A Workers’ Compensation Settlement – is it in your best interest?
If you are currently collecting workers’ compensation benefits in Louisiana, you may be wondering if it’s in your best interests to settle and for what amount. It’s possible that your employer or their insurer has offered you a lump sum payment, but you’re unsure if it’s a fair deal.
Regardless of where you are in the claims process, it’s vital that you speak with a workers’ compensation attorney who has experience evaluating and negotiating claim settlements.
Wanko Law Firm, LLC has helped countless injured workers navigate the claims process in Louisiana and receive maximum compensation for their injuries.
We will carefully calculate the value of your claim to make sure you are receiving nothing less than you deserve; we will reject any settlement that would jeopardize your ability to get medical care now and in the future. We will also explore your eligibility to receive benefits from additional sources like Social Security and Medicare.
Call us today for a Free consultation so we can discuss the specifics of your case and your settlement options. If we take on your case, we do not expect any money up front and will only collect a fee from the settlement of the case or after a trial judgment.
What Does it Mean to Settle? Lump Sum vs. Structured Settlement
The first thing you should know about the settlement of a workers’ compensation claim is that it is completely voluntary — neither you or the insurance company are forced to settle.
If you do agree to a settlement, you are agreeing to let your employer or their insurance carrier stop paying your weekly wage benefits and medical expenses in exchange for a tax-free lump sum payment.
The main advantage of a lump sum payment is that you get the money now and can use it for any of your immediate needs. It may make sense to take a lump sum if you need to pay off bills or if you are planning to make a large scale purchase like a house or a car.
You also have the option of putting all or some of your compensation money into a structured settlement or annuity which is paid out over a set period of time in a series of periodic payments. This allows you to earn interest and guarantees you will have money available in the future.
All lump sums and structured settlements are subject to approval by a Louisiana Office of Workers’ Compensation judge. If the settlement is not approved, there will be an opportunity to re-negotiate with the insurer in mediation and re-submit for approval.
A good settlement would typically include:
- any past-due workers’ compensation indemnity benefits (lost wages), plus late penalties if applicable;
- a realistic estimate of future temporary total disability or temporary partial disability benefits
- past and future medical expenses accounted for
If you do not want to settle, you can:
- continue taking your weekly permanent disability payments for as long as the insurance company has indicated it will pay you, or
- you can proceed to a hearing or trial with the insurance company to try to win higher weekly payments or a higher lump-sum payment.
Factors To Consider Before Settling
Once a settlement agreement is reached, there’s no going back. You will have no further
claim to benefits from the insurance carrier, even if further medical problems develop which are related to the original work injury. It’s important to have a plan in place after settling to avoid financial or physical trouble.
No two cases are alike but there are certain factors that need to be considered before
Some of which may include:
- Is your condition medically stable?
- Have all your medical bills been paid?
- Have you been appropriately compensated for time off work due to your injury?
- Have you been properly compensated for travel expenses to and from doctor’s appointments?
- Do you require ongoing medical treatment?
- Will the settlement be enough money to give you financial security?
- Are you unable to work ever again? If you can work, does your injury limit your ability to perform certain tasks?
- Will a settlement affect your Social Security Disability benefits, Medicare benefits, or unemployment benefits?
What Is My Case Worth?
The value of your case is essentially the amount you would receive from your employer’s insurance company over the life of the claim.
Your settlement amount is calculated based on the expected future cost of your injury and then prorates that amount to reflect the probability of the costs occurring.
Additional variables that factor into the value of your case include:
- number of weeks of potential compensation remaining
- the extent of your injuries and resulting functional limitations
- your impairment or disability rating
- whether your disability is temporary or permanent
- how much you were earning at the time of the accident
- what body part or parts were injured
- cost of past, current and future medical treatment
- your age, education, work history and transferable skills
Have You Reached Maximum Medical Improvement?
The optimal time to consider a settlement is after you have completed medical treatment and your treating physician finds you to be at Maximum Medical Improvement (MMI).
MMI means your recovery has reached it’s plateau and it’s as “good as it’s going to get.” In other words, even if you were to receive further treatment your condition would not improve.
Your Impairment Rating Affects The Value of Your Claim
After your doctor has acknowledged that you have reached MMI he/she will conduct a physical examination to determine if you have any residual impairment from your work related injury or illness. Based upon the results of your test, you will be given a permanent partial impairment disability rating.
The impairment rating refers to the percentage of limitation of physical ability, strength and range of motion resulting from your injuries.
- For example, if, before your injury you had a 100% range of motion in your arm but after MMI you now have 80% motion — you have suffered a 20% permanent partial disability rating.
An impairment rating is important because it assigns value to your claim and determines whether or not you can be expected to return to work. It’s also a huge factor in whether or not you will be entitled to permanent partial disability (PPD) or permanent total disability (PTD) benefits in the future.
To ensure you receive a fair rating we will compare it to the American Medical Association’s Guides to the Evaluation of Permanent Impairment book. We can also seek a second opinion with another physician.
Permanent Total Disability means
- the doctor believes you are unable to return to any type of employment (not just the type of work you were doing before the injury)
- you may be entitled to receive weekly benefits for life (2/3 of your pre-injury average weekly wage) or for so long as you remain permanently and totally disabled. If you and the insurance company agree, you can settle for a lump sum.
Permanent Partial Disability means
- you may be unable to do certain jobs or certain job tasks due to limitations but are still able to work at some type full-time job
- your benefits will be paid in a lump sum
Formula To Calculate PPD Benefits
The amount you can receive from an insurance company for permanent partial disability is determined by a very complicated formula that takes into consideration several factors including:
- the specific body part that was injured
- your average weekly wage
- your permanent disability rating
Wanko Law, LLC will be happy to review the particular facts of your case and crunch the numbers to arrive at a PPD benefit amount.