Worker's Comp process and when do we need an attorney?

Question

I am a nurse, and work on the insurance side of medicine. I need advice from anyone who works in Worker’s Comp.

Not a lot or room so make it quick. 33 y/o f Rt. Radial nerve damage at work. Undisputed. Worker’s comp has approved all care, treatment, and surgery. 8 months post op reveals permanent nerve damage with no set future treatment possible. Showing signs of early CRPS now. Undisputed she will never return to work.

My question is I need some detailed ideas of what to expect? We have done this without lawyers. We have not talked settlement, as the concern has been care, but we are almost to that point. Do I bring up settlement? What are we talking to expect if we chose to do it alone? She will never work again, but I have a home business and we have made accommodations for this. The government doesn’t recognize us and reality is she will never be able to make her own income again. How does that factor into this?

Answer 1

There are some factors that will make the exposure of this claim.  If the injured worker will NOT return to work than it's likely that the claimant will qualify for vocational rehab (VR).  She will likely be qualified to retrain in a different field that will suit best to her needs.

Total exposure depending on state vary but I would estimate at least 2 years of lost time on top of books, tuition and other factors, possible that you maybe looking at $50,000 for just VR total.

I like to explore the option of settlement.  The injured worker might not want to do any training.  So settlement might be the best option, and the cheapest.

She may not qualify for VR too, if that's the case you get off even more cheaper.

Answer 2

I have a friend that her and her husband went through something like what you are going through except it was his back. If you are talking about her never being able to work again. Please I advise you to seek at least the council of an attorney. My friends got put through the wringer here in Texas and received nothing. Workers Comp is not about the injured worker but the malicious insurance agency. Please be wary when dealing with them one wrong move at this stage and you could get nothing.

Answer 3

Well, you're absolutely right, if there isn't any dispute, there isn't any point in bringing an attorney into this.

Having said that, the most crucial information was ommitted from your question:  the state.  Each state has its own rules and regulations.  It's possible any settlement will be limited to three years wages.  It's possible it could go to 65.  You don't say if it's possible to do retraining for another position - are we talking total disability here, or partial?

In other words, there isn't enough info here for anyone here to hazard a guess.  IN which case, more detailed info and a free lawyer consult couldn't hurt.

Answer 4

My ex-husband  had 3 worker's comp cases, by all means you should get an attorney.  Most WC attorneys will take the case on contingency.  You are entitled to a tax free settlement from employer and to have all medical bills paid as well.  Attorneys will subpeona medical records and may even send you to a doctor they use to help facilitate the best possible settlement.  Do not discuss settlement with the employer! on your own!  They have their own best interest at heart and will try to settle for as little as possible.  Be patient, cases take a good while to settle.  

After settlement, I would then talk with a SSI attorney and file for disabililty.

Answer 5

the attorney will take one third

Answer 6

Why can this person not ever return to work?? I find that too hard to buy.  No work comp settlement will ever pay enough to retire totally so the injured worker does need to think about working.  An attorney can certainly help negotiate a settlement if the claim reaches that point.  If this person is truly permanently totally disabled, they will need to apply for social security benefits.  Work comp settlement could be based on wage established, age, type of work employee was doing, percentage of impairment, education.  Depends on the state and 33 year old is pretty young to be written of as totally disabled.  I am an adjuster and I would fight permanent total disability for radial nerve damage.