Workers Compensation

I'm Thinking of Settling My Workers' Compensation Case, But What If My Condition Gets Worse?

By Sachi Barreiro, Attorney, University of San Francisco School of Law
Before settling your workers' comp case, make sure your condition has stabilized.

Question: I injured my arm pretty badly while operating machinery at my job in the warehouse. I saw a doctor, who recommended steroid injections and physical therapy. After several months, my pain has improved. But I’m worried that it will get worse again in the future. Should I settle my claim and take what I can get? Or hold out for more?

Answer: As a rule of thumb, you shouldn’t consider settling your case until you have reached maximum medical improvement (MMI). MMI is a determination made by your doctor that your condition has stabilized and that you have improved as much as you can be expected to. At that point, if you have any permanent impairment, your doctor will give you a permanent disability rating. Your rating will determine how much you will receive as a permanent disability award.

Waiting until you reach maximum medical improvement will increase the odds that your condition will remain largely the same. However, there is always the risk that your condition could get worse in the future. If you think that this is a real possibility, you could try to negotiate a settlement that leaves future medical care open. In this type of settlement, if your condition worsens, your medical treatment will be covered and you can reopen your workers’ compensation claim (to potentially receive additional disability benefits).

However, the insurance company may only be open to a settlement in which you agree to release any and all claims relating to the injury. In other words, if your condition gets worse, you can’t go back for additional medical treatment or benefits of any kind. If you do decide to go with this type of settlement, you should make sure that the settlement amount accounts for the cost of any future medical treatment you might need. For example, if there’s a 10% chance you might need a $10,000 surgery, you can try to negotiate for $1,000 to go towards your future medical care. (To learn about other types of settlements, see Settling Your Workers’ Compensation Claim.)

Settlement agreements can be binding and final, and a good settlement amount will depend on the facts of your particular case. Before agreeing to a settlement of any kind, be sure to consult with an experienced workers’ compensation lawyer.

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