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Thread Title: What happens after VR Buyout?
Created On Saturday August 20, 2005 5:48 PM

Rea
Junior Member

Posts: 5
Joined: Aug 2005

Saturday August 20, 2005 5:48 PM

New Here. Can someone tell me what happens to the w/c claim after VR buyout? Does SSDI and/or PPD payments discontinue? Really Confused

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andyourlittledogtoo
Senior Member

Posts: 504
Joined: Jul 2005

Saturday August 20, 2005 7:50 PM

I'm not ignoring you, but there are just too many variables in the scenario you propose to answer your question. If you were more specific in your own particulars perhaps we could offer some possible answers.

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"For a long time it had seemed to me that life was about to begin, real life. But there was always some obstacle in the way, something to be gotten through first, some unfinished business, time still to be served, a debt to be paid. Then life would begin. At last it dawned on me that these obstacles were my life." Alfred D'Souza

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Rea
Junior Member

Posts: 5
Joined: Aug 2005

Sunday August 21, 2005 11:19 AM

Thank you.. I will be more specific. 53 yrs old, Injured 2001, P&S 2003 w/ PPD and SDI for both psych and physical injuries. Injury to lft & rt shoulder and left arm. My recent psychologist (who talks more about herself in our sessions) has now placed me on TD for the psych portion and am now being called to Voc Rehab although I am truly not ready, mentally or physically. I have no use of the left arm, type with one hand only, never sleep panic attacks and very depressed. I have been PPD by the psych defense since 2003. If TD means improvement, I had better get another dr.

If you could help me to understand all of this, I would certainly appreciate it.

1 If I take a VR buyout will SSDI benefits be affected.
2 If I attempt to take VR will I now be subjected to the IC's erratic TD pymts.
3 Is changing PPD to TD just to request VR a common practice by physicians??
4.DOI 10/2001. Don't I have 1 additional year before I lose this benefit (2006)?

I know I sound like a babbling idiot but after all this time I still know very little about what is going on around me. Sorry for typos as I am a "one hander". I can't believe I have become so paranoid. I no longer trust my dr or attys.

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gaiassoul1@yahoo.com
Senior Member

Posts: 2155
Joined: Feb 2004

Sunday August 21, 2005 8:42 PM

yes your SSDI benefits will be affected, call them and ask how it is affected. You are better off to go through rehab.

IF your TTD payments are erratic, your attorney should be covering this side, filing for penalties and making sure the checks come like clockwork.

Noboy changes from PPD to TTD to get VR, that statement makes no sense at all, so please try rephrasing that question. IF you are QIW, it benefits you to go through VR now because you can stretch the budget money since VRMA will not be paid and get better retraining.

You will not lose this benefit, if your attorney has demanded the benefit prior to five years from your date of injury, sounds like it has been demanded. The date all injured workers will lose this benefit is 1/1/2009, that is the sunset clause on all VR in the past legislation.

A general therapeutic technique for therapist is to talk how they also deal with adversity to give you coping skills, if that is not happening you need a new therapist ASAP.

What is happening for your pain management because the panic attacks and the depression stem from chronic pain most likely, and usually from feelings of hopelessness.

Request a program that is voice activated -- I think Dragon is the most common, you need assistive devices -- not to retire.

-------------------------
Ginger

To know how to say what others only know how to think is what makes men poets or sages; and to dare to say what others only dare to think makes men martyrs or
reformers - or both. Elizabeth Charles

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injuredworker101@yahoo.com
Senior Member

Posts: 1527
Joined: Apr 2004

Tuesday August 23, 2005 8:05 AM

I will add as a therapist myself, that when you are back in the working enviornment, you will begin to feel your own self esteem increase. The working enviornment gives you much more than just the work itself. It gives you satisfaction, and the stroke of others, seeing your ability to be a member of the community. It also gives you positive reinforcement that you are capable of doing something.

A therapist should not be just talking about themselves unless it is to help you to see how they handle situations. But I know some therapists do just this: talk about themselves. This is your hour to handle your things not theirs. You can remind them of this if it bothers you. Then if it is not resolved, move to another person who can help you. These sessions should be for your benefit.

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inkwell6
Junior Member

Posts: 4
Joined: Jan 2005

Saturday January 07, 2006 7:44 AM

Please clarify: are you considering State Disability Insurance (SDI) OR Social Security Disability Insurance (SSDI)? My understanding of SDI benefits-- for lump sum settlements such as a buyout of VR, there is NO conflict with SDI benefits however, I am not certain that this would be the case for SSDI benefits. Something else to consider on SDI is whether or not SDI is subtracting your PD benefits IF they are paying for an industrial injury or condition. I'm sure you don't want to have to deal with an overpayment issue with SDI.

I agree with the prior post who suggested that you call and clear. Better to lay the cards on the table by prompt reporting rather than to have deal with this later. I think that VR is a choice that only you can make and I would think in the midst of depression, etc., it would be difficult to DECIDE what/where you might want to go. VR interrupt is an option, but the caveat would be get an agreement for the longest and most feasible amount of time you would need to recover from your current health situation if you choose this option. The last thing that you would want to do is to lose your right to VR benefits or buyout because you missed the interrupt deadline.

I think I understand that your psychologist is now stating that your psyche condition has now temporarily disabled you and that you are TTD, though your WC carrier(WCC) would probably disagree. By having this additional disputed period of TTD it adds yet another log onto the fire of your case while you are on VR interrupt? If you are TTD and SDI is paying you for an industrial condition, remember they have the right to request payment from the WCC at settlement of your case for this period in question.

The workers compensation 'system' in both my own personal experience and professional observations (as a participant at the WCAB) does seem to take it's toll on folks who remain engaged in it. I think the adversarial aspect of WC make it more difficult than it needs to be. It's good that you have a therapist who is working with you, I wish you well on your journey.

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injuredworker101@yahoo.com
Senior Member

Posts: 1527
Joined: Apr 2004

Saturday January 07, 2006 11:27 AM

"I think the adversarial aspect of WC make it more difficult than it needs to be."

The entire crutch of the system!!! This is what's wrong with WC.

Posts: 115
Joined: Mar 2005

Monday January 09, 2006 5:51 PM

This VR "stuff" is just about the most confusing aspect of the whole WC scenario, as far as I'm concerned! I actually had a "counselling session" with a VR counselor--seemed like a total waste to me! I really don't feel that I can go back to work, don't have the desire to go "back to school", and am not sure where this leaves me as far as the VR goes. I was declared an IW, VR was suggested, as seems obvious, but can I get any money (to be frankly blunt!) out of this at my hearing, which is looming, like tomorrow?? I feel I could put the money to use in my charitable actions, don't want to go into that, but will probably have 2 minutes to talk to my lawyer before the inside bickering starts. My DOI is before 2004, if that makes any difference, which it seems to (or is it 2003" Before then, too, so no matter......), so, what to do?????? It sounds as if there are a lot of people as confused about VR as I am, so at least I don't feel like the "lone dumb blonde!"........

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rumbler
Senior Member

Posts: 683
Joined: Dec 2005

Monday January 09, 2006 6:37 PM

Yes--really confusing! It was my understanding that if the injury ocurred BEFORE 2004, that you could be re-trained, with some sort of mileage allowance, etc., but now I don't know AT ALL!

Also, don't know about the "buy-out" procedure--what is the procedure, and who decides the amount of the buyout?

Is the buy-out option affected by the NEW rules, no matter what the date of injury is???

We need a crash course on Voc Rehab--Benefits due PRIOR to 2004 and benefits due POST 2004!!!

Thanks!!!

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gaiassoul1@yahoo.com
Senior Member

Posts: 2155
Joined: Feb 2004

Tuesday January 10, 2006 10:01 AM

If your injury occured prior to 1/1/04 and your physician indicates you are a qualified injured worker you are entitled to some level of vocational rehabililtation -- not always retraining. There is a hierarchy that begins with direct job placement and ends with self-employment plans and retraining is up there on that hierarchy. So you are supposed to start on the lowest rung of the hierarchy "ladder" and move up, not skip the steps. Rarely done correctly, but that is a whole other issue.

Any claim with VR entitlement may be bought out. The legal maximum is $10,000. How the insurance companies and parties determine the level of buyout weighs in how much the insurance company thinks it is going to cost them to provide VR, then they subtract out the counselor's services and then they make an offer. NO insurance company can be FORCED to buy out your VR, but they can settle it lump sum if they so choose.

AFTER 1/1/04, there is no "VR" to buyout. The supplemental job displacement benefit (SJDB) is NOT a VR benefit, and is just a part of the case in chief and again, the insurance company can issue it at a ruling regarding PD or the insurance company can throw a partial value at you, since technically none of it ends up in your pocket and the voucher is ONLY good for tuition, books and limited supplies payable to a qualified educational institution.

That is the down and dirty, a crash course takes 16 weeks for 4 hours per week, trust me I took that course and the course was limited in its SCOPE. SO ask more questions from there. I can only address specific questions and cannot run a discourse on all of the ins and outs of VR that are itemized in my 400 page manual.

Just remember that we do not know how that sunset clause will work -- if as of 1/1/09, its into the sunset with the black and white hats disappearing like ghosts into the mists. IF you think you are not going to be able to return to work, ask your physician if you will be QIW, then have your physician lay down anticipated work restrictions. There is NO prohibition on securing VR services while you are on TTD and it usually maximizes the budget. Most adults know how time works and 1/1/09 will be here faster then anyone anticipates, in a drop dead heartbeat. We will then see a gazillion posts about all the people who lost the benefit because they did not "know" and their attorneys were not proactive or had too many files to see the handwriting on the wall.

Ginger

-------------------------
Ginger

To know how to say what others only know how to think is what makes men poets or sages; and to dare to say what others only dare to think makes men martyrs or
reformers - or both. Elizabeth Charles

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rumbler
Senior Member

Posts: 683
Joined: Dec 2005

Tuesday January 10, 2006 11:21 AM

Edited: Friday February 03, 2006 at 12:01 PM by rumbler

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gaiassoul1@yahoo.com
Senior Member

Posts: 2155
Joined: Feb 2004

Tuesday January 10, 2006 1:24 PM

1. It is supposed to be a reasonable distance, however, not growing up in CA I am geographically challenged in discussing it. Is there an other rehab counselor closer by, this would then help in arguing for a change in counselor. Is it well documented in the medical reporting how far you can drive -- this MUST be addressed FIRST, before you even start this battle.

2. IF you cannot make meetings due to weather, you call the counselor and assure this is documented as GOOD CAUSE.

3. We are NOT sure what the sunset clause of 1/1/09 means, does that mean if you are in a plan that started before 1/1/09 you are fine? Does that mean that all rehab just stops no matter where you are on 1/1/09, that is a crystal ball issue that has not yet been defined by case law and we won't see that case law until that time. (my opinion, obviously, other legal eagles may have counter opinions, but this is what I am seeing discussed)

4. YES you may.

5. Your VR counselor is a guide, you will have to do all the leg work as to advising what is available in your area. However, there is economic trending by zip code available, so good rehab counselors can do this from 500 miles away.

6. Your call, you know yourself best and you know your own drive, ambition and discipline best of all.

-------------------------
Ginger

To know how to say what others only know how to think is what makes men poets or sages; and to dare to say what others only dare to think makes men martyrs or
reformers - or both. Elizabeth Charles

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rumbler
Senior Member

Posts: 683
Joined: Dec 2005

Tuesday January 10, 2006 4:07 PM

THANKS!! When the time is right< i will go for the buy-out and work with the State Voc Rehab Agency that is only 5 minutes away AND knows of the employment options in my area. COOL!!! (Have read too many horror stories on this forum about the WC VR system).

So there IS light (you just have to get out of the WC tunnel).

Does MY plan to get out have to be approved by the Rehab Judge?

THANKS AGAIN!!!

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gaiassoul1@yahoo.com
Senior Member

Posts: 2155
Joined: Feb 2004

Tuesday January 10, 2006 4:14 PM

just remember one thing --- you cannot force a buyout, so you can ask, but don't get your heart set on it, count the chickens before they hatch kind of thing....see where I am going?

There is no such thing as a Rehab Judge, there are Rehab Bureau Consultants who have limited powers and when they are appealed the WCAB Judge splits the baby.

You must be represented to settle VR, so since you are represented this is not an issue. IF the parties agree to a plan it is usually deemed approved. If an unrepresented worker enters a plan, the plan is to be submitted to the Rehab Bureau and the Rehab Bureau is supposed to approve them, I have seen maybe 3 get approved in my whole career, more likely it goes to the second default which says if there is no response from the Rehab Bureau to an unrepresented workers' plan in 30 days it is deemed approved. That is what an examiner sees most often.

-------------------------
Ginger

To know how to say what others only know how to think is what makes men poets or sages; and to dare to say what others only dare to think makes men martyrs or
reformers - or both. Elizabeth Charles

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rumbler
Senior Member

Posts: 683
Joined: Dec 2005

Tuesday January 10, 2006 4:35 PM

Edited: Friday February 03, 2006 at 12:03 PM by rumbler

Posts: 115
Joined: Mar 2005

Thursday January 12, 2006 12:12 PM

I've had my MSC, and opted for the VR, which has been interrupted untill later this spring. This is where I'm confused--will I lose my SSDI if I go into VR training, or will they just pay me less to equal the amt. I'm making plus their amt. to equal what SSDI is paying me? Also, what if I can't find a job within my limitations that pays me as much as I was making at the time of my work injury--do I have to take a lower-paying job? Also, does the employer have to agree to the restrictions that were stipulated by the AME? This all seems to add up to an impossibility to me!

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STEVEPSCA@YAHOO.COM
Senior Member

Posts: 990
Joined: Jun 2002

Thursday January 12, 2006 12:47 PM

Your SSDI will go on until SSA determines you are no longer "disabled" under their rules..OR you return to "gainful" employment, which is defined by your wages, (I think it's around 800/900$ month now) and a defined period of time...uninterrupted by medical leaves due to your qualifying injury/illness. There is also a return to work program...you can find lots of answers about SSA/SSDI at their web site, www.ssa.gov

VR is not intended to retrain you to take a job where your wages will be replaced...it is a "new" kind of job, most likely entry level position...which sometimes means minimum wages. So you would be expected to complete the VR program, and take a job that fit the training, and is within your restrictions.

SSA/SSDI benefits remain subject to the 80% rule, income from ALL sources, as long as your receive benefits...so your benefits will be adjusted based on any income you would have from your new job, that's why there are qualifying amounts while you return to work.

Some of the answers to your questions are also some of the reasons VR was done away with. Do not postpone your benefits too long as the sunset clause is 01/09 and that will be the END of the VR program completely. And that time creeps up pretty quick...

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