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  1. #1
    Join Date
    May 2008

    Default Impairment Rating And What To Expect At Settlement

    My question involves workers compensation law for the state of: South Carolina. I injured back at work. MRI showed bulging disc. Also have 4 other discs in lower back with bulging, degeneration, curvature, stenosis, slipped disc, arthritus, muscle, nerve and ligament damage, etc. Pain never goes away. Had 2 injections & therapy with minimal success. Was told surgery not option because 5 disc levels involved. Was placed at MMI after approx 6 months following most recent injury. Doc gave work restrictions no lifting over 15 lbs, no prolonged standing, sitting, driving, walking; frequent breaks; no bending or twisting. Don't think company will accomadate due to nature of my job. Been in same type of business for over 30 yrs which includes consistent lifting and moving of products, driving, etc. I am almost 60 yrs old, do not have college degree, limited transferable skills and a really screwed up back. Don't know if anyone will hire me within my restrictions and not sure if I can even manage a job even if it is part time due to the pain & limited mobility. The case worker asked me after last appt if i had a lawyer & I told her I did not. She then told me that rating would only be around 5% to 20% & I should start looking for another job.
    These are my questions:
    1) Are the percentages she mentioned correct???
    2) What can I expect to happen at the settlement meeting?
    3) Is the settlement amt based soley on the impairment rating or do they take into account my age, limited education, possible inability to get another job or ability to even work and future loss of wages/lower paying job or part time wages & future medical needs.
    4) How do I handle future medical needs at settlement?
    5) I was told to have an attorney review the settlement offer before signing. Should I tell the WC carrier before the settlement meeting that I am going to have it reviewed by an attorney? Will this hurt or help me with regards to what they offer?
    6) Is there any way to calculate what settlement amt might be?
    7) Should I go ahead and apply for SSD?
    I am extremely discouraged, frustrated and worried about my future financial situation and would appreciate any help and advise in order to protect myself!

  2. #2

    Default Re: Impairment Rating & What To Expect At Settlement

    The case worker does not determine the %. The doctor gives his opinion and the commissioner determines the %. You can appeal his decision. What does your doctor say? That is usually what they accept. A settlement is just that. You don't get anymore for the future.

    The commissioner will take into account all the issues. I assume that they are paying your current medical bills and 2/3 of your salary. An attorney is going to take at least one third of any settlement. I see a lot of people actually lose money with an attorney since the WC system in SC is very pro worker.

    I would let them make a proposal and then pay an attorney for his time to meet with you, review your file and make a recommendation.

  3. #3
    Join Date
    May 2008

    Default Re: Impairment Rating & What To Expect At Settlement

    Yes, the WC carrier is and has paid the weekly check like clock work. He said even after the doc puts me at MMI the checks would continue until final settlement as long as I am reasonable about the settlement offer. WC has also reimbursed me for all medical, Rx & mileage. The doc they sent me to is one of the best in this area. I have read about other peoples horrible experiences with WC system. I guess I am fortunate that so far I haven't had to battle with them. It's difficult enough dealing with all the pain, change in lifestyle and not being able to earn a living.

    You mentioned that I could appeal the rating if i believe it isnt right. Can I do that myself or do I have to have an attorney to do that?

    Thanks again for all your help. My prayers go out to all the other people out there struggling with their life changing injuries. God Bless

  4. #4
    Join Date
    Apr 2008
    Chicago, Il

    Default Re: Impairment Rating & What To Expect At Settlement

    You really need to get an attorney and now. I injured my back at work in 2004. I had 2 back surgeries so far. I had 8 lumbar epidural injections over the 4 years, 10 months of physical therapy, I saw 4 different doctors, incuding a neurologist and had an EMG done which showed nerve damage.I am in pain management since my last surgery Nov, 2006 and will be in pain management for life. You don't want to settle unless you have a medicare set aside for yourself which will make sure you have money put aside in an interest bearing account for your future medical and drug usage. Don't settle unless they put money aside for future medical care.My drugs alone run almost $1500.00 per month. I am 54 now and also on social security disability. I applied on my own and was approved in 3 months without an attorney. Just make sure you have all of your doctor and medical dates in order before you apply. If you are like me and I really won't be able to do much work anymore. I can only sit for short periods of time. I took an FCE test and the results showed that I can only sit or stand for 2 1/2 hours per work day. The insurance company will have to pay you a wage differential settlement. It will be based upon what you were making before you got injured and what you are able to earn today. You NEED A LAWYER. Don't try to do it alone. In Illinois the lawyer gets 20% but I will still be way ahead because I would never be able to know all of the laws that I am entitled to without the knowledge of a good work comp attorney. Good Luck.

  5. #5
    Join Date
    May 2008

    Default Re: Impairment Rating & What To Expect At Settlement

    Thanks for your advice, although now I have more questions.
    1) What does pain management involve and is it helping you?
    2) I am in the process of filing for SSDI on line. Do you have to be approved and on SSDI before there can be a medicare set aside?
    3) My doc did not have me take a FCE...he just listed my restrictions and said I was at MMI & will issue my impairment rating. Does SS make you take a FCE before they approve?
    4) About the wage differential. How do they determine that if I haven't been able to find another job, yet or not sure if i will even be able to work period or perhaps part time or even whether someone will even hire me at my age and condition.?
    5) have you settled yet? IF so, how did it go?
    6) Couldn't i wait to get an attorney after i see what they offer first? I def. won't sign anything until a WC lawyer reviews it. Also, dread the lawyer route because it will surely delay things & the WC guy told me the wkly checks would continue thru settlement unless I was unreasonable about the offer. IF things are delayed and the checks stop it could really put me in a financial bind. I realize that i do need to make sure I get the best deal in the long run.
    Look forward to hearing back from you. Thanks again for your advice!!

  6. #6
    Join Date
    Apr 2008
    Chicago, Il

    Default Re: Impairment Rating And What To Expect At Settlement

    1. Pain management is me going to the doctor once a month and getting my pain medications refilled.

    2. If you are going to apply for SSDI now the work comp insurance company needs to know because if there is a chance that you are approved within 30 months of settlement they need to provide a medicare set aside. Medicare will force them to have it.

    3. My work comp insurance co. ordered the FCE to see if I could return to work and see what my restrictions are. SSDI has nothing to do with the FCE.

    4. As far as the wage differential they know what you were making before you were injured and like in my case they usually hire a vocational rehab company to help you look for a job and like in my case also I have applied for more than 250 jobs now with no responses. The voc rehab lady told me they usually will see what jobs are available based upon your restrictions that are within your area and take an average wage to come up with how much you should be able to earn today with your restrictions. That way they can determine a wage differential between what you were making before the injury and what you can make now with your restrictions.

    5. I have not settled yet. We made an offer to the insurance company and they came back with another offer which I refused. Now We came back with a wage differential demand based upon my work restrictions and now we are in the negotiation phase.

    6. How would you know what a fair offer would or should be in your case. Plus you must make sure that they set aside money for future medical and drug care for your life and I doubt they will do that unless they are forced to do a medicare set aside. You should apply for SSD right away and let them know you have applied.

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