Settlement of a workers’ compensation claim

by Kara Dolan-West | Aug 06, 2012 | Workers' Compensation Benefits

The settlement of a workers’ compensation claim can be a way for an injured worker to receive a final monetary payment under the claim. Once a claim is settled, no further costs (medical or monetary benefits) are payable under the claim.

The settlement value of the claim is largely driven by the likelihood that the BWC will have to spend money in the future on the claim. Claims with higher settlement values tend to be claims with more significant conditions recognized in the claim and claims with more ongoing activity. Claims with lower settlement values tend to have relatively minor allowances and have likely been inactive for a period of time.

The settlement of a claim involves multiple steps. If an injured worker desires to pursue a settlement, our firm analyzes the value of the claim and submits a demand to the BWC. At this point, the BWC must analyze the claim from its perspective. Depending on the complexity of the case, this can take several months. Once the BWC has analyzed the claim and made a counter offer, negotiations between the parties can take place. Obviously, both the injured worker and the BWC must agree on a settlement figure in order for the claim to settle.

Settlement can be complicated by an injured worker’s receipt of social security disability, application for social security disability, or potential enrollment in Medicare. In these situations, care must be taken to ensure that any costs associated for ongoing treatment after the settlement are not passed on to Medicare. Depending on the particular situation, the injured worker may need to allocate a portion of the settlement proceeds to cover his or her own medical costs that would have otherwise been covered under the claim.

Once the settlement has been negotiated and agreed to by all parties, the BWC will issue an order reflecting that settlement has been reached. After that order is issued, the parties enter a 30 day waiting period. During this waiting period, any party may withdraw from the settlement by providing notification in writing. Once the waiting period has ended, the BWC will issue the settlement proceeds.

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