minor injuries, P&S may be a few months after the injury. With major injuries, it may take a few years.

[@MoneyBagMafia258]

@@myworkerscompguide ok thanks I work two jobs so I’m in tricky position because it happened at one job would I be ok to work at both still during my case as long as I’m following my restrictions?

[@myworkerscompguide]

@@MoneyBagMafia258 Yup, an injured worker can keep working at the original job and/or other jobs as well, as long as the injured worker works within restrictions, is honest with the doctors, and isn't collecting temporary disability. The workers' comp case will keep going while you keep working.

[@cynthialynch9703]

What is a ppd rating?

[@myworkerscompguide]

Once a QME or PTP finds the injured worker permanent and stationary, the doctor should address the level of whole person impairment. That WPI then turns into the permanent partial disability (PPD) rating. This video goes through it in detail kzbin.info/www/bejne/fpOwk6iHjq57i5I

[@bobcrina-ps6mm]

Can an injured worker refuse a vocational expert evaluation set up by defense attorney, if a qme is on file already. Pqme doctors are not biased, but Vocational experts can be biasead being payed by insurance and work in the insurace favour.. What are the injured worker options. ?

[@myworkerscompguide]

A vocational expert will be paid by the insurance, whether hired by the applicant or defense. It's just like how any QME is paid by the insurance company. I can't think of a time when I've seen QME's issue reports, and then have the defense request a vocational expert but not the applicant side. I don't know off the top of my head if that can be refused. You may want to call the I&A Officer at your WCAB office, or consult with a local attorney. It could be that if you show good cause to a judge as to why you should refuse a vocational expert that the judge may agree. I'm not sure what that good cause would consist of.

[@terrenceallen323]

How long after a QME will you be offered a settlement? If I have three workers comp claims will my first QME include all three claims or will I have to wait for the other QME dates to come up?

[@myworkerscompguide]

That can be a complicated situation. If there are three injuries with the same employer, and all three claim forms are filed, and then a QME is requested, that QME will generally address all three injuries assuming the QME can do so. In that situation, generally all three injuries would be resolved at the same time. If the injuries are with different employers, or require different specialties (such as one back injury and one eye injury), then each individual QME would have to take place and the cases may or may not settle all at the same time.

[@niamdesudat2040]

Thank you for this video. After 6 years, the insurance company wants to bribe me for 2 hearing aids, and I did not accept it. So far, I have changed three lawyers, because all those lawyers were on the same front with the insurance company. They just drag the case so that I drop this case(Waiting Game). All these lawyers, despite my strong insistence and emphasis, do not let the insurance company come to the final trial (the last lawyer even interrogated me for two and a half hours). Please let me know if you have a solution.🙏🙏🙏

[@myworkerscompguide]

It sounds like you have a complicated case. I’d recommend reaching out to additional attorneys in your area for a consultation. You can search on the State Bar website, and do an Advanced Search to narrow your search to those attorneys who are certified specialists in workers’ compensation. The list will also include certified specialists who represent insurance companies, but it will help narrow your search. Best of luck. apps.calbar.ca.gov/attorney/LicenseeSearch/QuickSearch#searchlink

[@RedeemedRogueMolecules]

I was assaulted at work. I experienced concussion symptoms for a few months. I missed no work The comp company paid my medical bills Am I entitled to settlement? My med bills equaled to about 10k-12k Not sure how to proceed

[@myworkerscompguide]

Any accepted injury can result in a settlement. If you are still working for the employer, it will likely be Stipulations with future medical care. If not, then a C&R is a possibility. If settling with Stips, then it is based on the current level of whole person impairment. The prior medical expenses really don't matter. If settling with a C&R, then it's based on WPI, future medical care, and closure value generally. You may want to reach out to a local attorney for a consultation or to the I&A Officer at your local WCAB.

[@RedeemedRogueMolecules]

@@myworkerscompguide thank you so much for the reply. And I appreciate your content.

[@myworkerscompguide]

@@RedeemedRogueMolecules You're welcome. I'm happy to help inform.

[@user-km9zx4kb2p]

I have a rating of 20 percent yet my dr says 33 ..took care of medicaid lein

[@myworkerscompguide]

Workers' comp ratings can be confusing, as there is the WPI rating, the PD rating, and an apportionment figure which gets applied to the final PD rating. You may want to reach out to your local I&A Officer at the WCAB nearest to you to discuss the rating.

[@brianbui2460]

My payments just switch from ttd to ppd today. I was p&s abiut a month ago. Do you know when on average I will get my settlement or what usually happens from this point on?

[@myworkerscompguide]

There are many variables. If both parties agree with the report that found P&S status and you're settling with Stipulations, it's usually just a matter of the adjuster getting authority and sending Stipulations to you. If settling with a C&R, then negotiations will be needed to come to an agreement on a settlement value. Settlement could be weeks away, or it could still be months away.

[@MMAGUY13]

What can I expect from cervical fusion settlement How much

[@myworkerscompguide]

The level of permanent partial disability isn't determined so much by the type of surgery, but the outcome. The QME will need to determine if it's best to use the DRE method or the ROM method to address whole person impairment. Plus, there may be additional impairment for any other complications or related issues, such as difficulty swallowing or radiating pain down the arms. That will all be determined at P&S stage.

[@MMAGUY13]

@@myworkerscompguide hahahah I was really grateful that you answered my comment but remember I’m not a lawyer I don’t know all of Termanology😂

[@myworkerscompguide]

@@MMAGUY13 Ha! It's easy for us to fall into the lingo, especially when hurrying at lunchtime to get an answer out. To make my answer above shorter and easier to understand, it basically says, "It depends." To understand the terminology, this video helps - kzbin.info/www/bejne/q6u6kqWljNqqgrc

[@eyekon_media]

Amazon offered me 5k of the 50k we tried for. Now what should I do? It's been 2 years my issues aren't solved and I still have pain after 7 months of surgery.

[@myworkerscompguide]

There are many different strategies that can be taken including getting more reports from the current med/legal examiners, getting additional med/legal examiners, exploring surgery options (if any) so insurance increases their offer, and more. For specific recommendations as to your situation, I'd recommend talking to an attorney.

[@bethmiller5347]

I've been fighting Amazon for 5 years now for a work injury that happened in 2017. I've had to have three surgeries on my neck for herniated discs. The first surgery was a nightmare. I was left with nerve damage and it effected my left arm. They sent me to have an IME and this Dr said I was a middle age woman with frozen shoulder and I'll be fine. Work comp dropped my benefits. I found a new Dr and he said I needed to have the last surgery redone. My attorney fought Amazon for over 3 years to approve another surgery. They finally did but now I'm left with permanent nerve damage with limited mobility in my left shoulder and arm. My neck is fine now but I have other issues. Amazon offered me a low ball settlement which I denied. Still fighting them but I won't give up.

[@user-tm5em4vu7u]

@@bethmiller5347wow! I hope you win! Amazon is absolute horrible and ruthless! They mistreat their workers horribly.

[@Pump_up_the_jam]

Here's one for you Injured Jan 2022 rotator cuff Surgery on November 2022 Medically stationary July 2023 New job August 2023 Injured the same rotator again at new job 7 weeks later Same workers comp insurer Previous claim costed workers comp over $100,000 19 months of time loss benefits at $2200 a month, a arthroscopic shoulder surgery, 16 physical therapy sessions, and a $60,000 settlement. I did have an attorney that got $15,000 of the settlement. Didn't need a QME, it was just an agreement was wrote up by the attorney, and the work comp judge accepted it,, and I was paid a week later. This time I don't want surgery. It's going to be an open surgery not arthroscopic, and I cannot deal with that level of pain again. I just want to settle it now, after the orthopedic surgeon wants to operate. I've considered what I went through last year, and what it cost the Insurer.

[@myworkerscompguide]

It's frustrating when an injured worker reinjures the same body part, but part of California's workers' comp system is that the employer takes the employee as he or she is. So there may be apportionment of the PD to a prior injury, but that doesn't change the fact that a new injury occurred. I had one client who injured his shoulder, left that job and started another where he injured his shoulder again, then left that job and started another where he injured his shoulder a third time.

[@troyevans1014]

60k for rotator? Sheesh sounds low what was your impairment rate?

[@bowling1973]

I never get one after I fell .. yes my video here .. now my knee still injury

[@myworkerscompguide]

If you didn't settle your case, and you still need medical treatment after an accepted injury, you can generally return to your doctor or call the adjuster and tell him or her that you need more treatment. Medical treatment will remain open for as long as necessary to cure or relieve the effects of the industrial injury. However, if an injured worker stops treating for a long time (for example, more than a year) the insurance company may administratively close their file as it appears no further treatment was needed. If you have questions, call your local Information and Assistance Officer at the WCAB.

[@bowling1973]

@@myworkerscompguide well it is too late and now I m seek 7500 to get my knee fix

[@bennyblanco5857]

​@@myworkerscompguideacromioclavicular arthritis and mild bursitis in the shoulder...how much do you think case is worth?

[@michaelmontaname2umedia]

My case has been going on since 2019

[@myworkerscompguide]

Four years for a workers' comp case is not unusual. Very straightforward cases usually wrap up in a year or two, but complicated cases can go for many years.

[@lockupkeeper]

So, here’s my question: I work in law enforcement for 23yrs & I’m 45yrs old. Last year april 20th I was sucker-punched by an arrestee I was fingerprinting. This sucker-punch broke my upper jaw, knocked out my front tooth, knocked the teeth next to my front out of Alignment, split my upper lip in half to the point where I had to get over 20 stitches in my upper lip. My jaw was also broken. After I was hit my body went in to shock instantly. My front tooth fell in to my Covid mask & then I put it in to the garbage can. I then went after the offender & judo tossed him across the floor. I held him down while my partner called for help. I broke my the “radial head” of my elbow as I was fighting him. The offender was able to get to his feet & he still attacked me even though he was covered in my blood. My partner watched me fight this guy for about 1min & 30 seconds after I was hit. My partner is a coward. He stood by & held a roll of toilet tissue as this guy tried to kill me. I have the video of the incident & my extremely graphic injuries. I’ve been diagnosed with ptsd & I just found out I need surgery on my back. I need anterior C3-4 cervical discectomy & fusion for the front of my neck & posterior cervical C3-7 back of the neck laminectomy & fusion surgery. I’ve been doing physical therapy for almost a year & nothing has help me. I just got the diagnosis on my back about 3days ago. I’m looking to have surgery in about a month in a half. What do you think my case is worth? I’m in chicago. My doctor told me I have over 300pgs of documented injuries. Thanks in advance. Also, I’m on Workmancomp & now I’m trying to get disability from the city. I’m currently dealing with Gallagher Bassett. My lawyer has given me no idea on the type of settlement I may receive. I’m also a detention aide & I work in the lockup of the 018th district. I was also diagnosed with a concussion. I’m looking for them to settle this week. The IME spine specialist said I should’ve got surgery last year & that he couldn’t believe the first doctor let me walk out his office. What do you think my case is worth?

[@myworkerscompguide]

Unfortunately I couldn't even make a guess, as I'm not familiar with the workers' compensation law in Illinois. In California everything you mentioned would be part of the case, and you would see multiple med/legal examiners. But I just don't know about Chicago. I'd recommend talking to your attorney. Best of luck.

[@johnhouston635]

All that from a sucker punch?

[@johnjackson5281]

You in the wrong line of work. Sounds like you got your ass whipped and your embarrassed . Are you undersized for this position. Broke back ptsd. Fuck man Yiu gotta be making this shit up. Get out of that job

[@ElRUMBODELATIERRA]

😂😂😂good probably deserve that

[@MashaAveiro-ov3rq]

Wow, and what happened with your case? You are so brave

[@tracybacani1]

Can they take 23 years to do this ?

[@myworkerscompguide]

There's no requirement as to how quickly the insurance company has to settle a case. As an injured worker attorney, I often have to push the case along. Generally a case with settle with Stipulations within a couple/few years of the injury. That resolves PD. A case may never settle with a C&R, as that takes the insurance company wanting one, the injured worker wanting one, both sides agreeing on a number, and the judge approving it. It could take 23 years from the injury before a C&R is agreed to and approved.

[@Tampertownmediagroup]

And workers compensation will honor families that struggle with drug addiction and teen pregnancy before they’re own claimants of color. I’ve been through criminal courts on a small level multiple times. New York State workers Compensation is the ugliest most racist process I’ve ever been a part of. Job searches didn’t mean anything. In person interviews didn’t mean anything. Being on 100 percent disability following multiple surgeries didn’t mean anything. I’ve learned workers comp honored the hateful trash that’s closest to me

[@leonardoalvarez5965]

How many times can you file workers comp ? Cases

[@myworkerscompguide]

There is no limit to the number of workers' comp cases you can file as an injured employee in California. That said, most California employees likely never file a claim, while if someone else has filed ten or more cases over the years that will likely raise red flags at the insurance company. It seems fairly rare that someone files double-digit numbers of workers' compensation injuries.

[@AG-mm9wn]

If an IME doctor lies and says a traumatic brain injury's damage to ones vision is not permanent after more than a year of treatment & the workers treating doctors says it's permanent and nothing can be done, is this matter easy to overturn in court hearing? What effect would this have on the workers settlement?

[@myworkerscompguide]

It sounds like the IME is saying the condition isn't yet permanent and stationary, which means that he or she is recommending further treatment before addressing the level of permanent disability. In those instances where the IME and PTP disagree, the judge generally wants to see the doctors explaining why they disagree so that the judge can then determine which doctor is correct based on the law, the medical exam, and the complete medical file.

[@AG-mm9wn]

@@myworkerscompguide Okay, Makes Total sense! Thank you for the great information! The situation is odd because there had to be three IME's with three different type of doctors where the main appointment was still not the correct type of doctor to diagnose or have a solid opinion. The doctor stated he will tell the insurance that they should compensate, but he THINKS it can get better, but there is NO treatment that can fix the damage. He also recommend to seek treatment at the place that said the damage is permanent. Clearly did not thoroughly look at where medical records came from. Haha

[@myworkerscompguide]

@@AG-mm9wn That sounds frustrating. Which also means that sounds like workers' comp.