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re: Workers comp injury question (closing the case)

Posted on 6/25/14 at 11:31 pm to
Posted by meansonny
ATL
Member since Sep 2012
25568 posts
Posted on 6/25/14 at 11:31 pm to
I think people are confusing workers comp and employer liability claims.

Work comp is pretty much set and firm so long as it is classified properly. You are rarely going to benefit yourself by getting an attorney, and by that I mean you are more likely going to be getting less money.

Employer liability is a different story altogether. And if you don't have an attorney talking to you, then you are crazy.

I'm not in this field, but my current supervisor used to be an adjustor for work comp.
Posted by Mr.Perfect
Louisiana
Member since Mar 2013
17438 posts
Posted on 6/26/14 at 9:48 am to
quote:

And if you don't have an attorney talking to you, then you are crazy.


tap the brakes holmes. You can always go get an attorney. An educated individual can usually negotiate a better settlement with a carrier than what they ACTUALLY get once an attorney takes their huge cut. We are talking about STATUTORY coverage's here.

Now, I agree and pointed out early in the thread that this could revert back to employers liability.


Keep in mind that YOU can sue the employer under the EL policy. The case would be centered around damages for care and loss of service. Tell the court she can't do that "thing" with her leg anymore that made you fall in love This section of the policy is generally the loss of consortium area. But the point is if you two were used to taking long walks, jogging together, etc., and now that is not possible, this section of the policy is there to respond to those claims for damages.


Back to Workers Comp

An Alabama leg, by schedule is something like $44,000 if i recall correctly.

For scheduled injuries (a leg qualifies), it is 2/3 of AWW x Percentage of disability for the number of weeks for which compensation is due per schedule, with a maximum of $220 per week.

So the MAX WC payable would be $44,000 regardless for the Permanent Partial Disability.

lets say she makes 100K.
AWW would be $1,923.
2/3 of that would be about $1,270
$1,270 * .05 = $63.50
$63.50 * 200 weeks of Perm Partial = $12,700

If she makes half that, well half it pretty much.
Posted by Mr.Perfect
Louisiana
Member since Mar 2013
17438 posts
Posted on 6/26/14 at 9:53 am to
quote:

bamarep


Just wanted to tell you that these situations ALWAYS suck. It is our body and life and to see a "scheduled" amount that a finger, arm or leg is worth is always insulting and shocking.

Best of luck and I hope you and her leave the situation feeling like you were treated as a human being and not an item on a chart.

And I would not really worry too much about wanting to be "good to the company". This is the reason for insurance. I am sure they are a fine company and great people, but you have to make sure you protect yourself.

And if she feels she is terminated in the near future for making a claim then an attorney would have a field day on the employment practices liability policy (if there is one) or the ownership directly (if no policy)
Posted by meansonny
ATL
Member since Sep 2012
25568 posts
Posted on 6/26/14 at 10:08 am to
quote:

An educated individual can usually negotiate a better settlement with a carrier


Wait... I'm lost.
Where are we again?
And where do we find the educated people?

I said that an attorney will add zero value to a work comp claim (actually, he/she would detract from that value).

But a litigious settlement means that you have to be prepared to go to court.
I'm not telling anyone to get an attorney. But they absolutely should allow an attorney to make his/her sales pitch to show the value added by putting real meat behind a legitimate liability lawsuit.

I don't like attorneys. I see bad attorneys everyday tell people that they have no case when all they are saying that it's not worth the attorney's time to get involved, yet the plaintiff has legitimate claims to tens of thousands of dollars.

If there are legitimate long term repercussions resulting from the negligence or direct decisions of the company, you are going to have to remove onesself from the work comp aspect and go directly at the employer from a liability perspective. That means defining damages (and I don't want people to trump up damages) and determining if the employer can satisfy those damages without going to court.
Posted by Mr.Perfect
Louisiana
Member since Mar 2013
17438 posts
Posted on 6/26/14 at 10:20 am to
quote:

If there are legitimate long term repercussions resulting from the negligence or direct decisions of the company, you are going to have to remove onesself from the work comp aspect and go directly at the employer from a liability perspective.


with you 100%

quote:

I said that an attorney will add zero value to a work comp claim (actually, he/she would detract from that value)


agree
Posted by bamarep
Member since Nov 2013
51794 posts
Posted on 6/26/14 at 1:05 pm to
Thanks for the input MrPerfect. Just curious how they equate the loss of any activities to how much she makes. I mean, whether she makes $20K or $100K that's really irrelevant to her loss of activities away from work.
Posted by Mr.Perfect
Louisiana
Member since Mar 2013
17438 posts
Posted on 6/26/14 at 3:03 pm to
quote:

Just curious how they equate the loss of any activities to how much she makes. I mean, whether she makes $20K or $100K that's really irrelevant to her loss of activities away from work.


the calculation was on the Workers Comp side. Those numbers are pretty easy to determine a range for.


The suit YOU could bring would be decided by a judge or jury on the Employers Liability side. This is a number that is determined in the court system and you must prove negligence. So if the employer was negligent and your spouse was injured, the WC policy has parameters for what is compensable for her damages. YOU on the other hand can sue her employer under EL for the loss YOU sustained because of her injury.

Again, the best way to think about this is if she were paralyzed, WC will cover her earnings, medical, etc. But what about the fact that you and your wife can no longer have a normal (no such thing if married) sexual relationship? This is where you can sue the employer under EL for the consequential damages sustained by you due to her work related incident.

In my personal opinion a 5% impairment is not going to be a billion bucks, but I do not know your situation.

best of luck
Posted by Mr.Perfect
Louisiana
Member since Mar 2013
17438 posts
Posted on 6/26/14 at 3:21 pm to
By the way.... * and confirm this with an attorney *... I believe Alabama is a pure contributory negligence state.

If that is the case and, in the course of the trial/hearings, your spouse is found to be even 1% liable for her injuries, there is no recovery of damages available. (this has nothhing to do with WC)
Posted by sabansucks
Hammond
Member since Feb 2008
225 posts
Posted on 6/28/14 at 12:12 am to
You should just keep the medical portion open. Which means you won't receive any money, but atleast that will be covered. I was hurt almost 10 yrs ago. Had a L2 burst fracture in my back, among many other things that were broken. I got nothing other than the medical bills paid. It sucks but that's the workers comp system. The only thing that it pays is 2/3 of your loss of wages x's 10 years. There is no payment for partial disability, pain and suffering, or future pains.
Posted by Bama54
Neverland
Member since Nov 2011
5021 posts
Posted on 6/28/14 at 2:24 pm to
What matters is how it affects her ability to do her job. This is not a liability case. You may do better with a rating to the leg itself. Getting married does not give you the right to speak for your wife. She still has to give her permission to talk to you. Depending on what she does the voc rating would not be great. It would be more if her job were something that required the use of her leg. In a W/C case in Alabama, the recreational activity has no bearing.
Lawyers are limited in Alabama on the % they can get on w/c cases and a big bang attorney would not want to take a case like this unless some 3rd party shares responsibility.
They may offer more to get you to settle the lifetime medical, but soundsvlikevshe may continue to need some medical care so I wouldn't do that. Alabama w/c has lifetime medical and I understand in the last few years judges hearing the settlement cases aren't to quick to agree to this anyway. Any settlement has to go before a judge.
This is coming from a retired claims person.
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