Legal Question in Workers Comp in California

I was injured at work in January of 2012. My employers automatically tried to dispute my workmans comp case, but after a little over a year, I finally got approved, and ended up getting a lamenectomy and spinal fusion. After a four year process, multiple procedures, and being told I will need to give up my career, and get a new job, we're finally settling. However, the number they're offering me seems insanely low. I've spoken to my current lawyer, but he seems to be too eager to get me to accept the settlement and just close the case, which is odd to me. He also informed me that if I pushed for too much more for my CNR, the defense would completely pull out the settlement, and I would be forced to take the Stipulated Award, which basically leaves me with nothing but medical coverage. I don't expect some massive chunk of money to be dropped in my lap, but after 10 years of education and working, I'd like to be at least collect enough to cover my return to school, considering the sub displacement benefit wont even make the tiniest of dents against future student loans. I've never been through anything like this, but I have spoken to several people that have, and when they came to settlement, they were able to request the numbers they found fair. In my case, my lawyers are urging me to tip toe around the offer already made, and not to ask for much more. I don't understand this. Especially when everything I google, shows people who have had the same exact injury, same exact surgery, and settled in less time, end up with triple the amount asked. Is this normal? Should I approach this differently? I'm not sure what to do.


Asked on 5/06/15, 4:34 pm

1 Answer from Attorneys

Nancy Wallace Nancy Wallace Atty at Law

The number the insurer offers depends in good measure on the future medical treatment for which it will have to pay. If you want to maximize your offer, BE A ROYAL PAIN. See the Treating Physician on the MPN every 30 days instead of every 42 days, insist. Have the MPN Treating physician issue at least two Request for Authorization Forms every 30 days (acupuncture, meds, braces, a new mattress, a new cane, work hardening, strength training). BE A BIG EXPENSE for the insurer to keep paying companies to review the requests and paying the doctor for the report each month...and appeal every denial. The offers are lower today because your Assemblywoman and State Senator and Governor Moonbeam put into play a new system where nearly all treatment is denied, so because they have to pay for so little now (Maximus doctors -- nameless, faceless -- deny 80% of all requests so far on the Indpendent Medical Review IMR process), so the adjuster has no reason to boost up the 'buy out' of future medical until the law changes. That said, you can get a new lawyer, you are not married to this one who is clearly weary with you. I show people what they can expect at trial, in a stipulations with request for award and a compromise & release agreement ... if the Permanent Disability is not high enough, you get this attorney to return to the treating physician or the AME and confront them at a deposition with the Whole Person Impairment factors they overlooked. In addition, give the attorney a number that you expect, and just take the Stipulations With Request For Award when that attorney fails to get that figure for you, and attempt the Compromise & Release agreement if and when the Governor and State Legislature change the law and make treatment accessible again for injured workers.

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Answered on 5/06/15, 5:21 pm


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