What to expect

[pdworth2]

I am in Colorado.

I have been injured since April 2006 when my left quad was cut by a circular saw. I have been MMI since May of 2007. We have been in the process of getting an IME since I was rated back in May. I have had one doctor decide that she was no longer going to perform IME's and another remove himself because he was affiliated with the organization that was performing my care. I have my third IME scheduled for the beggining of December and my lawyer is very happy with the selection.

I have had no problems with any of the process as my injury and resulting disability are very clear cut. My lawyer thought my rating was a little low but resonable. The insurance company has already admitted liability for all of my future reasonable and necessary care related to the injury. The reason my lawyer states for wanting the IME is to make sure that the insurance company stays on the hook for all my future medical needs.

I have no use of my quad muscle on my left left leg which requires an orthesis to help me to have a regular gate and avoid back and hip problems and it also allows me to walk and stand for a longer period.

My lawyer has said and I have receieved a letter from the adjuster that they are very interested in settling and believe the IME is delaying the settlement.

In Colorado insurance companys want to settle and shred the file. My orthesis is 8500 dollars and the doctor and expert expect a three year replacement period with adjustments and repairs inbetween (I weigh 290 pounds and am not obese). I had spoken with my lawyer a week ago when he informed we of the last IME cancelation. He agreed that we could offer a settlement amount but would want to move forward with the IME. At the time I had spoken with him he calculated a settlement amount of 210,000 (3yr replacement, inflation, repairs est...40 year additional statutory lifespan)but I had not seen the list price for my orthesis and was guessing (6000 dollars). Well, the real list price (8500) I am guessing will push us into the 250,000 dollar range. My lawyer is getting a letter from the Orthesis specialist and is going to submit the settlement amount probably in the next couple of weeks.

I have finally reached the QUESTION...actually 2 questions.

If I settle does the money go into a fund or am I responsible for properly investing the money. The settlement requires me to release the insurance company from all future liability so I want to make sure I can pay for repairs and replacement easily (This is why I am willing to settle...it takes weks for me to get repairs approved)

Second, I was flabergasted when my lawyer mentioned what he called the reasonable settlement amount. Just to be clear I thought it was high and am worried. I have tooled around the intenet a WC websites and have never heard of such a large settlement. In Colorado the settlement can only be for future medical costs...I already receieved rating money for my loss of functionality and have recieved the statutory mandated benefits up to MMI. The settlement we are asking for is to cover just my Orthesis for my remaining lifetime.

Well, those are the two questions. I am asking because I need to know if I need to talk with a financial guy to invest the money myself or because of the large amount prepare for a long drawn out battle. The long drawn out battle won't be horrible as the insurance company already has to pay it just delays things.

Sorry for the long post....I will try and keep any future posting much shorter.

[bothknees]

I am in the process of finalizing my case, and my WC case worker has been a great help. The answer to the money question is Yes, you would need to put that money asside in a seperate account to cover any future medical costs related to your injury. You would also need to keep complete records and every medical paperwork remotely associated with your injury. My case worker told me straight out, if I didn't keep every piece of paper, it would cause problems with insurance coverage in the future. I am going to leave my medical open because I need total knee replacement within the next ten years, and If I took the money now, I would spend that money on something else, and I know I don't keep very good records. It is very unusual that in any state, they would pay that much money up front to buy out your future treatment. Don't forget that lawyer is most likely getting atleast 12 percent of that settlement for himself?.

[tweety00]

Pd My opinion is you also need to learn the laws for your state .. That way you understand as the lawyer is chattting with you ..

http://www.workerscompensation.com/colorado.php