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Should I Settle My Claim?

Once you have reached maximum medical improvement, its time to consider settlement of your claim. Remember the only damages you can legally get in a workers’ comp claim are for payment of medical bills and for wages. Let's separate the two types.


Wages

Depending on the injury type and the extent of the injury, the insurance will likely have to pay something for lost wages. There are too many variables to be able to say how much in a general way. It depends upon the specifics of each case, but in a nut shell, the insurance has to pay 2/3 of your average weekly wage(using the last 52 weeks) for time you are not able to work, for a set number of weeks depending on the injury.


Here is an example. A factory worker makes $400 per week, injures his/her thumb at work, and is out on a doctor’s excuse for one month. They would be entitled to payment for lost wages of $1,066.67(($400 X 4wks)x2/3). Remember there is a cap, so those earning more than 1/3rd over the cap won’t see the full 2/3rds.

The answer to whether to settle the wage portion of your claim is generally yes, if the insurance is being fair with their offer.


Medicals

There are two options on the medical side of your claim. Option one is to leave your medicals open. The insurance company will have to pay for any medical bill related to your job injury for life. The only caveat is that you have to see your doctor at least once per year for the injury. If you don’t, the claim can be closed. Sounds great, right? Hold on a minute.


The other option is to settle for a lump sum amount. It may be less than they would have to pay for a lifetime of meds. However, when you settle for a lump sum, you take control of your medical treatment. No more delays and no more restrictions on what docs you can and can’t see.


Most claimants find that option two is far better than one. The biggest frustration with a comp claim are the delays and lack of control of treatment.


Have a great Thanksgiving!


Kevin

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