Can you settle before MMI

I am still having problems after my initial surgery 8 months ago and with 4 months of physical therapy. My new doctor says I may need another surgery. My hardware is coming out (which was shown on an x-ray) Also I may have some nerve damage. I had a nerve test and am still waiting results.(my doctor wouldn't give me results over phone, wanted to talk to me in person. I have very little ROM in my injured hand. Also because of non use of my hand I may have a problem with my other hand as a direct result of the original injury.

I have a mediation soon. Before mediation I will know for sure what my doctor plans to do. I at least know that he will be fixing that hardware that is coming loose. (which is surgery)

So can you settle before MMI? If so what is considered? I have not improved 10% since I first started PT. I can not bend my wrist in any direction without severe pain. I am tired of dealing with everything having to wait for authorizations for either tests or continued PT.

yes you can settle before mmi. future lost wages and the value of future medical care are considered when settling.

So I need another surgery and more physical therapy. All that would be considered? What's determined for lost wages?

When you say future lost wages, how many years. Is it the 104wks? Is lost wages at the amount they paid me when I couldn't work or is it full wages at time of injury? My 2/3? pay was 200.00 a week for worker's comp. I was part time employee working about 20 hrs a week. Also when you say value of future medical care. What does that indetail?
Also most of the jobs I had previous. Cashier, cooking, secretary and even throwing news papers and delivering them to the stores, boxes and residents all require me to use both hands. There isn't much out there that doesn't require just one hand. Could or would they have to pay me for retraining??? and if so how is that amount calculated?

I know I am going to have another surgery. So I will basically be starting everything over again. They have to fix the tfcc repair because the hardware holding the ligament in place is coming out if it hasn't already and doctor says that it is likely the ligament tore (again) Which I would also need a MRI and arthrogram/floroscopy All which are expensive, especially surgery. Followed by a min of 3 months of physical therapy.

Can the employer/carrier attorney deny future lost wages and if so what are the reasons? I have been looking for employment and the ones that call me back or the ones I call back say they can not accomidate my restrictions which is no use of my hand. I have applied to at least 40 jobs. I'll be honest. I was released to go back to work a month after surgery and I told my doctor and employer that I couldn't because I was still in severe pain to the point I couldn't think it hurt so bad. I was taking vicodine and hydrocodone. So I also mentioned the fact that I couldn't drive or work because I would be doing those things under the influence.
OTC medicines did not even touch the pain.

So after I was fired, I applied for unemployment and after (the lady from unemployment)talking to my employer it was determined the reason I left my job was due to medical reasons. Which all that could have been resolved if they had let me "live out" my LOA which I still had several weeks left on that before they fired me.


as it stands right now and I know you are not a doctor. my wrist flex extention is 40 degrees/25 degrees and my grip strength is at 25# which I know is far from "normal"

What can I expect if they try to settle? (I have mediation soon)Do you know what would be an acceptable amount?

I would assume you have a lawyer if you are going to a mediation, so I have to ask, why isn't your lawyer answering these questions?

Settling a case is complicated. The insurance company isn't going to pay full value for the cost of any furure surgery because you aren't having it. You are saying you need it, but their attitude is, if you really were going to have more surgery, you would be having them pay for it. So medical care is vastly discounted.

Future lost wages are based on any time you might lose while recovering from surgery paid at 2/3 of your salary. Not the remaining 104 weeks.

The insurance company does not take into consideration the fact that you may have difficulty finding work, because they don't pay for loss of earning capacity.

If my clients need more surgery, I generally have the carrier pay for it so they can be paid while recovering. Most clients are very dissapointed by what they are offered at medication.

No I am not having surgery because I think the doctor is "working" with the insurance company. I asked my doctor when am I going to have my mri. (other tests etc..)surgery to replace the harware he smiles looks at me and says eventually. What the heck kind of answer is that???
My lawyer said they may try and settle for ten thousand. I will say this. Ten thousand would barely pay for 4 months of physical therapy I am going to need. So if the insurance company wants to pay for more tests. mri, arthrogram, x-rays, physical therapy, doctors visits, mileage, time out of work, prescriptions, their lawyers ...etc. I am sure you get my point! Then I say it is going to cost them alot more then 10000.00

If I were to go to the doctors and get a rating, as is right now with no future medical to fix anything, or physical therapy etc. they would render my hand useless.

I know my attorney works for me but I don't like to just call him and "bug" him for anything. Whenever I am ot treated the way I should I contact him and he takes care of everything.

I hardly call it bugging your lawyer to learn how to value a settlement. That is going to be the lawyers most important function.

Let me explain mediation another way. You don't want to have the surgery because the doctor works for the insurance company. Your carrier could care less why you are not having the surgery just that you are not. They will value the case based upon anticipated medical costs over the next few years and make an offer.

Say they offer you $10,000 to settle. You think it is too low, and want $50,000. They say no. The negotiation ends. You have no ability to go to court and get the judge to award you more money. The judge has no authority to make the carrier offer you more money. You will be faced with taking what the carrier offers, or you have the right to continue having them pay for your medical care. Period.

So the value of the case is based upon what the carrier thinks it is worh, not you. All your lawyer can do is try to pursuade them why it might be worth more. But the carrier's lawyer comes to the mediation with a set amount of settlement authority and that's it. So ultimately you either take their offer, take the medical care, or litigate whatever issue that brought you to court in the first place.

It's very lopsided, and I represent claimant's exclusively.

"No I am not having surgery because I think the doctor is "working" with the insurance company. I asked my doctor when am I going to have my mri. (other tests etc..)surgery to replace the harware he smiles looks at me and says eventually. What the heck kind of answer is that???"
When I said this I meant the doctor is putting it off cause he "works" for the insurance company. Not that I don't want it.
My wrist isn't getting any better because of that problem so yes I want it fixed. Yes I want the surgery.
So from the doctors notes and I am sure the carrier's lawyer has a copy. He recomends these test and the surgery and more physical therapy. So wouldn't all that be anticipated medical costs? and that's just over the next few months.

I greatly appreciate all your responses.

Yes they will consider future surgeries. But if it's in the next couple of months, and they are going to make any offers of settlement at less than fee schedule, then why not let them pay for the surgery?

For instance, lets say it's a $10,000 surgery if you were to pay for it out of pocket.

Workers comp only pays $4,000 for that surgery because they pay at a discount rate. Comp medical providers get a huge break on payments just like Medicare.

So if their exposure is $4,000 and you are trying to settle BEFORE surgery, they will offer $2,500 because they don't know if you are really going to have the surgery or pocket the money.

Now you have $2,500 in hand, for a surgery that will cost you 10K if you were to pay cash for it. What if there are complications? The need for more surgery?

It makes more sense to let them pay for it.

It makes great sense for them to pay for the surgery. Mediation was because my lawyer filed for petition for benefits. They offered an amount and my lawyer said no deal. But I know after mediation if the two parties can not agree it then goes infront of the judge. The lawyer for the employee/carrier wants another mediation though.
So while in mediation the carrier lawyer calls my doctor to see if they can make me an appointment (an earlier one cause I have one later this month) and see if they can get the doctor to schedule surgery. but he said he wanted me to finish out my physical therapy I have before he does that. Which i only have one visit left. Physical therapy is not working. I am only going backwards. They had no success in making me an earlier appointment. However my attempt to make an earlier appointment worked.
I am not trying to get rich. I want my hand back to normal. I want to be able to play with my son and take care of home the way I used to be able to.
I know there are alot of people out there who "fake" the system and that hurts the people that aren't faking.

I know one thing the "machine" I got hurt on should be destroyed. i had been hurt on it sevral times and so has many other employees not to mention customers as well.

Laymans guess:

1. If you are looking at a potential long future of difficult problems it make little sense to settle for peanuts now and be faced with paying "retail" for future care.

2. If that machine has a long history of worker and customer injuries --there may be other exposures the employer may not want to address in open court? (True WC puts a damper on things--but employer may have exposure he rather not address?)

3. I agree some master the art of faking it--and it makes it harder for those who don't. (Usually its back injuries?)

4. Lets assume hand will never be normal--what about payments for adaptive retraining for some new skill area? And I don't mean a weekend miracle course designed to make you a millionaire by learning to flip houses

CAN you?  Sure.  But why on earth would you want to  settle before MMI has been reached?  Makes no sense.