For the most part, workers compensation settlement is a comprehensive contract between the employer and the employee. Different steps are done depending upon the terms and conditions stated therein to settle the claims of the parties.
However, there may be situations where your injury has gotten worse despite undergoing treatments. The predicament may then cause an additional financial burden, which is why you should follow these steps to know what to do.
Check your settlement, whether it provides for a stipulation stating that future medical treatments and expenses would be included. If there is such a condition, then a mere submission for a bill of your medical treatment or surgery should suffice for its reimbursement.
On the other hand, if your settlement did not include future expenses, you should file a petition to reopen the compensation case with a showing of proof that the condition has now gotten significantly worse than before.
Before you file a petition to reopen your case, first check what type of settlement did you agree on and determine if whether or not the possibility of opening it is feasible.
These types of settlement cases are probably the least beneficial as it does not allow for a reopening of the case. The settlement will cover all future, present, and retroactive costs, and the claimant will receive a lump sum payment.
So, you must be wary in accepting these settlement agreements as this type of settlement will bar you from claiming future medical reimburses. The only way to reopen this is in cases of fraud.
If there has been a full and final release of settlement claims, however, one may no longer reopen the case for reimbursement of medical costs or other disability benefits. In many states, a full and final release of a settlement is a form of waiver, showing that you are now giving up your right to present any future claims concerning your injury.
Unless a statute or a special law in a state provides that it is illegal for workers to waive future settlement claims, one must prove fraud or misrepresentation for the waiver. That is why it isn’t very easy to reopen a final settlement. Workers must scrutinize the provisions of the settlement before accepting any agreement to prevent getting barred from availing future reimbursements and benefits.
This type of settlement allows workers to be compensated for existing disabilities and medical problems. Unlike Compromise and Release settlement, Stipulation and Award Settlement provides for the workers’ comp settlement to be reopened upon showing valid grounds such as new symptoms due to the previous injury.
The amount, however, is usually lower than that of the C&R settlement, and there is a prescriptive date on reopening a case – a 5-year statute limitation, or else you can no longer open the case.
If there is a new injury because of one’s occupation other than the previous injury, a worker also has the option of filing a new compensation claim. There are, however, certain conditions, such that there has been a further incident related to one’s occupation that may have caused the new injury, which may be used as a ground on filing a new claim.
If a workplace accident or work exposure has aggravated the injury or has made new symptoms thereof, it is more logical to file new workers’ compensation claim rather than reopening your previous or existing settlement. This is because specific agreements usually cover only definite trauma or injuries that do not comprehensively cover the imminent illness.
Cumulative trauma causes, however, occur over time. It involves progressive or repetitive illnesses that manifest differently later on. These cases are highly complex that a small specific settlement cannot cover beforehand. Hence these claims are treated as new claims for the benefit of the workers.
It is difficult to determine the compensation benefit, especially during a worsening condition. Settling a compensation case already consumes a lot of time and money for many workers, what more for those with deteriorating health. Both physicians and claimants have to see if these new symptoms are due to previous work injury, or due to the work environment, which would affect the worker.
It is best to work collectively with your physician and lawyer to provide for the best approach on whether or not reopening a case of filing a new claim would be the solution.
You may also find yourself in various predicaments as aggravated symptoms shows. Some benefits, while you are working on the additional claim, will not cover the present symptoms that you are newly experiencing.
Therefore, you may have to resort to other viable options such as private medical care or private health insurance to be able to cover these expenses. You must have an expendable substitute funds to be able to cover some costs while the case for additional benefits are still ongoing
Also, finding an attorney who is an expert in workers’ compensation settlements will provide significant assistance for the treatment and support needed in the case.
Your attorney would not only help you find the best strategy for your settlement claims but also help expedite the process for you to receive the compensation benefits you need.
A worsened condition is a financial nightmare. That is why you should call Davis & Sanchez to help you reopen a claim or file a new one. The firm prides itself as an expert in workers compensation cases and you will definitely get the best settlement available in the law.
To get a free case evaluation and to know more about Davis & Sanchez, contact the firm at (801) 746-0290 or (208) 258-7000, or visit them at 655 E 4500 S #120 Murray, UT 84107 or 4696 W Overland Road, Suite 162 Boise, ID 83705.
*The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only.
Davis & Sanchez