what does it mean

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Latest post Sun, Mar 2 2008 8:19 AM by Paul TR. 8 replies.
  • Thu, Feb 28 2008 7:49 AM

    • tammy6407
      Consumer
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    • NY
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    Question [=?] what does it mean

    What does it mean when your doctor uses the terms mild, moderate and marked in reports for you injuries . My treating doctor has me moderate to marked {am i say ing it correctly?} I dont understand it . Also, workers compensation has now hit me with wanting to settle my claim. I dont have to do i ? I am still receiving treatment for my injuries and it could get very costly because i dont feel i am getting better by any means . I kinda feel like my life has changed so much in what i am able to and not able to do that i couldnt put a number figure on what its worth to me . I am certainly not interested in settling at this time . Sometimes they make you feel like its a money deal they tell you they will give you X amount of money to close out your case ..meanwhile i am still suffering from my injuries and receiving treatment .
    Then i was told by my doctor for the amount i am receiving right now i could go anywhere and get a partime job and make that amount . Yes...that probably is correct BUT finding a job with in my limitations is difficult and finding someone who is willing to hire you . I cannot only sit for short periods of time and can only stand for short period of time . the medication that i need to take causes drowsiness and if i dont take the medicine i find it dificult to make it thru a complete day with out periods of having to lay down to ease the pain . The Med i take at night leaves me cloudy and foggy the next morning and i am not comfortable with driving . more than not the feeling lasts a good part of morning and sometimes most of day . any help is appreciated. Also if i were to go back to work with just any job after i settled and the injuries that i have prevent me from carrying out the job then what? I cant go back on it because my case is closed because i settled ? is that how it works?
  • Thu, Feb 28 2008 9:20 AM In reply to

    re: what does it mean

    The WCB Medical Guidelines give degrees of disability. Mild (25%), Moderate (50%) and Marked (75%) are the partial rates, and Total (100%). Some doctors will state "moderate to marked"--which gives some room to argue that this stands for a marked disability. Some judge and carrier will view this as a 62.5% disability, or a 66.6% disability. Depends on the locality.

    You cannot be forced to settle.

    If your doctor is encouraging you to find employment, you should follow through. If you have a partial disability (which you doctor says you have), you are obligated under the WC laws to seek employment within your restrictions. Finding employment can be a true benefit to you financially. Not seeking employment would give the carrier ground to suspend payments until you start looking for a job.

    The benefit of a job is the reduced earnings that are paid while you are employed with a lesser pay. Let's say your AWW is $600. This would make your temporary total rate $400. A moderate to marked disability, read as a 62.% would merit a continuing payment of $250. If you found a job which was part-time, within your restrictions, and something you enjoyed doing, which paid $200 a week, you would receive an increase in your WC payemt to $266.67 a week, as the carrier would owe you 2/3s of the reduced wages, which would be $400 ($600 AWW - $200 earnings = $400 reduced earnings). If the job you found paid $150, and was an accurate reflection of your wage earning capacity, your WC payment woud increas from $250 to $300.

    So . . . follow your doctor's advice. It's good advice. Look for the job you'd enjoy. Work in an area you'd find enjoyable. If you're a reader, look in libraries, or book stores. If your into sports, look at sporting-goods stores or sports-card shops. If you're into cars look at car sales. If you're into cooking, look at gourmet shops, or kitchen supplies. Find a job you'll enjoy, and the WC disability you have will cause you to be subsidized while you pursue a new career. Time to take the lemons you've been dealt and make lemonade.
  • Thu, Feb 28 2008 10:06 AM In reply to

    • tammy6407
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    • NY
    • Posts 36

    Sad [:(] re: what does it mean

    Yes i am looking for work i am working with vesid and career visions to find work . I have applied to numerous jobs and cant seem to find anyone to hire me . Its not my doctor who is encouraging me to work its workers compesation. My lawyer suggested it too. Its not like i havent looked i keep a log of all the jobs i have applied for but because of my limitaions finding work has been difficult . In all honesty with having a back and neck injury who really wants to hire someone with those complications ..i am finding so far noone . Its very discouraging . They act like you can just go out and get a job ...thats not how it works i cant even seem to get interviews. i am working on getting up to date doctors reports so i can be retrained . I cant sit or stand for only small periods of times and need to take frequent breaks from both . walking is difficult which causes me back pain . and sitting causes both back and neck pain . I do want to find something i can do with out causing extra pain or worsen what i have going on already . I have days where just doing the small tasks around my house is hard for me and find many days i have to lay down to find relief. The man i am working with from Career visions have commented that finding me work is going to be difficult
  • Thu, Feb 28 2008 9:46 PM In reply to

    • NYMike1
      Consumer
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    • Joined on Sun, Jul 2 2006
    • NY
    • Posts 253

    Feedback [*=*] SSD

    Hope your looking into Social Security Disability at this point or have started the application search. If you haven't, my advice is to get a SSD atty. and go that route instead of trying to do it yourself.
    I'm in the same boat as you injury wise it sounds like.
    I'm with VESID also and it is definitely hard to grapple with a radical career change. But like Scott said, lemonade is the way to go.
    I know you already know this.
    Good luck
  • Sat, Mar 1 2008 12:14 PM In reply to

    • Paul TR
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    • Joined on Thu, Aug 10 2006
    • Posts 61

    Question [=?] re: what does it mean

    I recently checked my eCase and saw a scheduled IME for this coming March 10 (nothing in the mail yet March 1st). I have a deformity of my ankle as a result of my injury and surgery in Jan. '06, and have been determined by my doctor to be 50% moderate and have been since May of '07. This was determined after my last IME where their doctor actually had me at a greater degree of disability than my attending physician. My AP had me at mid-marked or 62.5%.

    I am working part time and going to school full time, earning a degree in Chemical Dependency Counseling this coming December. I receive reduced earnings through the NYSIF and have been treated fairly to date. My question is, every time I attend one of these exams (and I use the term exam lightly) it seems to be a method of reducing my determined degree of disability. If this exam does what I think and they try to reduce my rating, does this affect reduced earnings or it still 2/3 the difference of my AWW determined by my present earnings up to $400.00 if I continue to work within my restrictions?

    It has been two years since my accident and one year since my last surgery. I am still deemed temporary by my attending physician, who has repeatedly told me that the only option left is fusion if my present state persists. I am reluctant to have this done as I have heard a number of horror stories but.... if this is the only way to stop the constant daily pain or get off the pain meds I may have to consider it (after I earn my degree, [need to get a career that will support my life). Is this possibly a move from the IC to maybe instigate some kind of closure or settlement?

    Unfortunately I see a storm brewing :-(

  • Sat, Mar 1 2008 2:01 PM In reply to

    re: what does it mean

    A reduction in the temporary degree of disability should not affect your RE payments. The only way it would is if there was a significant change in your disability to the extent that you could be working more, e.g. a finding that you can work 8 hours a day, whereas you currently limited to four hours a day. This would be unlikely, as your schooling and job are full-time, especially when combined.

    What may be more of a problem is the possibility of an SLU opinion. If the IME believe you have reached maximum medical improvement, are stable, and can be found to have a permanet loss of use of the foot/leg, then the carrier can argue for the award of that schedule, and limit their future payments. For instance, if the IME said a 50% loss of use of the leg, that would equate to 156 weeks of compensation. If there is no protracted healing period, that would be the maximum benefit the carrier would be responsible for paying if the SLU were implemented.

    As soon as you receive the IME report, make an appointment with your attending to review the IME opinion. Your doctor may disagree with any opinion of an SLU, as it sounds as though he does not see you as being at MMI, but rather is contemplating a future surgery. In addition, if there is an instability, or continuing pain syndrome, those are reasons to not do an SLU, and rather do a classification.

    That being said, if you expect to get a job when you graduate which will pay well, and exceed your AWW, there may be a reason to accept an SLU, as the payments would continue to the maximum number of weeks allowed by the SLU regardless of your wage level. If you are classified, and earn more than you AWW, there are no benefits due to you. Note that the medical continues in either case.

    Talk to your lawyer. There is some strategizing to be done . . .
  • Sat, Mar 1 2008 2:33 PM In reply to

    • Paul TR
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    • Joined on Thu, Aug 10 2006
    • Posts 61

    Question [=?] re: what does it mean

    Scott,

    I do have moderate + pain everyday and am on meds to help alleviate it. At this point I am not interested in any $$$ just my future (although everyone has a price...so it has been said). Can I be forced into an Scheduled Loss? If this was how it went, does this type of award add in the payments already received for the past two years?

    Thanks in advance.....

    Paul Tr
  • Sat, Mar 1 2008 9:17 PM In reply to

    re: what does it mean

    If the SLU is awarded, the carrier will take credit for prior payments. However, if there is a long period of TT payments, there may a protracted healing period to add on to the SLU. Talk to your lawyer, as this gets complicated, and you need real data to determine how to go.

    You do not have the ultimate decision of whether you accept an SLU or classification. The judge will decide that, based on the medical evidence, unless the parties agree. There are times when it is advantageous for a worker to take an SLU, and the carrier will agree. There are times when it is advantageous to take a classification, and the carrier will agree. There are also those times when the carrier does not agree, and you have a battle of the doctors on your hands.

    Best to wait and see what the IME says. If you get a chance to meet with your doctor prior to the IME, you might be in a better position to advise the IME as to the reasons why your doctor believes you are not at MMI, and his reasoning for the proposed future surgery.

    Good luck . . .
  • Sun, Mar 2 2008 8:19 AM In reply to

    • Paul TR
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    • Joined on Thu, Aug 10 2006
    • Posts 61

    Feedback [*=*] Thanks Scott

    Again, thanks for taking your time to answer. I already know the reasons for the possible surgery, as I have discussed this with my doctor for almost a year now.

    Thanks again,

    Paul
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