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Workers' Compensation

Do All Workers’ Compensation Cases End in a Settlement?

By January 30, 2023May 25th, 2023No Comments

A settlement is one possible outcome of a workers’ compensation case. Settlements can benefit both parties when they are negotiated in good faith, often by workers’ compensation experts representing both the injured worker and the insurance company.

Not all workers’ compensation cases end in settlement but some do. Enlisting the support of a workers’ compensation lawyer can be a reliable way to seek a fair settlement offer from the insurance company. Representation by a Lewis & Lewis attorney in your workers’ compensation case requires no up-front costs. Contact us today for a complimentary case review. Read more to learn the basics of workers’ compensation case settlements.

What is a Workers’ Compensation Settlement?

A workers’ compensation settlement is a financial resolution reached between an injured worker and the employer’s workers’ compensation insurance carrier. The vast majority of those seeking a settlement hire an attorney to negotiate their settlement.

There are many factors to consider when deciding whether a workers’ compensation case will end in a settlement and whether this is the ideal legal path for a claimant and their lawyer to pursue.

Types of Workers’ Compensation Benefits

A workers’ compensation case involves two types of benefits that can be incorporated into any settlement offer:

  • Disability benefits to replace lost wages.
  • Medical benefits to cover the cost of healthcare services.

Settlements are negotiated to include compensation for these benefits. The amount typically balances the estimated total costs of these benefits over time with the advantages of a one-time, final settlement payment that covers the medical benefit, the wage benefit, or both.

Section 32, Workers Compensation, and You

Settlements are governed by Section 32 of the Workers’ Compensation Law. A Section 32 settlement can be “full and final,” closing out both indemnity and medical benefits. Claimants can also negotiate the closing of just one of the benefits while continuing to receive compensation for the other. However, many workers’ compensation insurance carriers will only agree to full and final settlements.

A Section 32 settlement must be a mutual agreement between the injured worker and the workers’ compensation carrier. The terms must be acceptable to both parties and need to be approved by a Workers’ Compensation Law Judge before any settlement is paid out.

It is possible for the parties to fail to reach an agreement under Section 32 rules or have a judge reject their proposal due to its unfairness to one or both sides. If an injured worker decides that the proposed terms of a settlement are not adequate, they can decide to keep the case open.

New York is a “capped” state, meaning that for accidents occurring after 3/13/2007, injured workers face a limit on the length of time they can receive disability benefits. By contrast, the law dictates that the medical portion of a case can remain open indefinitely based on the beneficiary’s health needs.

It is important to note that if an injured worker is Medicare enrolled, Medicare’s interests must also be considered when settling the medical portion of a workers’ compensation case. There are also implications to settling when the injured worker is in receipt of Medicaid benefits. An injured worker may be entitled to a lump sum award for permanency/scheduled loss of use in cases involving extremity, such as an arm, leg, hand, or foot, even without a Section 32 settlement.

If you are interested in settling your workers’ compensation case, the experienced workers’ compensation attorneys at Lewis & Lewis can review your case at no cost to you. Contact us today if you have questions about the Section 32 process or your workers’ compensation case.

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