workmans comp settlements

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Info current as of 11/09/01

                                WORKERS' COMP SETTLEMENT OFFERS

QUESTION: I was seriously hurt at work, and I will be partially permanently disabled. I will never be
able to return to the job I had. I’ve been getting weekly checks for almost a year now. The insurance
carrier just made an offer for a final settlement on my case, but I think the amount is too low. Do I have
to accept the insurance company’s offer?
ANSWER: No, you do not! All final settlements, usually called lump sum settlements, must be
approved by the Labor Department. It will approve a settlement only if both sides agree. The process is
designed to encourage negotiation between you and the carrier, but the insurance carrier has substantial
experience and knowledge in this area. For example, the carrier knows all of the benefits to which you
are, or might be, entitled. You probably do not. In order to determine the fairness of the carrier’s offer, or
the reasonableness of your counter-offer, you need to know what you might receive as benefits in the
future.
        The future cost of benefits to the carrier is the most critical fact upon which settlements are based.
A carrier will never pay you more in a settlement than it will have to pay you in future benefits.
        Perhaps the most important single factor in determining the value of your case is the type of
disability you have. Disability can be partial or total; temporary or permanent. This is a medical
determination made initially by your treating physician.
        If you are anything “less” than totally and permanently disabled, the maximum period for which
you can receive weekly benefits is five years, even if your partial disability continues long after that. If
you are totally and permanently disabled, weekly benefits will continue for as long as you remain so, even
after retirement age.
        Obviously, an insurance carrier will place a lower value on a claim that can last for a maximum of
five years than it will on a case that may continue for a lifetime. However, there are other benefits under
the workers’ compensation law to which you may be entitled. Claims for those other benefits, such as
vocational rehabilitation or permanent impairment awards, can increase the value of your case, if evidence
supports those claims.
        There is not enough space in this column to detail all the types of benefits to which you may be
entitled, since many of them are tied to the specific facts in your case. If you are eligible for Social
Security Disability, the settlement agreement must contain specific language to avoid the loss of your SS
benefits. Seek out an attorney who is experienced in workers’ compensation, and buy an hour of the
attorney’s time. Based on the information the attorney provides you, you could write the demand
yourself. If your case is complex, you may hire the attorney on a contingent-fee basis. Even after paying
the attorney’s fee, you may have more in your pocket than if you’d settled the case yourself.
        Remember, lump sum settlements are final. There is no looking back or changing the agreement
later. You should gather as much information as possible regarding your future benefits before agreeing
to a lump sum settlement.

                                     Answered by Attorney Kenneth M. Brown
                                        Sullivan & Gregg, P.A. in Nashua

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