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: Fri Jun 20, 2008 10:16 am Post Subject:
Please tell me this lady is wrong!! I'm expecting like 30K which is basically a very low pain and suffering amount. I'm really worried now.
That would worry me too! My inital thought is she said that well, to scare you frankly into signing with them...See what the adjuster says first. I've never heard of anyone not paying loss of wage, assuming of course that everything is in order (ie doc had you off work, and your employer provides the requested information, or you can prove this amount) I think your expectation of settlement is probably a good one, however of course you want to ask for more than you are willing to settle for...remembering if you are attorney rep'd...that 30k becomes about 20k after attorney fees! :roll: Let us know and try not to let this worry you unless and until you know there is something to worry about! let us know if we can help you along and please do update us.Posted: Thu Jul 03, 2008 12:09 am Post Subject:
OK I turned everything in and today get a letter from a "claims specialist" who has taken over my case. In the letter it states to fill out medical authorization forms for ANY doctor history for the past 5 years. The only thing I have is a gall bladder surgery a couple of years ago which I have stated. I will drive to the hospital tomorrow and get those records and fax them to the specialist. Other than that I have nothing, not even a doctor vistit. Is this standard procedure (my friend told me that it may get passed on to a specialist because it is a pretty costly claim) hopefully that is correct. I am just worried. Are they trying to find something? Or is this all standard procedure? I'm a little worried and very impatient now.
Thanks
Posted: Thu Jul 03, 2008 12:37 am Post Subject:
It's standard, but you don't have to go get the records, just sign the medical information authorization release and the rep will request the information.
It's routine to look into someones history to see if there was a prior injury..just fill out the med auth and send it back...hang in there!
Posted: Thu Jul 03, 2008 12:55 am Post Subject:
Ok thank you I feel better. What is a reason though of them handing it off to someone else? Are there levels of adjusters based on size of claim, or difficulty of claim, set.
Thanks
Posted: Thu Jul 03, 2008 12:57 am Post Subject:
One more ? as well please. I understand it is routine to look at someones med history. However when the adjuster asked me about that I told her no that there had never been another injury. Then when they go to review the file and make an offer, so I thought, it gets transferred and then he sends the med auth forms. Again, this is nothing for me to worry about?
Thanks again
Posted: Thu Jul 03, 2008 10:15 am Post Subject:
What is a reason though of them handing it off to someone else? Are there levels of adjusters based on size of claim, or difficulty of claim,
Yep...that's exactly it..or the other person that was handling it quit, got fired, promoted etc.However when the adjuster asked me about that I told her no that there had never been another injury. Then when they go to review the file and make an offer, so I thought, it gets transferred and then he sends the med auth forms. Again, this is nothing for me to worry about?
I have a little clearer picture (I think) why it was transferred...Is this the first medical authorization you've got? If so the first adjuster wasn't doing their job, and sounds like they got caught not doing their job...by the time it came to review that claim and get an injury range figured out...there should've been every drop of medical information available on you in that claim file. If there was not that is a problem, and something for that adjuster to worry about but not you...Just telling an adjuster you have had no prior injuries isn't good enough (for anyone). We work in an industry that is 'documenation crazy'. I'd say that first adjuster (if I'm understanding this) just might've lost their job...and if so I'm sure it wasn't just your claim... :wink:Posted: Sat Oct 17, 2009 05:52 pm Post Subject: Pain and suffering
RPS I can feel your pain because I am in a boat like yours. I slipped and fell at the grocery store 19 months ago.
I have had 2 MRIs, 3 sessions of Phy Therapy(total of 14 weeks), 5 weekly sessions of deep tissue needle therapy (PNT therapy) on my back, countless appointments with my orthopaedic and neurologist and pain management doctors, 1 surgery consult, 1 surgery for entraped nerve in arm.
My medical is a whopping $83,000 and I have lost about $20,000 in wages (would be more by my boss only lowered my salary $100 a week for 9 months) then I had to go to part time, and because I can not work full time I have lost my medical and 4 weeks of paid vacation time a year and also 18 days of paid sick time a year.
I have a good lawyer and we have had written interrogaritories, discovery (interesting thing came out of that) like the store was told to keep the dirt and debris cleaned out from under the ice machine or it could cause the machine to leak, and then the repair work order when they came out 1 1/2 hours after I fell says the machine is clogged with dirt and debis and leaking with a lot of water under and around the machine. We have had depositions followed by supplimental interrogitories, an appointment for settlement mediation which the store cancelled at the last minute, we are now rescheduled for mediation again in 2 weeks and if I do not settle then we are already on the trial docket for January.
I can tell you, dealing with all the pain and dealing with the lawyers and suff is hard but there is no help for that.
I would recommend you get a lawyer but that is just my opinion. There is no way I could have handled it all by myself. Keep us posted and up to date on how it goes for you.
Posted: Sat Oct 17, 2009 06:00 pm Post Subject: pain and suffering
RPS it is NOT your job to round up records for the insurance adjusters, just fill out the authorization form and let them do their job.
As for mine my nephew in law got a subpoena to produce records and he is like WHAT THE??? I turned in a prescription he wrote out for pain patches for my back when we were at there house for Thanksgiving and I was in so much pain. OUTCOME.... his legal staff sent a letter that there was mor records that I was family.
Be thankful you only had to list medical for 5 years, mine was the last 10 years. Was hard to think back that far so I did the best I could but made note that "AS FAR AS I COULD REMEMBER". I must not have left anything out because my attorney said they did not find any medical except for heel spur and a check up.
GOOD LUCK and keep us posted.
Posted: Thu Sep 09, 2010 04:51 am Post Subject: TNihBLOj
rJZWwO
Add your comment