Work comp confusion

What is the name of your state?Florida

To make this short as possible. Was injured on job on July16,2001. Have done everything the insurance co. said including letting work comp doctor go in my knee 4 times. I went from walking in pain to being in a wheel chair. The last surgery was suppose to be on Jan 20th but when I went to the dr. he told me he didn't know how to repair the problem and he also told the insurance carrier the same thing, so I stopped the surgery. Now the insurance adjuster has on her own put me at a mmi rating of 13% and stopped my checks ( my doctor has not released me and has told them my statis is still no work and I am to keep using the wheel chair.

Question1).How long before my case runs out?

Question2). Can insurance co. just decide to stop checks?

Question3). Do I have to accept a offer in front of work comp Judge?

Question4).How do I figure what I am entitled to since I am very unlikely to ever work again?

Question5).Would medical be seperate from the monetary part.

I have been to a Social Security Dr. and he does not think it can be fixed.I am waiting to her about disability from them. I have a lawyer I have only seen once and talked to about 3 times , this is the reason I am asking so I know what is going on for myself, he offers no information and I don't know what to ask him. We are set to go before the work comp Judge on Nov.1

Thank you for your time and effort to answer it is appreciated. Hope to hear from someone soon!

I'm not %100 postitive on this since all state laws are different.. I don't think your workman's comp adjuster can put you at MMI, that is something the doctor has to do.. The doctor will do range of motion test to detrmine what your rating will be.. In my opinion I would consider talking to another attorney..

To make this short as possible. Was injured on job on July16,2001. Have done everything the insurance co. said including letting work comp doctor go in my knee 4 times. I went from walking in pain to being in a wheel chair. The last surgery was suppose to be on Jan 20th but when I went to the dr. he told me he didn't know how to repair the problem and he also told the insurance carrier the same thing, so I stopped the surgery.

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Have you obtained a second opinion?

Now the insurance adjuster has on her own put me at a mmi rating of 13% and stopped my checks ( my doctor has not released me and has told them my statis is still no work and I am to keep using the wheel chair.

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Only a physician can give you a MMI in FL, so how do you know it was the adjuster? Your MMI will be in your medical records.

If you were receiving TTD payments, those payments are only available for about 2 years. Then, the injured worker must have an extension for their continuation, which would have been done by your attorney. Once you reach MMI, the TTD payments stop and you should receive indemity payments based on your impairment rating, which should be half the amount of your TTD and ONLY for a certain amount of weeks thereafter.

Question1).How long before my case runs out?

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Unknown, unless you settle and release the carrier from any further liablity for your injury.

Question2). Can insurance co. just decide to stop checks?

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Answered above.

Question3). Do I have to accept a offer in front of work comp Judge?

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Why are you having a hearing rather than mediation, which is always first?

Question4).How do I figure what I am entitled to since I am very unlikely to ever work again?

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That is something that your attorney and w/c adjuster and their attorney will be negotiating.

Question5).Would medical be seperate from the monetary part.

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It depends on how a settlement is written and whether or not you leave future medical open for your injury in the settlement.

I have been to a Social Security Dr. and he does not think it can be fixed.I am waiting to her about disability from them.

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This is totally different than what you are doing with the w/c case even though it can affect the w/c case.

I have a lawyer I have only seen once and talked to about 3 times , this is the reason I am asking so I know what is going on for myself, he offers no information and I don't know what to ask him. We are set to go before the work comp Judge on Nov.1

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Sounds like this is one of them attorneys that advertise on TV. If so, you really need to consider firing him and/or going to his office and not leaving until you see your attorney and then firing him.

Thank you for your time and effort to answer it is appreciated. Hope to hear from someone soon!

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You are welcome. You can read FL w/c statutes at this link www.flsenate.gov/statutes

Much appreciated help

Answer to your question This was the second choice that I was entitled to, but, he is saying he is not qualified to do the need surgery and told the insurance carrier this.

The doctor never put me at mmi he still has me at no work .adjuster sent me notification and since the doctor didn't she is the only one who can and this is not the first time she has done this. Last time she said it was a mistake and she was sorry. I do not believe that! They have paid 72 weeks of 104weeks.

We already went to mediation and they said they are done. They have done enough and they are refusing the settlement offer that my lawyer feels I am entitled to. I did not get my lawyer from a tv ad I used the phone book.If I fire him then I have to pay him and I really don't have money for that either. Thats why I came here to ask questions to let him know that I am not stupid and even though I am not a brain at this at least I have some knowledge.

Answer to your question This was the second choice that I was entitled to, but, he is saying he is not qualified to do the need surgery and told the insurance carrier this.

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Then, why have you not been to a surgeon that can do the surgery if that is what you want done? A good w/c attorney can get you to a surgeon that is NOT on the w/c carrier's list of providers.

The doctor never put me at mmi he still has me at no work .adjuster sent me notification and since the doctor didn't she is the only one who can and this is not the first time she has done this. Last time she said it was a mistake and she was sorry. I do not believe that! They have paid 72 weeks of 104weeks.

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You still should be receiving compensation via an extension of TTD or imdemnity payments. Imdemnity payments are payable after reaching MMI.

We already went to mediation and they said they are done. They have done enough and they are refusing the settlement offer that my lawyer feels I am entitled to.

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Then, you have seen your attorney more than once? Going to mediation already was important info excluded in your original post. Just exactly how does your attorney know what you are entitiled to when you do NOT have an MMI from a w/c physician?

I did not get my lawyer from a tv ad I used the phone book.If I fire him then I have to pay him and I really don't have money for that either. Thats why I came here to ask questions to let him know that I am not stupid and even though I am not a brain at this at least I have some knowledge.

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Good attorneys can be obtained from the phone book. From what you have written about your attorney, I think he/she is not that good. Good attorneys return your phone calls or have their assistants return your call with an answer to your questions. If you hire another attorney, the new attorney will work out the fees with the one you fire. It's up to you whether or not to keep your current attorney.

If I go outside the workcomp doctors who has to pay for the surgery?


The first time I met him was at mediation on June5. I usually talked to his paralegal on the phone.

I don't know how he knows I know he has met with my doctor and has taken his deposition what ever that means.

I want you to know I appreciate your replys.

If I go outside the workcomp doctors who has to pay for the surgery?

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If your lawyer finds you a surgeon outside of your workman's comp insurance, they still pay.. A lawyer can get you more options than you could over the phone with the insurance company..

The first time I met him was at mediation on June5. I usually talked to his paralegal on the phone.

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You hired an attorney without even meeting with him? And please don't say no, I hired him after talking to his paralegal... A good attorney will meet with you look over your medical records and review your case, then give you his/her opinion on what he/she thinks they can do for you... You don't have to hire an attorney just cause you talked to one..

If I go outside the workcomp doctors who has to pay for the surgery?

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Work comp will. This really needed to be done prior to mediation or right after mediation. The biggest problem you have is that you have a trial scheduled. There is not enough time to jump through the hoops required for an IME by a physician not listed on the w/c carrier's list of providers.

The first time I met him was at mediation on June5. I usually talked to his paralegal on the phone.

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Sorry to also inform you, you have a lousy attorney. Haven't you heard of a pre-meditation conference? This is something you do face-to-face with your attorney and not his assistants as should be the initial consultation. What county in FL do you live?

I don't know how he knows I know he has met with my doctor and has taken his deposition what ever that means.

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What is crucial is one's impairment rating and cost of future medical treatment for an attorney to evalute the worth of a case. This is documented in the medical records. Didn't the defense take your deposition? This should have been done prior to mediation too. Now are you getting the hint about you having a lousy attorney?

I want you to know I appreciate your replys.

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You are welcome. I am very curious to know what your attorney has said your claim is worth.

tjr5150 said:

If your lawyer finds you a surgeon outside of your workman's comp insurance, they still pay.. A lawyer can get you more options than you could over the phone with the insurance company..

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It's more complicated than this in FL. Because the OP is so far along in the case, this option can only be attempted if the trial is stopped/delayed and by getting a very good w/c attorney.

Originally Posted by tjr5150
You hired an attorney without even meeting with him? And please don't say no, I hired him after talking to his paralegal... A good attorney will meet with you look over your medical records and review your case, then give you his/her opinion on what he/she thinks they can do for you... You don't have to hire an attorney just cause you talked to one..

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Looks like the OP did hire the attorney without a face-to-face consultation with the attorney. The w/c attorney that took over my case does not advertise, even in yellow pages, nor is listed in the yellow pages. He doesn't have to. He was found by referrals from attorneys that did not do w/c.

really confused now?

When I originally started this case I met whom I thought was the attorney who was gonna do my case ,signed papers and we proceeded and just recently is when I found out he was not the attorney,( on their letterhead it says hes a mediator.( I never paid any attention to that) The man I am now dealing with is my lawyer and he apologized for not meeting me sooner especially after he saw my leg.

He says he is going to ask for 250,000.00( which I feel is not enough since I have 11 years before I could retire) plus medical plus fees for him. All I know is this has destroyed my life and I am so frustrated because I am unable to even go to the grocery store or even walk my dog anymore.I am used to being very independent and cannot anymore. No I donot know anything about legal matters of any kind.

I am going to call tomorrow and ask why they have not got me a doctor outside w/c to see what their answer will be. I do know they do not like me calling them.

The county I live in is Hillsborough county

twinkie152 said:

When I originally started this case I met whom I thought was the attorney who was gonna do my case ,signed papers and we proceeded and just recently is when I found out he was not the attorney,( on their letterhead it says hes a mediator.( I never paid any attention to that) The man I am now dealing with is my lawyer and he apologized for not meeting me sooner especially after he saw my leg.

He says he is going to ask for 250,000.00( which I feel is not enough since I have 11 years before I could retire) plus medical plus fees for him. All I know is this has destroyed my life and I am so frustrated because I am unable to even go to the grocery store or even walk my dog anymore.I am used to being very independent and cannot anymore. No I donot know anything about legal matters of any kind.

I am going to call tomorrow and ask why they have not got me a doctor outside w/c to see what their answer will be. I do know they do not like me calling them.

The county I live in is Hillsborough county

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Whoa, there twinkle. The request for seeing a doctor outside of the w/c system needed to come from you, not your attorney. You need to find out if there is an impairment rating. That is what the value of a claim is determined by. Can anyone take you to your attorney's office so that you can look at your medical records?

Your claim was opened prior to FL changing it's definition of an injured worker being classified as totally disabled. Knowing if the old classification is being used for your case important. Now, even if you lose a leg, an arm, or an eye, under FL new guidelines, you are no longer classified as being disabled. These guidelines have nothing to do with SS guidelines.

I'm sending a message to someone regarding a w/c attorney in your area. Again, it's probably too late. Read through the impairment ratings and people's settlements on this forum. Without you being classified as totally disabled by w/c, I haven't a clue how your attorney thinks he's going to get what he is asking for.

I do not have an mmi rating because there is still more surgery to be done.Like I said w/c says they are not paying for anymore surgeries? They feel legally they have done enough?I might have been the one to go to another doctor but the lawyer should have told me I could do that.I did call other doctors here to get an opinion but every time I would tell them for what they would denie. One says he doesn't do w/c cases,one said he does not clean up someone elses mistakes,there is not a lot of reconstructive surgeons that deal with torn tendons and patella repairs in tampa bay area

twinkie152 said:

I do not have an mmi rating because there is still more surgery to be done.Like I said w/c says they are not paying for anymore surgeries? They feel legally they have done enough?I might have been the one to go to another doctor but the lawyer should have told me I could do that.I did call other doctors here to get an opinion but every time I would tell them for what they would denie. One says he doesn't do w/c cases,one said he does not clean up someone elses mistakes,there is not a lot of reconstructive surgeons that deal with torn tendons and patella repairs in tampa bay area

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Again, the request had to come from YOU, not your attorney. Then, you would have to find a surgeon who would take w/c. Because w/c pays so much less than other insurance coverage, a lot of surgeons won't take w/c. Again, it's way to far in your case to acquire another attorney. I wish you the best with your trial.

Thanks again for the info

WC in Florida and legal counsel

Hello Twinkie My name is Marie and I just read all your posts> I was wondering how you made out on this issue?