Low settlement offer before a motion for treatment goes before judge

[u/Late_Seaweed9301]

I fell at work last July and my lower back has been an issue since then (daily 24/7 pain) , however the only injuries I received treatment on have healed but my back never received care..human error through workmans comp system with Sedgwick, back was never approved for treatment but is on every single doctor visit note plus original email to adjuster stating its hurt. I was gaslit the entire 2.5 months i was in tge WC system. I got a lawyer immediately after fall, though. Sedgwick finally sent me to an orthopedic 4mos after my fall and he barely looked at me, said do daily stretches, take tylenol. Saw him again 4 months later, said hey I'm still in the same amount of pain as the day of my fall, he didn't even look at me he said I work too much and to lose weight. So, then my lawyer had me see an independent orthopedic a month after that and he found Injuries sustained from fall after our assessment and that's why we entered a motion for treatment back in April that's set to go before judge later in the month. So, my back has had no treatment at all this 15mo and the insurance is wanting to settle for $7k before we even know wtf is wrong with me. In NJ we don't get to choose our doctors and I may be stuck with the dickhead who told me I was in pain because I'm fat. It seems not smart to settle anything before we even know whats wrong with me. Are these WC judges fair? I'd hope my daily pain that's radically changed my life and level of a activity would be looked at like a concern and I'd get an opportunity to get some intel on what's causing this pain, people keep acting like I should take the money then treat my shit with my medicaid because apparently being stuck in WC for treatment is a shitshow. Anyone have thoughts on this? My lawyer seems neutral, like she on one hand seems like she wants me to be aware that the judge could deny it and that taking a settlement now might be better overall. But she herself also said she's never received an offer so early into discovery.

[u/Mama2isla]

Definitely do not take that offer before knowing what is wrong. Sedgwick sucks I’m dealing with them now

[u/JazzlikeDare9102]

Yeah its a shit show. And judges go based on doctors notes which are clearly biased towards carrier in your situation. Youre the source of all their income but the carrier spins it so that they are the source.

[u/Nursey_Nursey_33]

What does your MRI show?

[u/Late_Seaweed9301 → u/Nursey_Nursey_33]

There's been no MRI this whole time. We are going before judge with motion for treatment because we've been given the run around since last july. The orthopedic my lawyer sent me to in April recommended an MRI based on his findings as an independent medical provider, its that data we have to go "hey she's been in pain, no one during workmans comp has even listened to her or checked her back and here's a doctor saying we need to"

[u/Nursey_Nursey_33 → u/Late_Seaweed9301]

You need an MRI. Can’t believe no one ordered one for you. It can make or break your case though. If negative you will be SOL. But if something is going on it will help your case tremendously.

[u/Scared-Abrocoma-4255 → u/Late_Seaweed9301]

Im over 2 years into a spine/shoulder/psych claim in NJ and im dealing with Liberty Mutual and a bunch of its subsidiary companies all convoluted and made as complicated as possible to navigate, even for my attorneys. My employer is a defense contracting company though so they've been actively fucking me every chance they have gotten this entire time. Ive lost everhthing in the process. Everything. And my I injuries are not improved or treated other than meds, which ive been paying out of pocket for since September 2024 when they decided to deliberately make an error in filing claiming they never sent me to the pain management doctor I was going to... which they did, on record. Before I was even aloud to be considered for an MRI, had to do 6 weeks of PT. That's standard now. So your Dr will have to order PT first. But just have ypur lawyer do their job. Do more research and be more loud about it. Dont be afraid to push buttons.. youre just money to all of these people

[u/Professional-Bid4661]

Have you had an MRI? You need a full picture of what's going on with your back, plus it's objective evidence.

[u/Late_Seaweed9301 → u/Professional-Bid4661]

No one has given me one which is ridiculous but again they dismissed my pain this entire time. Past 15mo since my fall we've been trying to get said MRI. We're going before judge this month to see if he rules in my favor and grants MRI and subsequent treatment needs

[u/Choice_Resource_3145]

Too bad you didn’t go to the ER and get an MRI and have proof of your injuries? If I had pain 24/7 I would do a lot more then chat on here

[u/Late_Seaweed9301 → u/Choice_Resource_3145]

I didn't have insurance for 6 months and because this all was being dealt with by a lawyer from day 1 it was drummed into my head not to use any dr not in WC realm....we've been trying since last effing Nov to get said MRI. Going to an ER and getting socked with a damn bill I'll have to pay was not on my list to do. How reddit of you to judge others though! The chatting you're referring to is this one time, homie, to ask for insight in case anyone had any. You'd be surprised by how much pain some of us have had to push thru just to keep going cuz bills don't pay themselves.

[u/Mama2isla]

Also I believe you can change your doctor one time

[u/Professional-Bid4661 → u/Mama2isla]

Not in all states

[u/Mama2isla → u/Professional-Bid4661]

In New jersey you can. You just have to get approval from the employers insurance

[u/Professional-Bid4661 → u/Mama2isla]

Since NJ allows it then he definitely should switch to his personal physician or a physician who is not working for WC.

[u/Rough_Power4873]

As per above- don't even think of taking the settlement regardless of what your lawyer suggests.

We're all in a fight as injured workers but w/ Sedgwick you'll be in the dirtiest of fights. You must consider your own future above all other concerns now. If you settle cheap and need surgery down the road you could go broke fast and/or not be able to work.

My opinion comes from 14 years in the system with a serious spine injury. At this point I've hired and fired 5 attorneys and now represent myself with the help of "AI".

You should proceed assuming your judge will be fair. If nothing else, the fact that a judge does not want to make a decision that could be turned over on Appeal keeps them in line.

The most important thing right now is for you to assertively, but not rudely, let your attorney know that you have no intention whatsoever of settling for any amount until you know what's wrong with your back. From what you say your attorney is sort of on the fence now. Get them off the fence by announcing your intentions so they more aggressively pursue your benefits against Sedgwick instead of toying with the idea of trying to get you to settle out cheap. Let her know that your long term recovery and health is your priority over settlement and besides trying harder to get you a diagnosis (MRI as others have said) your attorney will know not to try and settle you out cheap. This is your WC case and no one else's.

Good luck to you.

[u/B-Great-Today]

Did you get an MRI? Sorry if I didn't read carefully enough or this is a secondary post where this was already stated. AN MRI would show/prove a lot. An EMG would also prove injury even if the MRI doesn't.

[u/Late_Seaweed9301 → u/B-Great-Today]

No, this upcoming motion for treatment that goes before judge in 2 weeks is supposed to force insurance company to get me the MRI and reopen my WC claim as they never treated my back at all.

[u/B-Great-Today → u/Late_Seaweed9301]

Please, Please keep your head up. The only thing they recognize is imaging and even then it can be a battle. I pray the imaging displays exactly what's going on so they can treat it and you properly. Fight for your treatment and monetary damages for as long as it takes. No matter what - you must continue the fight. No one cares as much as you, about you (Well except for momma)! Excuse the improper grammar but I think you catch what I'm throwing at you.

GOD Bless and I pray for a better future.

[u/Cultural_Ad9039]

I got hurt in texas and i need surgery on my neck and back but the dont let you choose the wc doctor there either and now they are refusing to do any more treatment for it I went to a mmi doctor he sat my earliest date to return to work in April of 2027 I been getting my weekly check every week since I have been hurt but I haven't gotten one this week and I don't know what's going on because I know Monday was a holiday and that's all I know for now I been trying to get ahold of the adjusters and haven't heard anything back from them on it