Posted on Wednesday, March 13th, 2019 at 3:45 pm
A compromise and release (C&R) is a way to settle your worker’s compensation claim. In Virginia, these are commonly called Full and Final Settlements, whereas in North Carolina, these are commonly called Clincher Agreements. These kinds of settlements are generally used for workers who are disabled from their pre-injury job and will likely need future, long-term medical care. There can be settlements even when the worker returns to his/her former job – based on the understanding that the worker will need continual funds for medical treatments.
These full settlements mean that the entirety of the case—both the future indemnity (some portion of the value of the future compensation checks the worker would likely receive), and the future medical value of the claim (some portion of the value of the future work injury care that the injured worker will likely receive for the remainder of his or her life) are completely resolved. In exchange for a lump sum which represents these two sides of the injured worker’s case, once the final settlement Order is entered by the Commission, then all of the ongoing benefits for both weekly checks and medical stop, permanently.
There are many considerations that you will need to review with an experienced North Carolina or Virginia work injury lawyer depending on where your claim is:
Additional questions include:
Some of the answers to these questions are general. Most depend on the individual facts of your case.
The employee and employer may have different ideas on how much medical treatment you will need in the future. The amount that will be included in the settlement needs to be artfully negotiated so that the worker gets the best amount. Experienced work injury lawyers understand the legal arguments. They also work very carefully with your doctors to fully understand what treatments, medications, and other health care costs you’ll have. In some cases, it can be fairly clear that the worker will need to see a physical therapist several times a month. In other cases, where the health effects of the work injuries may deteriorate over time (such as when he/she has a disease), it can be harder to determine what care is needed. In other situations, the injury may be so severe that it is clear that as the worker ages, home healthcare or attendant care will be required, with potential significant future costs.
At the end of the day, unless dealing with a Medicare situation, the portion of the claim and any settlement that deals with future medical care comes down to the comfort level and a frank discussion between the injured worker and his or her attorney. How likely is it that the injured worker will require future surgery? How likely is it that the injured worker will return to employment and obtain health insurance to cover the cost of such surgeries? Are the contemplated future medical costs based in reality or are they just “worst case scenario” medical costs?
It is also important to understand that full settlement means just that—it settles all aspects of your case. It is possible to use the C&R to just settle just settle the wage issues (indemnity-only settlements), but leave the medical payments open. The second scenario is useful, for example, when someone’s future healthcare costs are so extremely high or at this point unknown that it makes a full settlement impractical. In such cases, settling the indemnity side alone—providing a lump sum to the injured worker—while leaving the medical portion open, may make sense.
Then again, many insurance carriers simply refuse to engage in such settlements and insist on an “all or nothing” approach. Either the entire claim is resolved, or not at all.
Injured workers need to review what other benefits they may be entitled to with time or due to a disability. Some workers may be entitled to Social Security Disability. (SSDI) Workers may also be entitled to Social Security retirement income when they reach age 62. They may also be entitled to Medicare, Medicaid, or other government benefits.
Experienced lawyers will also review the workers’ family situation. Who can the employee rely on for support? The education and ability to earn another type of income needs to be considered. The severity of the injuries needs review. The more doctors and healthcare providers the patient requires, the harder it becomes to make an evaluation of how much money is needed for long-term health problems. If a worker has mental health difficulties, it can be extremely difficult to know how much psychiatric and psychological help the worker needs.
At the North Carolina and Virginia Law office of Joe Miller Esq., we have helped thousands of workers get just recoveries for workplace accidents and illnesses. We’ve been fighting for clients for more than 25 year. We’ll explain when you should consider a settlement and what the terms of the settlement should be. For help now, 1-(888) 667-8295 or complete my contact form to schedule a free appointment.
Posted on Sunday, June 7th, 2015 at 8:53 am
In Virginia, the entry of the Open Award isn’t 100% foolproof. The employer has an additional 30 days AFTER the entry of the Award to withdraw the Award Agreement. This is also referred to as the Award becoming FINAL. Until those 30 days pass, the Award is not yet final. This means if it is withdrawn during that first 30 days after it is entered, the Award will be vacated and it will be as if the Award was never entered. (more…)
Posted on Tuesday, June 2nd, 2015 at 12:00 pm
The Authorized Treating Physician. The authorized treating physician in a Virginia workers’ compensation claim merely refers to the doctor who the workers’ compensation carrier has agreed to allow to coordinate and direct your treatment. It is also the physician through whom they agree to pay for all recommended medical treatment. This medical provider is usually chosen and one of two ways: (more…)
Posted on Friday, May 22nd, 2015 at 12:00 pm
Employers will try to change even an Open Award in a workers’ compensation claim. They will normally do this through an Application to Terminate Benefits (or a Termination of Benefits Agreement) because you are able to return to work. The basis for filing this application will be a report from a doctor that you are able to do your job. (more…)
Posted on Friday, May 15th, 2015 at 12:00 pm
In other articles we’ve spoken about an Award Agreement. That is a document which you may sign whereby you and the workers compensation insurance company agree that you are to be paid certain benefits under the Virginia Workers Compensation Act.
But just because you signed and returned and award agreement to the adjuster doesn’t mean you get paid. The employer still needs to sign it AND forward to the Commission AND then the Virginia Workers’ Compensation Commission has to convert that agreement into a formal AWARD ORDER. Then 30 days must pass before the Award Order is considered FINAL. Until that happens, almost any change in circumstance will result in the comp carrier reneging on their agreement to pay you, which means you have nothing. (more…)
Posted on Monday, May 4th, 2015 at 5:21 pm
Have you filed a claim for workers’ compensation benefits? If so, your employer has 20 days to respond to your claim, which can include denying your claim, even if you already started getting benefits. Another option is to accept your claim and send you an award agreement. This video explains why an award agreement is important in your claim and what can happen even if you have an agreement.