How do I make my workers comp case as valuable as I think it is?

Asked about 1 year ago - Gainesville, FL

I want to close my case so I can control what I feel needs to be done but the insurance company doesn't think it is worth very much. I hurt my back almost a year ago. It's an aggravation of a pre-existing condition but I don't need surgery. I do need continuing chiropractic and maybe deep massage or PT. As it is they won't approve these treatments anymore. The insurance co. has only approved a with revolving care staff for pain mgmt + rehab. Will going back to the walk-in clinic for a referral for any of the above help with the value of the case? I’m seeing my WC lawyer soon but he has been very bad about giving me straight answers. And, any idea what this case might be worth?
Thanks.

Attorney answers (8)

  1. Kenneth Brian Schwartz

    Contributor Level 15

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    Answered . Even though I agree with Barry Stein, I'm going to give you a very unscientific rule of thumb for valuing a non-surgical case like yours: your case, for settlement purposes, is worth about 15-20% of the carrier's exposure, which is the total of every penny that the carrier is ever likely to have to spend on your case over the remainder of your life. So, if you think that all that medical care you described will eventually add up to $50,000, don't expect the carrier to offer you more than $10k to settle, if that much. Carriers settle claims to buy off risk (e.g., complications from surgery). They simply have no incentive to write settlement checks now when they could keep relatively low-risk claims open and just pay out little dribs and drabs over time (to your providers, btw; not to you directly) that might never amount to the estimated exposure.

  2. Jeffrey Marc Friedman

    Pro

    Contributor Level 11

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    Answered . Without more information it is difficult to evaluate your case. What is the cost of your medication, if any? How much therapy do you require? How much is related to your pre-existing condition? Also, recent case law has made it much easier to get coverage for pre-existing conditions if they were also a result of a work accident. I suggest that when you sit down with your lawyer, find out how he is evaluating your case and the basis for his evaluation. The insurance company may not agree, and never can be forced to settle, but you can at least find out your options.

  3. Don Paul Harvey

    Pro

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    Answered . As you are represented, your attorney is the one you need to address this question with. In general terms, a carrier does not have to settle your claim, nor do you for that matter. Unfortunately, changes in the law have greatly weakened the injured worker's bargaining power when it comes time for a washout. I can promise you this, you will never be rich from a WC settlement, especially post 2003 date of accident. I am sure your attorney will do all he can for you, remember he gets paid a percentage of what he gets you so he is going to maximize the amount as best he can.

  4. Barry A. Stein

    Pro

    Contributor Level 18

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    Answered . A worker's compensation case is valued by virtue of the potential for future lost wages and medical expenses being incurred. That is what the carrier is buying themselves out of if they settle. You have to show them with documentation that they will be incurring either or both of these in the future. It is impossible for someone to give an opinion on your case without seeing your medical records.

    The answers given are limited to the facts as given and presumed by the answer itself. Without seeing actual... more
  5. Robert David Shapiro

    Contributor Level 14

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    Answered . The main way to make your case worth more money is to hire the right lawyer in the first place. Great cases don't just happen...it takes a great lawyer to do so and this begins as soon as possible after the accident.
    Bob Shapiro

  6. John F. Ayers III

    Pro

    Contributor Level 10

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    Answered . Most people with claims have heard stories of what others received and most of those are not true or are grossly inflated. Keep in mind that case evaluation is different in every case. Trust your atty or switch attorneys.

  7. Charles Joseph Michael Candiano

    Pro

    Contributor Level 20

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    Answered . If you don't trust your attorney's advice, why is he still your attorney? I'm certainly NOT suggesting you fire him. Perhaps you need to have an in-person conversation about what you can expect.

    If this information has been helpful, please indicate by clicking the up icon. Legal Disclaimer: Mr.... more
  8. Bobby L. Bollinger Jr.

    Pro

    Contributor Level 16

    Answered . There are not many "straight answers." Most of it falls into gray areas. I am sure your lawyer will get you the best deal he can.

    This answer is intended as general information and not as specific legal advice. If you want to have a free... more

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