insurance co wants to 'help' us settle AZ injury

[barefootdiane]

We need help figuring out what a fair & reasonable settlement would be. I hear there is a mystery formula somewhere but I doubt we even have the secret code to use it if I could find it. Please help! We've talked to attorney's before but because he hasn't missed much work they said their pay wouldn't be enough. They did say bad faith was an option but that was 3+yrs ago and we've moved out of state since then.

WC Insurance co adjuster offered us a small settlement ($10K) to buy orthotics for life. Too bad my husband has a broken foot that healed incorrectly due to their stalling and he needs another surgery but will still probably have problems.Then they suggested we take the settlement and pay for the surgery ourselves but it is impossible to get an accurate price when figuring surgical costs since it's so different for each company & policy and it's hard to tell what can happen. So they asked us what would work. My husband said $100K and she said no but called me back and asked me if it was just a number issue what amount would work. We tried to get an AZ attorney before but were told that since he didn't miss much work-he walked on a broken foot for 6 months and probably only missed 4 weeks total through all the surgeries, etc.-an attorney wouldn't be paid much because of the formula. We can't afford to live on the $268 weekly max that AZ pays so time off hasn't been an option.

My husband broke a bone in his foot 4 years ago while working at a large company in Phoenix, AZ. The company doc said it was bruised finally got our own doc who said it was broken recommended surgery. Insurance co denied surgery and we had to appeal for 6 months. Got surgery with bone graft & screws but due to delay had complications. Eventually had another surgery to remove screws. He's had physical therapy, cortisone shots, orthotics and everything else recommended except the surgery they don't want to pay for.

In the meantime we relocated to Washington state. We have seen several specialists including ones from the insurance co. All have agreed on permanent damage although the insurance co won't let us see their docs reports. How can a normal worker figure out an amount without access to all the secret formulas? How can we deal effectively without the help of an attorney? We can afford to pay one out of pocket. Sorry about the LONG story. Thanks for your help!!---Barefootdiane-wife of limping worker

[Still in Limbo]

Hi and Welcome to the Forum!! I Wish I had an Answer for you, but Unfortunately I'm not From Your State. Here in Pa. Our w/c Injuries are Covered Medically for Life unless We Sign those Rights away by way of a Compromise and Release Agreement, which is a Full Settlement with the Ins. Co., Including Medical. You have a Tough One Here, and I'm Sure One of Our Folks with Much More Experience than Me that will be On to Help! My Very Best to You!!

[ace25]

What are the surgeons telling you it will take to repair the injury? If you can get an assessment of what the surgical costs will be, plus related therapy, that may be a place to start. Workers comp will not pay you anything for pain and suffering. It is exempt from that legislatively, so your best bet is to figure out what you will need to fix the problem, and go for that amount. That is the formula you should look at. I am assuming that surgeons have deemed the issue "repairable", as an attorney would have likely been more interested if they smelled a bigger potential settlement for a lifetime care injury.

[Bad Boy Bad Boy]

State of Injury Arizona;

There are no secret formulas for making a settlement.

Next even though you and injured husband moved from State of injury (AZ), to now the State of Washington, you still need to follow the Work Comp Laws and Rules of (AZ).

You need to search around the State your in, and try and find a Attorney that is willing to handle this case across State lines. You need to call the State of Washington Attorney Board for help with that.

http://www.ica.state.az.us/

http://www.ica.state.az.us/ALJ/ALJ_Video_Support.aspx

Next anyone can obtain their medical records. They must follow the protocol to get them is all. Ask for release forms to be sent to you. Sign and send back. Ask for how much coping fee's will be, and agree to pay them. This is the first and simplest way to get medical records.