First of all, I’m in Wisconsin, if that comes into play.
I had a worker’s comp injury a while back (see saga here), I had surgery last week. Officially, I was off for a week and I’m back to half duty now.
My agent called me the other day to let me know that she sent me a paycheck for the missed week and said “It’s for $xxx.xx you’ll notice that it’s less then your [gross] pay. That’s because we pay 2/3rds since you don’t pay taxes on it.” I didn’t think much of it at the time, but later on I realized that it works out to $100 less than I would normally take home per week (I’m on salary so my paycheck is the same week to week).
Some Googling reveals that 2/3rds of your average gross for that past 52 weeks is just what they do, so is it even worth calling her up and asking why I’m getting $100 less? OTOH, they (and everything I’ve read) say the money “isn’t taxed”, but is it possible that they mean they’re paying the taxes on it. If that’s the case, I’d get some kind of 1099 or W-2 (showing that I took home $xxx.xx and they paid [gross]-$xxx.xx in taxes to the government) and it would figure into my refund and increase my return and I’d end up with the $100 back when I do my taxes. I’d have no problem with that. Unfortunately, I suspect I’m just out the $100.
I had my first post-op appointment last week and they gave me the script for physical therapy. The PA told me I could go wherever I wanted, she didn’t have much of a preference. I took the script to the PT place across the street from where I work so I can just walk there and back. A day later my agent called to give me a very mixed message, paraphrased: “They’re not ‘in-network’. You have to go through the Align Network. Someone from Align will call you and tell you who in your area is in their network, but if none of them work out, I can authorize you to go to the one you already set up the appointment with”. Almost the second I got off the phone with her, the PT place called me to tell me that my agent had just called her and told her the same thing, but, my PT person informed me and the worker’s comp agent that under WI law, I’m allowed to go anywhere I want. She also told the worker’s comp agent that, no, she wouldn’t cancel my appointment without my consent.
My plan is to talk to the Align people then call the worker’s comp people and hopefully just be able to tell them that all those places don’t work because they’re too far away and I’m not comfortable driving that far yet…or whatever other excuses I can think of…or just tell her that according to WI law, I can go wherever I want. Or maybe I won’t have to since she did say that she’d authorize it if I wanted her to. I was going to just push it and tell her to authorize it now, but everything has been going very smoothly for the most part and I don’t want to rock the boat. I can play along if I need to.
Also, if they do make me drive somewhere, I’ll have to take more time off of work that they’ll have to pay me for and they’ll have to pay me for the miles on my car (which they will, they offered to when I did PT at the beginning of this). That’s about $310 for the 18 sessions they authorized (I don’t know how many the dr prescribed, it’s probably safe to assume it was more that that.
3)
I didn’t think about this one until know. She mentioned on the phone that they authorized 18 sessions. If the doctor prescribed more than that, am I just SOL or is that normal? I supposed it’s normal that I go through the first 18 sessions and then the PT people and/or the doctor call them up and get more authorized. I assume they don’t want to just go ahead and authorize a year of bi-weekly sessions and have people back to 100% after 3 months and spend the rest of the time getting $300 massages and paid time off of work.
At the end of all this there’s a disability settlement. Looking around on various message boards. I see two groups. Half the people getting 10,000-15,000 and half the people saying the got a worker’s comp lawyer and getting 100,000-200,000. FTR, I checked WI law and it’s very clear that in WI, WRT this settlement, the lawyer can only collect a very specific percentage and they can only take it from the settlement itself. So this isn’t a case of ‘great, now you owe a lawyer $45,000 and you have to collect the money’.
However, I’m just not sure I can bring myself to do that. For starters, it just seems like such a pipe dream, like it wouldn’t actually happen. Either it would never actually come to fruition or I’d get a lawyer and my settlement would go from $12,000 to $16,000 and the fees would knock it back down anyways. Secondly, years ago, my broker mentioned that it’s not the cost of the injury that drives our rates (or rather, our experience mod) up, it’s the amount of claims we make. He went on to say that one $70,000 injury every couple of years isn’t a big deal, but if 4 or 5 people need stitches in one year, that’ll hurt you. I’m going to guess that this claim is already going into the $30,000-$50,000 range. I have to imagine that if, somehow, got a 100,000 settlement out of it, the insurance company is going to want their money back…and this is a family business, my family.
That’s all I can think of now, I’m sure I’ll have more questions.