by Guest » Tue May 06, 2008 01:50 am
Hi, 3 weeks ago (April 21) I was walking down a flight of stairs at a business office complex. They were tile steps (covered by tile). Well I got about 3 steps down and one of the tiles on the step shattered and sent me flying down about 4 more steps. I immediately took a photo and called the property management. They said "oh we are sorry we knew the steps had hairline cracks and we actually have someone schedule to come out Wednesday" (April 23). There was no sign or warning or anything. The fact they knew about it sort of upsets me. It could have been a much older person and they could've been seriously injured. Anyway I went to the doctor the next day and have been diagnosed with sciatica. I feel miserable I have shooting pains down my right leg and into my feet. I am on percoset and valium and flexeril as well. I have missed 3 weeks of work (I am contracted through a place so I have no benefits) Im a 1099 employee. The inurance company (Chubb) has told me they have accepted liabilty for the claim. I also have an email from the property management with before and after photos of the steps and them saying they were sorry and that they did have it scheduled for repair prior to my falling (which shows negligence I would assume). Here is my concern:
The adjuster said they will do nothing until ALL medical is finished then they will determine a settlement amount based on lost wages, pain and suffering, medical bills, etc. However they will not do anything before my medical is done. She told me that if I could find someone who would do medical treatment on a lien then they would simply pay them directly when the settlement is done. That is fine, up to now I have been paying out of pocket but last appt my Dr. stated I may need an MRI and/or physical therapy. I am sure I can find someone to do this on a lien basis. I am really starting to feel this financially now and as much as I don't want to just hurry through this and settle but I feel I don't have much of a choice. My pain is pretty bad and I cannot work because I have to lift heavy objects. Should I find a way to make it though financially and take this until I actually feel better or would it not really effect the final pain and suffering amount? Also does the fact they knew about the steps and didn't close them off counts for anything? I have a 9 mo old daughter who I cannot even pick up right now and this is really effecting my life at this point. It really stinks and I read a lot of stories of people getting their wages, medical and like $1000 dollars. That just doesn't seem fair. I am open and appreciate any advice. Thank you in advance.
Robert
The adjuster said they will do nothing until ALL medical is finished then they will determine a settlement amount based on lost wages, pain and suffering, medical bills, etc. However they will not do anything before my medical is done. She told me that if I could find someone who would do medical treatment on a lien then they would simply pay them directly when the settlement is done. That is fine, up to now I have been paying out of pocket but last appt my Dr. stated I may need an MRI and/or physical therapy. I am sure I can find someone to do this on a lien basis. I am really starting to feel this financially now and as much as I don't want to just hurry through this and settle but I feel I don't have much of a choice. My pain is pretty bad and I cannot work because I have to lift heavy objects. Should I find a way to make it though financially and take this until I actually feel better or would it not really effect the final pain and suffering amount? Also does the fact they knew about the steps and didn't close them off counts for anything? I have a 9 mo old daughter who I cannot even pick up right now and this is really effecting my life at this point. It really stinks and I read a lot of stories of people getting their wages, medical and like $1000 dollars. That just doesn't seem fair. I am open and appreciate any advice. Thank you in advance.
Robert
Posted: Sat May 10, 2008 12:07 pm Post Subject:
he is pretty sure
Or is his diagnosis enough
no it's not...should I find a way to get it done.
yes, and there shouldn't be any trouble, the mri folks will file a lein against your settlement.I am just wondering what is going to be better for the adjuster to figure out amounts. Also, IF I have the MRI and it is not not a herniated or bulging disc and just nerve damage is that going to be a lower grade of injury. Or would it be better to just leave the doctor notes for that and not have the MRI
Have the MRI for a couple of reason's first if you have a hern.disc you need to know this, and how to treat and prevent it from going all the way out (fight these daily)...second the adjuster will not take 'pretty sure' as anything...will be same as if it weren't said...so it won't be considered...Also, do meds matter, he prescribed me a steroid, another muscle relaxer and something else. 4 in total.
Yes, you will be reimbursed for all Rx as well...and it will go to show treatment,type and length.Posted: Tue May 13, 2008 10:11 pm Post Subject:
Also, in the beginning of this I called a lawyer and just asked a few questions before deciding to do this on my own. He mentioned the adjuster would call me and take a recorded statement. Well she called but just asked what happened, said she had to do an investigation and then 2 days later said they are accepting liability for my loss. Is it odd that I was not asked for a recorded statement? I am just so skeptical and don;t want to get screwed on anything. I am losing $1400 a week and plus med bills I cannot afford to be out that money. I mean she said they will figure my settlement and all with the info from lost wages, med, pain and suff, etc. I shouldn't be worried just because of the recording thing right?
If I never called the lawyer I would have never even been asking this
Thank you
Posted: Tue May 13, 2008 10:43 pm Post Subject:
Also, in the beginning of this I called a lawyer and just asked a few questions before deciding to do this on my own. He mentioned the adjuster would call me and take a recorded statement. Well she called but just asked what happened, said she had to do an investigation and then 2 days later said they are accepting liability for my loss. Is it odd that I was not asked for a recorded statement? I am just so skeptical and don;t want to get screwed on anything. I am losing $1400 a week and plus med bills I cannot afford to be out that money. I mean she said they will figure my settlement and all with the info from lost wages, med, pain and suff, etc. I shouldn't be worried just because of the recording thing right?
If I never called the lawyer I would have never even been asking this
Thank you
Posted: Tue May 13, 2008 11:58 pm Post Subject:
You should not be worried one bit that a recorded statement was not taken. A recorded statement cannot help you in anyway. Here is the thing... most carriers will have their adjuster obtain a recorded interview. It helps to keep the person from changing their story later on. Notice, I said "help". On every state I know of, recorded statements are not admissible in court. This means a recorded statement cannot be used at all in a court case. What some insurance attorneys will do is ask the person a question such as, "Isn't it correct that you told Mr. Adjuster...". It's kind of an end run around the fact that the recorded statement cannot be used. But truth is, the insurance company can have the person on tape admitting to something and that same person can simply deny it under oath. There is nothing anyone can do about that. But who's to say the person is lying... perhaps they were just "confused" when they gave the recorded interview. But as I said, all carriers want their adjusters to obtain recorded statements... it's good filler for the file and can't hurt the insurance company in any way. But also, most people become defensive when the insurance adjuster asks for a recorded statement. It's not to the carriers advantage to make the injured person upset so many times adjusters will just skip it. If their investigation then finds some conflicting information or they need to nail down some details, they can always ask for the statement later on (but this does allow for the person to change their story). Personally, if the details are pretty clear, I won't obtain the statement. It does me little good and I like to try to maintain a good relationship with the injured party.
Keep in mind that no offer will be made until the full extent of your injury and treatment is know. If this takes months, it takes months. Your loss wages are not paid on an ongoing basis... they are included the the offer/settlement.
Posted: Wed May 14, 2008 01:19 am Post Subject:
Thank you so much for that. You seem very knowlegeable. My Dr's assessment is pinched sciatic nerve due to deamaged disc. He gave me some steroid meds among others. He said if I feel relief I do not have to go have the MRI. I am feling a little better now. If the MRI is not done does that hurt me in the settlement? Also, my lost wages now are going to be about $9800 which seems a lot to me at least. But I have my paychex showing my weekly take home and a letter from work which I will obtain showing my missed time as well as doctor notes saying to be off work(I life heavy objects). With the medical at $2500 that puts me at $12,300 which from what I am reading am pretty muched assured of. What is a ballpark I can expect for the pain and suffering? Without the MRi or with it. ALso is it better having a negative MRI than none at all. I am just wanting to make the right decisions here. When I think of pain and suffering I have been hurting pretty bad up to now. It will be 7 weeks by the time everything and all treatment is done. I guess Im just looking for some kind of reassurance that my finances will be able to be back to normal. I have lost a lot of money and have kids and a wife to support.
Ballpark on the pain and suffering just from your experience?
Also, one last thing if the doctor says ok you can go back to work now( at the 7 week mark) and puts restrictions on what I can and can't do for the next say 3 weeks which would cost me apprx. 600 a week is that applicable at all. Or would I need to wait until the end of that 3 weeks even still to get a settlement. Oh, and how long does it normally take once all records, treatment, etc are in to the adjuster before I have a check?
Sorry for so many questions I hope you understand it is sort of scary the amount of money I have been out and will never recover until this is done.
Thank you again in advance.
Robert
Posted: Wed May 14, 2008 10:57 am Post Subject:
Is it odd that I was not asked for a recorded statement?
well no and yes, some companies apparently are not as strengent on this...I personally have not worked anywhere that wouldn't have thrown a big old giant hissy and made me get one... :roll:On every state I know of, recorded statements are not admissible in court. This means a recorded statement cannot be used at all in a court case
Maybe it depends on the 'reason' for the admissablility in a court case tcope and not that they are flatly excluded, I know of a few that have went to court and the statements were used, to prove (as you said) changes in story....generally (IMO) there isn't much information in them that would help (either side) in a court case....I think as well more times than not recorded statements are used by the carriers as training tools, I know where I work the bosses routinely review new adjusters statements...Another thing they are good for is if a party says, 'the adjuster told me they were going to fix my car and give me five gazillion dollars, just because i'm pretty!' and this can be shown incorrect in the statements...Don't concern yourself with this at all...some carriers just don't require it on all claims...
RE: your money etc...I know it's hard to be so stretched...as tcope said nothing will be paid untill you have finished treatment...if you are forthright and upfront with your creditors, (call them BEFORE you are late), and let them know the circumstances most times something can be worked out...
Let us know if we can assist you further.
Posted: Wed May 14, 2008 08:34 pm Post Subject:
You've helped a lot. Im just so concerned with the money I'm getting back. If possible can you let me know what you think about my settlement questions and the MRI.
Thanks again
Posted: Thu May 15, 2008 10:17 am Post Subject:
You've helped a lot. Im just so concerned with the money I'm getting back. If possible can you let me know what you think about my settlement questions and the MRI
Were it me I'd have the MRI, you'll have to make that decision. There is really no way for us to evaluate an injury so much goes into it....Of course you will get all your med bills, loss of wages, etc. Then depending on the diagnosis and prognosis pain and suffering...I personally would make the carrier make the first offer then tell them I want to think about it awhile...and then do that..If you'd like after they make an offer let us know what it is and we can probably say if 'we' think it sounds fair or low, or just plain nuts and you may want to consider an attorney. It really is what you think this is worth...and what the diagnosis is....Posted: Thu May 22, 2008 02:15 am Post Subject:
Hi, below I have copied the letter I included to the adjuster on my claim.
Please do me a favor and just let me know a ballpark range of settlement you would offer if you were the adjuster. I know it is just your opinion but maybe it will make me feel better and not worry so much.
I really appreciate it. Here is the letter:
Dear Ms.
I have enclosed the medical bills, all prescription receipts as well as my paycheck stubs and a letter from my work stating the 7 weeks of work I have missed due to my back injury.
The total work missed is $1400 X 7 weeks for a total of $9800.
All medical including prescriptions are a total of $2400.
When determining my pain and suffering please take into consideration that I have basically been extremely limited to absolutely everything I can do on a normal basis. First, my children, my 6 year old son had to have his basketball camp cancelled due to lack of funds. We have not been able to go outside together and play catch or soccer which we would normally do on a weekly basis. My oldest daughter has not been able to take her weekly bike ride with me now for 7 weeks. I have not been able to hold my 11 month old daughter without sitting down and having sat on my lap. Even then, it is only for a few minutes before I am too uncomfortable. My wife and I have not had any intimacy at all and she has had to pick up 2 extra shifts a week just so we can have food. We have had to call all utility companies and ask them for extensions so they would not have us turned off. It has been a highly stressful environment around here the past couple of months that has affected my entire family.
As for me, I have gotten an average of 3 hours sleep a night. Most of the times in intervals of 15-30 minutes before waking up in severe pain. I have woken up and had to vomit on probably 20 occasions due to the medicines I had to take. I have had to rely on my wonderful wife to manage and take care of everything which includes housework, working, the kids and yard work. I have been basically useless the past 2 months.
The doctor has mentioned to me that this may never fully heal and that scares me because my job involves lifting heavy items. I will just be very careful and pray nothing happens in the future.
Please take these circumstances into consideration when determining the pain and suffering amounts.
Sincerely,
Posted: Thu May 22, 2008 11:45 am Post Subject:
RPS,
Sorry had to go out of town for a business meeting...
Did you do the MRI? What is the actual diagnosis, and prognosis?
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