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How much money will I receive as a settlement in my workers comp case? How long do these cases take?

Walnut Creek, CA |

Tore my ACL and Meniscus and had surgery last August. The graft didn't take and I am still with left with no ACL and some tearing in the meniscus. Basically the surgery failed. I have decided not to go through with another surgery and would just like to cash out. I am 33 years old and a specialized athlete, I can no longer do my sport (much less any sport) and have been out of work for 1 1/2 years. My leg has now atrophied and the pain is constant. They sent me for a QME in June and the Dr. rated me at 10% (this is before an MRI confirmed the surgery failed).
Will the Affordable Care Act impact my case at all?

Thanks!

Attorney Answers 6

Posted

I think possibly what you are suggesting is that you can settle out your future medical in workers compensation and still get your private insurance to cover treatment for your injuries under the Affordable Care Act. The answer is we don't know how the act will be interpreted but its certainly possible.

With respect to your question about how much money you will receive, there are a lot of variables that play into the equation. Is the insurance company willing and interested in settling out your future medical? If so, they will take into consideration what the average cost is for a lifetime medical treatment plus the QME rating. The QME rating may change as he/she should review the MRI.

With regard to how long will it take? Well as soon as 60 days and as long as a year if you are done pursuing medical treatment. The workers compensation process is long, I don't know enough about your case to give a timeframe.

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Posted

Your case sounds pretty complex. Your best bet is to consult a local workers' compensation attorney for a thorough review of your case. Good luck.

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Posted

This is something you need to consult an attorney for. 10% PPD for the knee when you don't have an ACL after surgery seems like a low rating. The period of time you are allowed to collect benefits is different from state to state but before settling you need to consider things like future medical care, future surgery and more important your future work capacity. IF you settle your case you foreclose the possibility of having your employer's insurance pay for future medical treatment. Before settlign your case you should consult a workers compensation attorney in your area, use the Find A Lawyer feature here to find an attorney in your area for a consultation. Good luck.

This response is to a question posed in what is considered to be a hypothetical situation. The response is for educational and reference purposes only and should not be relied upon as legal counsel. No fees are to be exchanged for this response and the attorney/client relationship has not been established in this context. You should contact an attorney within the jurisdiction of this matter for legal counsel.

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Posted

10% seems low. Have a local workers comp lawyer investigate. Avvo has a terrific "find a lawyer" tool to find a top-rated Avvo attorney. Good luck.

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Posted

10% WPI sounds low for this type of injury. I think you really need to consult with a good WC attorney in CoCoCo. He needs to look into Guzman analysis and a DFEC analysis. There are some great WC attorneys in Pleasant Hill and in San Ramon. Give them a call.

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Posted

The affordable care act should not impact your case. But you should hire a WC attorney. In my experience, your chances of getting a good settlement are increased when you have help. You can get a free consultation from someone out in CA.

I am sorry you are in so much pain.

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