Y
YnotonY
Guest
- Jurisdiction
- California
Hi. I have a question regarding amount offered by insurance company as payout for future medical care.
adjusterjack
Super Moderator
What's the question?
Last edited:
army judge
Super Moderator
If you believe the offer isn't enough, negotiate for more, or hire a lawyer to negotiate or litigate on your behalf.
No one can say if you $2,000 or $2,000,000 is enough for you.
In the end, you need to know that enough might simply be the legal maximum statutory payout in your state.
I suggest you discuss your predicament with a lawyer or two in your county.
army judge
Super Moderator
Again, I suggest you discuss this with a couple, licensed workers comp attorneys in your state.
Don't worry about costs, the lawyer knows how to get paid.
The lawyer's cut won't come from your piece of the pie.
Educate yourself, mate:
Workers Compensation Settlements
How is a WC settlement calculated in California
How to Calculate the Worker's Comp Settlement with 17% Pd
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adjusterjack
Super Moderator
Forget pies.
The lawyer gets 15% of your settlement.
As for how much the settlement is, there are statutory amounts that are computed based on the percentage of disability.
It's proving the disability that often requires the services of the attorney.
army judge
Super Moderator
That's a very easy question, mate.
You get yourself a little apple tart, or a large apple pie, if you select the right attorney.
When determining whether to hire a lawyer to represent you in your workers' compensation claim, you should consider hiring an attorney as an investment to ensure you receive the maximum workers' compensation benefits that you are eligible for.
Often, you will receive greater benefits, even after paying the attorney's fees, than if you choose not to retain an attorney, simply because the attorney understands and can navigate the workers' compensation system in your state.
The MORE a lawyer obtains for you, the MORE a lawyer makes, too!!!
In most cases because the lawyer gets a BIGGER reward, the fees the lawyer earns won't affect your bottom line.
The lawyer's fees wll come out of your settlement money, not out of your pocket. A workers' comp lawyer will typically get between 15% to 25% of your settlement amount; in a case where you settle for $40,000, your attorney's fee could be $6,000 to $10,000.
Your workplace injuries are severe enough to require surgery.
Your workplace injuries are moderate to severe.
If you and your doctor believe your health won't return to the condition it was prior to your injury, you may be entitled to a "permanent partial disability" award.
You believe you are no longer able to work on a regular basis in any job.
You believe you cannot go back to work at your current job, but believe you could work in some capacity.
You have significant pre-existing disabilities.
You would like to dispute an adverse decision made by your employer, your employer's insurance company, or your state's workers' comp division regarding your workers' compensation claim.
You believe you are not receiving the correct benefits, or wonder if there are additional benefits you could receive.
Your medical benefits are denied.
Your employer has disputed a decision made by your state workers' comp division.
You do not understand the workers' comp process and would feel more comfortable if an expert were representing your interests.
Regardless of the circumstances of your workers' compensation claim, you are entitled to obtain an attorney.
If your injuries are severe enough that your life will be permanently altered, either because of permanent bodily impairment or a change in ability to work, a workers' com lawyer will be able to advocate on your behalf to ensure that you receive the medical care and workers' compensation benefits you are entitled to.
If your injury(ies) may keep you from working permanently, a lawyer can advise you about filing for Social Security disability benefits as well.
Most states offer vocational services to individuals that are unable to return to work in their former jobs due to an industrial injury. A workers' comp attorney can assist you in navigating the system so that you are most likely to receive retraining or monetary payment to assist you while you obtain alternate employment.
If any aspect of your claim is in dispute with your employer, or your employer's insurance company, it is important for you to obtain an attorney. In many states, the dispute process is highly technical, involving complex legal rules and procedures. You will likely be at a disadvantage if you do not retain an attorney to represent your interests in these proceedings.
Your response is appreciated.
I was asking what I thought was a generic question and perhaps should have offered more info. My apologies..
I am a bit farther along than all that, having already had surgery and being declared disabled to a percentage.
The 'tart' in which you speak was offered several years ago in the form of a settlement amount which would close my case permanently. A laughable amount..
Another offer was made which was still unrealistic. I threw a number out, thinking that it would either sink or swim.
I did not follow up with them and awaited a response.
After several months, another offer was made and now we're in the high 5 digits.
My perspective on this is that the insurance company is always going to lowball the amount they offer, so if they are at this amount presently, there is probably 50% more that they COULD offer. However, I may thinking unrealistically on this point.
With that said, I have done fairly well in my negotiations thus far but do believe that I may have reached maximum.
I am concluding from consensus that I indeed may be well advised to seek a lawyers advice and hope that they will attain a larger sum that will accommodate their cut of the pie.
Thanks again for the advice.
I was asking what I thought was a generic question and perhaps should have offered more info. My apologies..
I am a bit farther along than all that, having already had surgery and being declared disabled to a percentage.
The 'tart' in which you speak was offered several years ago in the form of a settlement amount which would close my case permanently. A laughable amount..
Another offer was made which was still unrealistic. I threw a number out, thinking that it would either sink or swim.
I did not follow up with them and awaited a response.
After several months, another offer was made and now we're in the high 5 digits.
My perspective on this is that the insurance company is always going to lowball the amount they offer, so if they are at this amount presently, there is probably 50% more that they COULD offer. However, I may thinking unrealistically on this point.
With that said, I have done fairly well in my negotiations thus far but do believe that I may have reached maximum.
I am concluding from consensus that I indeed may be well advised to seek a lawyers advice and hope that they will attain a larger sum that will accommodate their cut of the pie.
Thanks again for the advice.
army judge
Super Moderator
I always advise my clients to look long term.
If your current life expectancy is 25 years, an offer of $99,999 is about $4,000 a year.
If your medical needs will increase as you age, as all us know, that four grand is nothing.
Many times people cheat themselves by thinking they can be their own lawyer.
This is your life friend.
Anything that has something to do with my life improving is worth whatever it costs.
None of us will take a dollar to the grave or crematory.
You owe it yourself to investigate if there's anything more there, insofar as the insurance company thinks.
It's been my experience that if you've gotten them to $100,000, taking the matter to trial s going to cost them at least half of what's on the offer table.
Plus, what's on the table generally means another 20-30% isn't on the able, often it can be far more.
You also need to know how your medical problems will impact you over the next 5, 10, 15, or more years.
Lots to ponder, pal, lots to learn.
army judge
Super Moderator
I hope you get enough to compensate you for your losses, take care of your medical needs for the remainder of your life, pay for any skills or job training if you want to work and can work, assist with your living expenses for life, and something for a rainy day.
army judge
Super Moderator
I always root for the under dog.
The big shots got theirs from feasting on ours.
Time for you to get paid, mate.
Here's the thing, settlements in WC land are MUCH lower than in general liability land, and if they include on-going medicals, must account for Medicare's interests. This means nor only must you, the IC and the state approve the number, but so must CMS. At least at the kind of numbers you are talking they must. Workers' Compensation Medicare Set Aside Arrangements - Centers for Medicare & Medicaid Services In many cases, it may not be worth it to either of you to actually settle the claim permanently.
You are far from trial. That isn't how WC operates in any state. Taking it to a WC hearing is pretty low costs and unlikely to be a deterrent.
Lawyer's fees are set by statute in WC and always come out of the award. Legally your lawyer can not charge you more for the work related to the WC claim.
You are far from trial. That isn't how WC operates in any state. Taking it to a WC hearing is pretty low costs and unlikely to be a deterrent.
Lawyer's fees are set by statute in WC and always come out of the award. Legally your lawyer can not charge you more for the work related to the WC claim.
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