WC wants to settle and...

[Mariaa]

Sent me a letter stating they were in the process of seeking approval for a Compromise and Release. Included a form for me to fill out re eligibility for SSDI and Medicare. This is for the State of California.

Called the Risk Manager and first question was did I want to do a Compromise and Release so I asked what it was. Didn't get a clear answer so I asked if this was a lump sum settlement and was told it would be.

Then I asked what the Medicare Set Aside was and didn't get a clear answer either so said that I had gone to a website with company that specializes in working on this and had seen what was involved in this.

Therein in this website I saw something about the person should be at MMI and so then I said since I had seen a surgeon whom I was sent to by WCAB for a 2nd surgical opinion and he had recommended surgery (ADR and fusion) and WCAB authorized the surgery but I've yet to do it because of varying circumstances (auth'ed since 2/06) wouldn't I be determined to be MMI after surgery vs. before it?

RM agreed. I asked if I could keep benefits structured as they are as that would be my preference (Future med benefits on low back since injury in early 80's).

RM said that I could and if I didn't want to Compromise and Release or do the Medicare Set Aside just the form back stating that as she could not proceed without my signature re proceeding with Medicare Set Aside.

She sounded somewhat aghast when I stated I hadn't been working since 2000 and had SSDI and Medicare since then. Even I feel somewhat aghast at this as truly in the world of everything is right with the world, I'd rather be back working making 3-4 times what I make now on benefits and I'd rather be well enough again to do this~ just have so much fear after my last failed spine surgery. Still the time will come when I have to act one way or another to survive and it will come sooner than later~ realistically.

So does this sound right does anyone know re sending back the paperwork with a statement as to the effect that I don't want to proceed with either offer? I asked if that was definately OK to do as I didn't want to jeopardize anything...

I'm always fearful with WC that they have yet another shoe to drop/trick up the sleeve and so forth.

Haven't had a WC attorney for a long long time as I've been told there is no money to be made off my case anymore and I would have to pay for attorney now and it wouldn't be worth spending my money on. Was actually told to "take the money and run" by old WC law firm I utilized.

[Dabbadoo7]

Mariaa,
Unless the proposed settlement has at least $250K in income benefits, there will be no set-aside. It is not required by MediCare unless that amount is accepted. And, if your atty. says there's no $$ to be made from your case, you may not get that amount.

And yes, it is definitely advisable that you be MMI at the time of any settlement. In a sense, you would be starting with a clean slate, and there wouldn't be any unfinished business hanging around.

I wouldn't send anything back to them with my signature on it at this time, especially the kind of form they are asking you to sign. It just doesn't sit right with me. I would try to get some kind of legal advice first, even if I had to pay for it.

Good luck to you!

Dabbadoo

[Mariaa]

Dabbadoo,
I am feeling this way as well re signing anything. I no longer have a nurse case manager as she was pulled from the case as were 3 others since I've yet to have the proposed surgery.

I am going to try contacting a WC attorney today that an employment attorney has referred me to. I will surely pay if necessary.

My previous NCMs said they thought a signifcant amount of $ was involved (at least the $250k)but who knows. I've had 2 spine surgeries, and WCAB of CA has authorized a 3rd which would be fusion at L5S1 and ADR at L4. I think putting everything together that this surgery would entail it might hit this figure (diagnostic testing pre op and surgery, aftercare, etc).

[Mariaa]

I was referred to a kick butt employment attorney who referred me to a kick butt WC attorney. The info was taken by the secretary re my case and an attorney from the firm returned my call.

I asked about the Compromise and Release form I was sent in terms of could my future medical be taken away from me and he not if I didn't want to settle in the form of a compromise and release or medicare set aside. He said that some people are very willing to settle because they need the $ (he also thought it was amusing that no monetary figure was even offered on the letter sent).

When I told him that the Risk Manager wanted me to send back the letter with a signature stating that I didn't want either option (Comp and Release or Medicare Set Aside) then he told me to send her a letter stating I would like a letter confirming what we had spoken about and that I would sign this letter in return re discussing options and declining options.