Workers’ Compensation – One time settlement?
Hi, This is my first claim. I was diagnosed with right radial tunnel syndrom as well as right lateral epicondylitis. I was treated with medications and occupational therapy. The symptons improved slightly. Doc suggested cortisone injetion but i didnt want steroids so requested for more therapeutic sessions. I had worked 10-11 hour days every working day for the last employer for 3.5 years. I quit that job recently and now I got a notice “Permanent disabilty benefits denial form” and when I contacted the insurance adjustor, I was told that they will do a one time settle of $8500 to close the claim and any future issues will not be treated under workers comp.If I choose not to take that one-time settlement, they could keep the claim open for a finite period of time (6 – 12 months) . If I have to go in for surgery after the 6-12 month time frame, it will have to be under my own personal insurance. My question is – Should I take this ? If I do go for the one-time settlement, is this a fair amount ? How do I arrive at what is fair ?
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I assume that your primary treating physician outlined and you lifetime future medical care provisions.
Unless your doctor specifically states that you need to have surgery within the year, the insurance carrier cannot finalize your case without a settlement. The only way a case can be finalized and liability is released is by way of a lump sum settlement amount. That is why they are pushing so hard.
Whether this settlement is fair depends on exactly what future medical needs the doctor states. Other factors that we need to consider is your age since the older you are, the harder it would be for your body to recover and in turn, more care is needed. If you are near retirement age, you could be eligible for Medi-Care, which would factor into your decision on whether to settle for that amount.
Good luck
You and the ins carrier can settle this claim at ANY TIME you can
agree. Whether or not there is need for future medical treatment
doesn’t matter in the settlement. Whether or not you are paid for
future medical does. They are attempting to close this claim now
because you are refusing treatment. Since you quit your job, you
are no longer entitled to temporary disabililty payments, because
you don’t have any wages to replace. You should NOT settle this
claim until you have completed the treatment as recommended by your
Dr, and stablized at MMI/max med recovery. Only then can the value
of your PPD be determined. You also should know you CANNOT use your
own personal health coverage for treatment to your work related
injury. That carrier WILL DENY payment when billed by your Dr.