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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Employment Law
Satisfied Customers: 118175
Experience:  20+ Years of Employment Law Experience
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I am writing today regarding a workers comp/disability

Customer Question

Hello. I am writing today regarding a workers comp/disability question. I was a corrections officer that was assaulted by an inmate in jail 2 and a half years ago. I have since been diagnosed with post-concussive syndrome, upper and lower back pain, a right eye injury, neck pain, and PTSD and anxiety as a result of my assault. Workers comp has established my case for the post-concussive syndrome, upper and lower back pain, right eye injury and neck pain. I had an IME to establish my worker's comp case for PTSD and anxiety as well, and the IME came back and said only the PTSD is causally related to my injury. Worker's comp is now contesting the PTSD and anxiety and we are scheduling depositions before the next hearing. At the same time, I am filing for retirement disability from my job as a result of my mental health and physical conditions. My question is: my case for Worker's Comp is established for my physical injuries, but not for mental health. If my case settles with Workers Comp out of court before the depositions and the settlement includes paying my previous mental health bills which had been denied by them, does that mean they accepted and established my Workers Comp case for mental health? If the settlement doesn't include paying my past medical bills for mental health, will that effect my retirement disability?
Submitted: 1 year ago.
Category: Employment Law
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
Most all of these IME are paid quacks who will say whatever an insurance company wants. You would need to focus on your treating physician's testimony and records, since their opinion has much more credibility and weight based on their long term treatment compared to some quack who saw you one time and barely looked at the medical records.
However, if your physical injuries still prevents you from working, you are still entitled to the settlement. Usually, the workers compensation insurer, while they may challenge this type of PTSD claim, they lose most of them if your treating physicians are strong enough.
However, if your case settles and they include your mental health bills, that means they have accepted the whole claim including the PTSD. Generally if your physical injury is severe enough, the PTSD would not impact your disability. If your physical injury would still render you unable to work, then your retirement disability payment should not be impacted.
Customer: replied 1 year ago.
Thank you for your response. I have one follow up question. When I filed for disability retirement, they asked me to state which aspect was preventing me more from going to work, physical or mental (you are only allowed to submit based on one aspect). Because of the fact that my PTSD and anxiety prevent me from even driving to work and being around inmates, my number one reason for filing for disability retirement was the mental health aspect. If my case is not established for anxiety and PTSD, would this then effect my disability retirement?
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your reply.
It is still going to be up to your doctor who is treating you. Just because the IME quack who met you one time and did not read all your records says something does not mean that is gospel to a court. The court weighs the testimony of the treating doctor who has been seeing you regularly more heavily than someone who just met you.
It depends on the percentage of your disability rating as to how much the PTSD makes up your full disability rating as to whether it will have any major impact on your disability payment.