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Workers Comp Settlements in CA
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- เผยแพร่เมื่อ 11 พ.ค. 2021
- Whether you are in the beginning stages of a workers' comp claim or at the end of one, knowing the difference in settlements is a must.
That's why we're sitting down with CEO and Co-Founder of Pacific Workers', Bilal Kassem to discuss in an in depth conversation about the different types of settlements in the CA Workers' Comp System.
This is an episode you are definitely not going to want to skip.
Thanks for the very informative information. God Bless🙏
My work comp case is over 20 years old. I was forced to retire at 53 years old. Insurance company for my employer denies everything from a band aid to total knee replacement. Won’t close my case so they control my life. I’ve had the same attorney for the entire time. Hands are tied from the flawed system. From my congressman’s office to the attorney generals office in Sacramento, the story is the same. Nothing we can do. 😡
Yikes! Maybe it's time to get a second opinion from a different lawyer? We see cases deteriorate the longer they go the harder it is to get things approved. Wishing you best of luck!
Left message for consultation for workers comp also called and was hung up on by receptionist.
HI Jeremy, I just got to your message. We have been having issues with our phone service provider. I'd be more than happy to have our team call you back.
it was great . very informative .
Hello, Im a nurse I had shoulder surgery and after a few months went to modified duty for 2 months, but got an MRI as I was plateauing on ROM/strength some pain despite this I went back to work in the nursery as I was good enough to do my duties and PTP agreed and worked for 4 months at bedside without major issues just very mild pain w arm and slight decreasee rom, I did my QME and she put restrictions. Employer put me on LOA as they said they cant accomodate restrictions and may have no job Im shocked as Ive been doing my work just fine for 4 months...the QME has some inconsistencies and some things she said I said are not accurate as well as missing data...how do I go about getting a new QME or rescind this, does the label of Permanent disability stay with me for life? Im only 51 and capable of working, please advice
Hi! I know that the workers' comp system can be a bit complex. Regarding a new QME doctor, unfortunately, you can't change QMEs. It's better to consult a professional to ensure you get the best outcome. Feel free to give us a call at 510-444-2512
I have a w/c case for a torn meniscus and the claim took a year to get accepted during that time my lower back was affected bc of my off gait. We amended my claim to include the back. During my case my employer has filed for bankruptcy and has stopped payment on my TD paymentd and r no longer paying me. I have applied for SDI and they won’t pay me bc they say that the w/c ins co. Is to pay me. I have an ame in October but what do I do in the meantime to get money to live on and pay my rent and bills. I am so far in debt now. All this has caused me great stress and anxiety leading to my depression so my PCP has put me on an anti-depressant.
I'm sorry that you have been going through this.Dealing with a WC is not fun and can become very stressful. I would love to obtain more information to see how our office can help you and represent you. Can you provide me with a good phone number so one of our amazing Intake Specialist can reach out to you. You can also give us a call directly at 510-444-2512
I contacted ur office and u said u couldn’t help me bc I had previous counsel. But they r substituting out bc the don’t have experience with this in their level of practice and say I need a bankruptcy styirnry so
Now I will by in pro per. But I need some sort of guidance
Can you make a video on mental workers comp scenarios such as workplace violence. With all the things going on with ex employees coming back after being let go and attempting to hurt staffs and their old managers.
This is a great topic suggestion. We will add this one to our next videos. Thank you!
how do they calculate future income loss
The small settlement and the small amount of money for retraining is not enough to get a position doing something comparable and if the job I was doing is what I wanted for my career, then it's injustice to pay so little to someone who has many potential years left until retirement.
Unfortunately this is what many others feel as well. :(
I injured my leg at Amazon.
Initially, they said at the Dr. it was a knee strain... over two months later, they think it is a torn meniscus or torn acl.
For Worker's comp, they're giving me nothing. They say my restrictions allow me to work. I am expecting to get my MRI soon, but if it is a torn meniscus or acl, I am considering legal counsel.
Sorry to hear about your situation, Don't wait until it's too late.
Is it more polite to ask you're attorney or the case worker your case value? Appreciate all Pacific Workers does 🙏
Asking your attorney would be the most accurate. Your attorney is the one litigating your case and your caseworker is there to assist the attorney.
Miss. Naomi, my MMI date is approaching on 12/30 of this month. I still have pain on my left wrist and upper left back shoulder, since trip and fall at work I injured left arm. I’m worried MMI date comes and they want to sent me back to full duties at work. I don’t see the work compensation doctor until 1/3/2023. What should I do? I got injuries on 11/27/2023 and I live in California.
Hi Michelle, thank you for your comment. Usually you would see a QME doctor who then reviews your entire medical report and then suggests the next steps. If you have yet to see one, that usually happens before an MMI. If you have seen one and you were given an MMI, there are options to get another QME or AME if you have an attorney. If you'd like for us to take a look at your case and help you answer any questions you might have, we're here to help! Send us a DM with your number or call out team 800 606 6999.
Good video Bilal!
What can be an average workers comp settlement for a first responder requiring two lumbar fusions? With or without surgery? Or if you take the lump sump. Thank you
After Qme result my employer force me to do leave of absence before transition form work ,coz they said that’s the only available for me and file me for LOA own illness /injury (not related work injury ) .what can I do ?
Hi! Thank you so much for your comment!
I'm very sorry to hear about your situation ☹️ You can try giving us a call to see if there is anything we can do to assist you. Our main phone number is 510-444-2512
I’m located in Southern California. I have a broken Fibula. I’ve been on TD Total Disability for 2 and half months. Should I seek Legal Representation?
Hi Jreal714, if everything seems to be going well for you and you are getting paid and all of the medical benefits are being provided you could seek to speak with an attorney for a free legal consultation. If things are off or delayed or you have issues than the answer is a definite yes! Regardless, it's always best to consult for the things you wouldn't even know you need.
What if they wanna stipulate a settlement of 40k in bo weekly payments . Does that mean you start getting the 290$ weekly from the end of the case . ? Or does any get paid up front ?
Can I go get my own Surgery with my own Insurance/ Monies , & then ask the the Workers Compensation Process , at the End , Pay this Medical Bill , because , the Workers Compensation Claim Process , Refused for Many Months , to Even Help me in any RealMean full Way . So , I decided to Take my Health in to my own Hands . I need my self Fixed , in order to Live properly & still go back to Work, in my Regular Work . Any Ideas on this ? TY.
I hope you were able to get the treatment you needed even if it wasn't through workers comp 🙏
It is possible to try to get the Workers comps insurance to pay, it is not guaranteed though so it is something that we do have to fight for our clients. An attorney can try and help you get reimbursed.
You can give us a call at 510-444-2512, we can see if it's something we might be able to help you with 🤗
Thank you for the information. I have been contacted by the insurance company through my attorney that they want C&R. I won my case, received payments, have future medical, and I am 45% disabled. I will have to have back surgery at some point and my life activities have been altered, (dancing, skiing, big hikes, and in some cases intimacy). I am 52. What would you say is a fair amount to settle on? They have offered 80k. Thank you for your help.
Hi Tiffany, thank you for reaching out and leaving a comment. It would be hard for us to give you an amount without getting into the specifics of the case. Every case is different. The idea of a C&R settlement is to be able to cover any future medical expenses that you may need to pay. Have your attorney explain thoroughly so you know where that amount came from. Wishing you nothing but the best!
What resources does a lawyer has to make a emergency spine surgery that was denied to get it approved ASAP for emergency surgery approve???
None. Call your state representative. Vote.
You appeal the denial. Get a QME if none have been had and or a second QME.
Excellent!
the insurance will pay for a surgery after the 5 years and after stipulation and award.
Betty,
A surgery request will go through utilization review assuming your future medical is still open. If the surgery is approved then the insurance company will pay even if it has been 5 years.
Hope this helps,
Naomi Gonzalez
I have a surgery approved after a independent medical review 8/22 end. Know I not sure to take this surgery right know but I want this surgery in the future my specialist said I will get worse with or without spine surgery I want to wait when I need 2 fusions. Hwo can I get that I know if I take the surgery after 5 YEAR I need to forget about the money of more permanent disability. What I can do if I not agree with the permanent restrictions by the QME
First off, we are glad to hear that your IMR surgery appeal was successful. Most appeals are denied, so this s a big win! Whether to get surgery really depends on what is going on in your case and what fits your needs. In CA you can only reopen your case within 5 years from the date of injury. So if you have surgical complications which make your disability worse, but your case has settled by stipulated award and its been more than 5 years, you won't be able to receive benefits for the additional disability. That being said, a lot of our clients prefer to defer surgery because of the risks or other factors (financial, family, etc) that make for bad timing. If its an issue with your confidence in the doctor, you can always request a second opinion consult to have another doctor weigh in on the issue before moving forward. Typically when we don't agree with work restrictions from the QME, we will request a supplemental report or take the QME's deposition. If you are handling this on your own, I would recommend consulting with a lawyer or talk to information and assistance at the wcab.
@@Pacificworkers Thank you!
Does surgery(s) increase the settlement as there might be the need of revisions down the line
Hi Monica,
Sometimes surgery can lower the value of the case for two reasons 1) surgery can fix the problem and lower your permanent disability 2) It's money the insurance carrier already spent, so it's money that wouldn't go toward future medical in a settlement. That being said, surgery can also increase the value of the case because of a poor outcome where you are left worse off than before. Also, long as the doctor indicates in their report that future surgery is needed, whether that is the first surgery or revision, you would likely be able to get more money for your settlement.
So I’m out on an injury right now. I want to go back to my job. Will I get a settlement at the end of this? I work for a large company
Hi Flyrabbit1, it all depends. Settlements are given usually when there is a percentage rating on your disability. The settlement is meant to cover any future medical expenses you might need to fully recover. These ratings are given by a QME. If you fully heal and there is no rating, chances are you injury healed 100% and you can go back to your normal life and thus settlement was not needed. In this case Workers' Comp helped you cover the medical bills and wage replacement while you were out of work due to your injury.
Great Video 📹 👍 what if my lawer told me that the insurance company denies my claim what next my lawer told me something about a judge hearing or something like that?what next⁉️🤔
If the case is denied, your attorney will likely have to set the case for hearing at the WCAB to get the claim accepted. This would occur if your lawyer believes there is a medical, legal, or factual issue ready to address in court.
@@Pacificworkers Thank you very much 😊
I went to my QME appointment today. If the doctor decides that I am permanent and stationary then when does the temporary disability workers company stop the day of my appointment for the day he reaches the report or how does that all work how is a determined?
Generally, Stops when the insurance carrier gets the report. Maybe a month or less
@@MartynCollins thank you for your response.
What's a working comp offset to social security
workers comp benefits can offset what someone receives from social security disability provided that the amount they receive from both benefits combined is more than their maximum social security disability benefits
What about Liberty Mutual?
Not sure what the question is about regarding Liberty Mutual.
What a QME does in works Comp ??
Provides an evaluation to help determine injury, cause, treatment, future medical needs and level of permanent disability
Nothing just a run around with asshole drs
Thank you for replying. Yes, we have a few videos on this topic.
Does your attorney collect any fees on future medical care? After a case has been settled?
Yes they collect 15% and it comes out of your lump sum settlement amount and you can’t touch the Medicare set aside except for medical bills..it gets audited yearly. So you end of with a shitty pittance of a cash play out‼️
Thank your for jumping in and answering this question.
Hi Jorge, here is a quick link to the answer for this question th-cam.com/users/shortssGy2MN5CZ8M you can also listen to the full podcast episode where we discuss your question here workcomptalk.net/work-comp-talk-episode-58-your-top-workers-comp-questions-answered/.
Thanks!
Does surgery affect your workers comp settlement in any way talking about lower back surgery and if you refuse to get surgery because obviously I'm scared can this also affect my workers comp
You have the right to reasonably decline treatment. It should not impact your case. If you unreasonably refuse treatment, the defense can try to argue that its the unreasonable refusal that is responsible for your permanent disability. This argument rarely works. If you want to keep surgery as an option in the future you can do that too. Keep in mind, you can only collect temporary disability for up to 5 years after your date of injury so if you wait for surgery at a later date you may not have temporary disability to support you while you are off of work.
@@Pacificworkers so if I do get the surgery is my case worth more
@@Pacificworkers
Can I close my case and have Worker’s comp give you the money for future surgery?
That was approved already from them.
Say a back fusion would cost $30k
Thanks
@@edwardkareem6446
Nope because they already paid to fix you.
Impairment rating is what they pay on.
So say one surgery will probably put you at 28% is still $10-$20k look it up. They have a chart for this.
Good luck 👍🏼✌🏼
I had a heart attack lifting scaffolding?
Sorry to have taken so long to answer. Really sorry to hear about your condition. I hope you are recovering well. Would you like to chat with us?
What my employer told me he had work didn't even look at my work restrictions tried talking to him about it and he just caused told me I didn't want to work terminated me made up bunch of lies. Basically screwed me over
We are so sorry to hear that! This sounds like a case of discrimination. Check out Labor Code 132a. It is illegal to discriminate/or retaliate against someone for filing a workers comp case. It may also be a FEHA/ADA case for disability discrimination.
@@Pacificworkers dose FEHA and ada fall under the 132a or is that a different fourm ?
Reason I'm asking is bc I got an attorney but I let him know to file a 132a but I don't know if I need another attorney for the FEHA ada
@@taztazblackwell3927I would consult with an employment attorney to find out your options for a civil suit.
Just wondering why you didn’t put your diplomas in a frame…looks pretty tacky with a pin holding them up
That is our Marketing Director's Home, her kids pinned their Honor Roll Certificates at her home office.