Hello! My name is Lisa, I am a 50 year old female in Pennsylvania. I have been receiving Workman's Compensation for a year as of 11/11/12. I have recently received a letter from them wanting to settle so they can close my file. I am still seeing Doctors for this injury. The medical testing that was done on me, just recently, showed I received two bulging discs in my lower back and I have lost 75% of my nerve reaction in my left leg. I was told by the consulting Doctor that there is nothing that can be done to improve my condition. I have to live with the pain, discomfort and limitations for the rest of my life. They are offering me 1 year of compensation, which totals $13,623.48. I don't think so!! If I don't agree to this they will just continue to pay me bi-weekly. If I do agree, then they will pay me that amount and stop medical when they close my file. What I want to know is 1. Can/Should I handle this on my own? 2. Do I need legal representation? I feel I will never be able to hold a job that would pay me to even go, because I couldn't handle too many hours a day. I just dont know what to do about this. I do not agree to their terms at all. Help
6 Answers from Attorneys
Hire an experienced work comp attorney in your area. Call me if you need recommendations.
Richard Senker 610 279 1600
You shoul speak with an attorney experienced in handling worker's compensation matters. The insurance company is most likely undervaluing your case. Call me for a free consultation.
This offer most likely represents an "opening salvo" and can be improved upon. Whether the ultimate number they are willing to offer is sufficient to make settlement attractive is up to you. Your other option is to remain on the benefit stream but that will not be forever. There are legal ways the insurance company can use to limit your claim to a certain period of time. For most claims, the longest one can even conceivably be paid is roughly 11.5 years. The insurance company will certainly try to shorten your claim to a period much smaller than that. Most claimants choose to settle their case when they are given an offer that will likely pay them more than what they are likely to get by fighting the efforts to cut them off.
Because you are 50, you may be able to combine a settlement with an application for Social Security Disability benefits to improve your situation. SSD benefits would replace some significant portion of the cash flow that you would lose if you settle your case for a lump sum. Using this strategy, you essentially "retire" on your full, unreduced social security benefit without waiting until you are 62. Care must be used, however, to include the right language in your WC settlement agreement so that your WC settlement does not unnecessarily redcue your SSD benefits.
It is also possible that you can settle your case in a way that provides the opportunity to receive unemployment compensation benefits after you settle, if you would prefer to settle and then look for alternative work, rather than pursue the SSD strategy.
Sometimes, you can settle, collect SSD and collect UC if you stage the various benefit sources correctly.
Settlement of your medical benefit claim is a separate issue that raises many complicated issues. You should know that other insurance plans are unlikely to pay for treatment of your work injury after you settle your medical claim. Unless you get enough money or unless you use some other techniques, you may have to pay for your future care from money you had intended to compensate you for lost wages.
In short, you should not try to settle your case without the advice of an experienced workers compensation lawyer, who is also familiar with the Social Security system, the Unemployment Compensation system, and health insurance laws.
Feel free to refer to my article "Representing the Older Injured Worker" at my website for further exposure to the issues relevant to your situation. http://www.wmpalaw.com/lawyer-attorney-1734665.html.
If you have any other questions, feel free to contact me directly. Consultations are always free of charge.
As noted by others, please consult an attorney before settling your case. I would be happy to consult with you. Feel free to call for a no obligation consultation. (800) 433-9700.
Lisa- You should follow the advice of all the attorneys who have responded. It is unlikely you will be able to negotiate and complete a worker's comp settlement without an attorney to help you, for a variety of reasons. For example, you are not experienced in the value of these claims and the insurance claims is trained. Also, there is too much interplay with worker's comp, social security, & possibly unemployment compensation. You should consult with an experienced worker's comp attorney who will protect your interests. I have been handling worker's comp cases for over 25 years & would be happy to speak with you. There is no charge for a brief consultation. In any case, good luck!!
The carrier offered one year's worth of comp. or $13,000.00 Tell it you will need five years' worth plus continuing medical, i.e., 5 x 13,000 = $65000.00. the value of medical bill protection for a possible corrective surgery requires a reserve of $10 - 25000. You may end up abandoning this right to indemnification if the carrier makes a more realistic offer.
Since you are already receiving compensation, the burden is on the insurance company to change the status quo, so it will be motivated to negotiate. Sorry you are injured; hope you feel better soon.