If you have been injured while at work, you may be receiving weekly workers’ compensation checks from your employer’s insurance company while you continue to heal. However, the insurance company may also be pushing for you to settle your workers’ compensation claim as soon as possible. They don’t want to keep paying on your work comp claim if you are willing to settle for a lump sum payment. Be aware that the insurance adjuster is likely to offer you as little as possible to settle the claim, believing that you will do so because you don’t know any better.
Before you settle your claim, there are several things you must consider.
If you are still being treated by a medical doctor or physical therapist when the insurance company approaches you to settle, resist the urge to accept. You may not know the full impact of your injuries until you have completed treatment, or even until you return to work after your treatment. Some injured workers experience a temporary relief from pain following a stint of physical therapy, an injection, or a surgery, only to have the pain and limitations return when they go back to work. You need time to heal.
If you have received weekly benefit checks (not mileage/not expenses related to medical care), you have three years from the date the last check was mailed to settle or file your claim. If you have not received any checks, you have two years from the date of your injury to settle or file your claim. Long story short – you have time to treat your injuries before you settle. If you are still treating when the deadline to settle or file your claim rolls around, then you may need to file your case to protect your rights.
In cases where weekly benefits are paid, you are entitled to lifetime medical treatment for your work injury. There are several different ways to settle a workers’ compensation claim—one way includes closing out your right to future medical care, paid for by the workers’ compensation insurance company. Insurance companies generally like this option because they want to be completely done with you when they settle.
If you are going to close out your medical benefits as a part of a settlement, the lump sum needs to be substantial enough to cover your current and future medical bills and any continued care. Even if you have been released from the doctor and declared to be at “maximum medical improvement,” you may still need medical attention to maintain your current level of health—injections, medications, physical therapy, future surgeries. Your settlement should be able to cover any of the necessary medical expenses related to the work injury for as long as your medical needs will last.
You also need to make sure your Medicare benefits are protected—even if you are not on Medicare. There is a federal law that basically says a workers’ compensation insurance company cannot pass the buck to Medicare to pay for medical care related to your work injury. If you close out the medical care benefits as a part of your workers’ compensation settlement, and you have not set enough money aside out of the settlement to cover the cost of your medical care related to the work injury, Medicare may refused to cover your injury-related medical bills. Even if you are not going to be on Medicare any time soon, you’ll need to take certain steps when closing out your medical benefits to protect your future Medicare benefits.
To protect your Medicare, you’ll either need to lay out what portion of the settlement money is for future medical in the settlement documents you sign, or you may need to set up an official “Medicare Set-Aside” account or MSA account. This account holds the money that can only be used to pay for medical care related to your work injury. In some cases, you’ll have to file yearly reports with Medicare explaining how this money is spent. Once the allocated funds have been used, then Medicare will start picking up the tab for medical care related to your work injury, if you can prove you spent the money appropriately.
You may have applied and/or received Social Security Disability benefits if you were unable to return to work. If you receive a lump sum workers’ compensation settlement, this may lower your SSD monthly benefits. In order for your SSD benefits not to be affected by a settlement, you should speak with a workers’ compensation attorney. They may be able to help reduce or even eliminate this issue.
As you can see, negotiating the right amount for your workers’ compensation settlement can be complicated. In order for you to make sure you’re receiving the right amount for your Iowa workers’ compensation settlement, contact an experienced attorney at RSH Legal today at 1-800-433-0283. We will be able to answer any questions you have about settling your work comp claim.
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