While employed as foreman for a building and highway sandblasting company in California, my fiance sustained a significant back injury in 19...

Question

While employed as foreman for a building and highway sandblasting company in California, my fiance sustained a significant back injury in 1992 after being crushed by a three-quarter ton piece of heavy equipment that was not properly secured.

After 9 surgical attempts resulting in a diagnosis of "Failed Back Syndrome," he was awarded life medical care, 62% permanent disability rating and permanent disability advance of $50,613.00.

Since the attorney who represented him at inception of the case is now deceased, another attorney at the same firm has negotiated a final settlement of $150,600, who, although previously unavailable by phone or email, is now making attempts to schedule a meeting with him, indicating he needs to explain how the terms were arrived at and, of course, get his signature. Since we have learned through various workers compensation forums that the terms negotiated by his counsel are unfavorable, he will not be signing this C & R, since after it requires the permanent disability advance be paid back, only the MSA allocation of $88,000 plus attorney fees remain.

My concern, however, is this: although he is considered to be under the active care of an orthopedic surgeon specializing in spinal reconstructive surgery, he has been refused/denied almost ALL necessary care since January 2014, although his condition has begun to worsen since then.

Along with frequent numbness, burning and amputation-type sensations from his lower back to his feet, he has an increasing possibility of becoming paralyzed when attempting most ADLs.

We need help!!

Is there a way for him to get the additional medical treatment he needs right now, and what is a fair settlement for an injury of this magnitude?

Answer

1) Treatment is difficult to obtain because it is almost impossible to find a physician who will treat on a lien basis, meaning everything must be approved by the carrier in advance. UR and IMR have effectively cut off treatment. I am not hawking my services, but see my website at mahurinlaw.com for an explanation.

2) It seems to me that given the extent of the injuries there should be some consideration for in home care. I believe you need to consider a life care plan and will therefore need to consult a life care planner. Such costs can be hundreds of thousands of dollars over several years.

3) The and MSA seem low unless your fiancee is older, say 65 and above, and not taking any prescription pain meds.