Does anyone know what type of settlement is better- a lump sum or structured payments?Are there risks with structural? What medical benefits should i request? Do i push to get RSD included or just use my health ins? Is w/c coverage a pain in the neck to get things covered after settlement?
I'm so afraid- I don't trust anyone. Please give me your input. momof4

RN , I would go with your attorneys advice (hope you are using one) , realizing every state is a bit different with settlement laws and W/C I would surely go with the advice of a "good" attorney that is familiar with RSD and the states W/C laws.....good luck and take care !

I am not a lawyer.

I am also looking at settling with WC but not for RSD. I hope I am able to answer a few of your questions.

If your RSD is work related and being treated by WC, then I WOULD NOT SETTLE the medical portion of your claim. Your personal health insurance WILL NOT cover anything that is workers comp related even after you settle.

The cost to treat RSD over your life time could possibly be in the hundreds of thousands of dollars and if you settle the medical portion of your claim, then all of that expense will come out of your pocket and you will not even come close to settling your workers comp claim for that amount. You will receive a set amount from WC depending on your MMI Rating. And also remember, that your RSD can spread to other parts of your body and then you will have even more costs of doctor visits and meds.

I personal think it will be a huge mistake to settle your medical portion of your WC CLaim if you have RSD.

If you do settle your Medical Portion you most likely will have to have a Medicare set aside. WHich means Medicare will also look at your WC case and they will determine an amount that will need to be into an account to only be used for the RSD (if that is what the WC case is for) bills such as doctors, meds and such. Medicare wants there interests to be protected because at some time in the future you will be able to get medicare and they will not want to pay for all of your RSD Issues. That is why they will want a Medicare set aside and once you use that money up, keep receipts and all, then medicare will pick up the tab. It is advisable to speak to your lawyer if you are wanting to settle your medical portion and have Medicare go ahead and look at your case to see what set aside they will want. It can take medicare a few months to get the amount of set aside you will need if you close the medical portion of your claim, so its best to have your lawyer get onto that months before you settle. Or else you will have to wait extra months for medicare to make their decision.

An example: If you settle for $25,000 and Medicare set aside is $25,000, then you may end up with $0

Even if you leave Medical open, you will have the same issue's getting medical approved as you do know. It wont make anything any faster.


From what I have read, the difference in a lump sum and structured settlement is a lump sum is in today's dollars so it would be less money. Structured Settlement gets paid out monthly/yearly till the funds are exhausted. In the long run, a structured settlement will pay out more as it will sit in an interest bearing account while it is being paid out. And the insurance company will pay out more in a structured settlement as they are not paying out 1 large sum at 1 time, but in several smaller sums for a set amount.


Again, I am not a lawyer, but I am going through the process and hopefully settle by the end of next month.

I hope it helps.


Again, if RSD is your industrial accident and is the reason for your claim for WC, then I WOULD NOT SETTLE my medical portion unless you can afford to pay all the medical out of your pocket for all your treatments, meds and so on for RSD. As your personal health insurance WILL NOT cover it.

mom/4
I suggest a hybrid type of settlement, i.e. you get some cash up front, then buy an annuity from a GOOD insurance company like Northwestern Mutual, or Pacific life.
I got one that was called 20 plus life, and it pays around 7.7% interest. So, it's guaranteed to pay for 20 years, then, as long as I live. A very sweet deal.
The money that I got as cash, is All gone, due to two wives that had it counted before I did. (First wife actually knew I settled before I did).

I stunned the ins. industry into realizing that RSD was REAL.
I fired 5 attorneys, got the best in the city (who had lost an rsd case) and had a score to settle, and I had Dr S. At the time circa 1990, nobody had really gotten any more than around 50 thousand.
I got well over a mil. I later ran into the insurance adjuster who had to write my check (imagine that) in of all places a tiki bar in the FLA keys. I told him a bit of my story, and he told me about some guy with a 'weird disease' that you can't even SEE! Got this ridiculous amount, that's sending ripples through the industry!
I bought him a cocktail.
I wish you the very best!

Pete

Did you tell him who you were?

Of Course, Jim!
We were both thinking, what a small world, with me being from eastern PA, and him from Jersey, we meet in the FLA keys. Just happened to be @ the same place, same time!

BTW, mine was NOT a W/C case, it was Auto, and I was relatively young, and successfully self employed.

And, when I say 'I stunned the ins. industry'. I mean just my case, my lawyer and Dr S!
Without that team, it couldn't have been done.

p

In a WC Claim, you will not get pain and suffering. You will only be paid on the rating your doctor gives you in your MMI. Each % is worth a set amount. And you can get some money for future medical and then Medicare will want a set aside so they don;t get stuck with your bills. There is already a chart that is used by WC on the amount to pay you by the % of disability that the doctor rates you at. I hope the doctor isn't looking out for the best interest of WC when he MMI's you and give's you a rating. Some doctors are considered Workers Comp doctors and will lowball your rating so WC doesnt have to pay you much in your settlement.

Your rating may only get you $5,000 with future medical or maybe $10,000 with future medical closed. Can you afford to pay for your lifetime future medical for the RSD? Which includes all doctors visits, meds, hospital stays, medical equipment, travel expenses to and from the doctor? That $10,000 won't last long then the money comes out of your pocket.

If your lawyer and WC doesn't protect Medicare's interest it can be a $1,000 a day fine until it they do so. And Medicare has cracked down on that.

My WC claim is not for RSD, but I do have RSD from a prior injury and I now as well as you do that unless your a multi - millionaire, you won't be able to pay cash for all your future medical for RSD.


DO NOT CLOSE OUT YOUR FUTURE MEDICAL when you settle.


I will give you an example of what Florida pays per % in a WC claim.

PPD means Permanent Partial Disabilty.

1% -10% including 10% is 2 weeks of PPD
11% - 15% including 15% is 3 weeks of PPD
16% - 20% including 20% is 4 weeks of PPD

SO if your MMI rating lets say is 19% you will be paid another 51 weeks.

Know minus from that 51 weeks your lawyers fees of 25%

You may get paid another 38 weeks. SO every 2 weeks you had been getting lets say $400 from WC...

You may walk away, without settling future medical, about $7,600 (19x400)

Nothing for pain and suffering. Just paid on your MMI rating.

Ask your lawyer how much in Medical costs you currently have.

If you have $20,000 so far in bills, and have had your claim for 2 years for RSD, that means you spend about $10,000 a year on medical.

Over your lifetime if you live another 50 years, thats $500,000. And thats if your RSD doesnt spread or get worse.

You will be lucky to get $10 - $15k for closing out your medical with WC.

Is it really worth closing it?

I don't know anything know about W/C at all but my case was a personal inquiry law suite and won over a 1/2 million dollars, by the time I paid attorney, doctors for depositions on my behave, graphic people I came home with $405,000.00. My attorney has won top attorney in NJ 10x's in his career incredibla man. Anyway I remember at one of the meetings the insurance company wanted to pay me over time set up a trust or sometype of investment pay over time policy and he just absolutely said NO.I want to a full jury trial over it because they refused to pay and I was very nervous and the jury pool was not the most savy group. Went 4 days in court and then settled and received the above in 30 days....Your attorney and very knowledgable doctors who are willing to work with your attornies is so key...


Good luck don't rush a decision, my attorney made it very clear to me right from the beginning you have to be very patient when you are fight in court.

gabbycakes

make w/ccover your future medical and future meds before settling. does your state offer retraining, if so they usually pay for 2 years of schooling including expenses for scholl and housing=about $65,000 for 2 years(check into it).

your body is worth $177,000 according to w/c. so a 10% rating gets you a check for 17,700.

some states allow you to sue to company for( )i forget the word, but it means the company is liable to make payments to you monthly for a determined time(some for lifetime) and i hear the check is about the same as you currently make. this depends on where you live and how you got hurt and an awesome attourney.

good luck,

mike