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ADR workman's comp award is it my choice to get one lump sum or is this the ins. co. choice

Riverside, CA |

my first award was a c r the judge gave the ins. co. 90 days every thing was sign if not paid in a timely matter sanctions and penalties would be added in the ins co. hag ignored everybody not until 120 later there woe a arbitration hearing. apparently the day before the hearing my attorney had talk to esis and esis att. said they would approve the surgery the day of the hearing my attorney said to me to do the surgery that would give the incentive to make esis pay the settlement .I thought if not paid in a timely matter judge would order penalties' as soon as I took my attorneys advice it through the first settlement out 2nd settlement offer was very min. my attorney was very rude to the judge and very unprofessional this is the best deal he would do with only 2yrs for medical

Attorney Answers 4

Posted

I think you are very confused about what is going on.

A judge cannot award a C&R. Also, the 90 days that you think the Judge gave ins to pay makes no sense. The 2 year medical is also not making sense to me.

If you had a surgery and it was successful, your permanent disability will likely go down which would make your case value go down as well.

If you had a surgery and it is was NOT successful, your permanent disability will likely go up which would make your case value go up.

In addition, since you already had your surgery (and insurance company had to pay for it), a new settlement offer will not include a consideration for a surgery.

You really need to schedule a meeting with your attorney regarding your concerns. Write your questions down to make sure your attorney responds to all your concerns.

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Posted

If the judge approved an Compromise and Release before you had the surgery, You will be liable for the surgery expenses. If they failed to pay you within 90 days as ordered by judge (usually they have 30 days at the WCAB as per LC and I believe ADR has to abide by such as well) you are entitled to sanctions and penalties up to 25% or $10K whichever is less. BUT YOU ARE STILL LIABLE FOR THE SURGERY EXPENSES. C&R you relinquish all rights (including future medical). Basically you and the WC insurance (ESIS) have no remaining relationship at time that judge orders OACR. You sell out PD, future medical, out of pocket expenses, etc... = nothing is left.
There is another type of settlement a STIP. This type of settlement you settle only you Permanent Disability but stipulate to doctors findings in regards to future medical. Therefore you get the future medical as to the doctor and get biweekly payments until PD amount is reached.
I would recommend that you get some clarification from your attorney because it seems that you are a bit confused of what is going on. Good Luck!

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Posted

You should probably discuss your situation with your Attorney, since he probably has a better idea about what is going on. If you mix conflicting terms and times, it is difficult to follow.

We offer general concepts, but you should give ALL your facts to a licensed Attorney in your state before you RELY upon any legal advice.

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Posted

In Missouri, permanent partial disability is paid in a lump sum. If you are a perm total, the parties can agree to a lump sum. If not, perm total cases are usually tried. If you prevail, the checks are weekly.

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