The Importance of Securing a Comprehensive Workers’ Compensation Settlement

The Importance of Securing a Comprehensive Workers’ Compensation Settlement

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If you are eligible for workers’ compensation benefits due to a work injury, the payments and medical care you receive are typically finite. Once your treating physician okays your ability to return to work, your benefits end. This is the situation in temporary disability cases. But what if you suffer a permanent disability?

Maximum Medical Improvement

At some stage during your care, you will reach a point where your recovery is at an endpoint. This means that you are not likely to continue improving, even if you are not back to your pre-injury state. If your injury was severe, it’s possible that you may not be physically able to return to the workforce. When this is the case, you may continue receiving weekly benefits through worker’s compensation or request a lump sum, subject to a 4% per annum reduction. Some permanently injured workers may want to consider a settlement that covers future financial and medical needs.

Normally, in a settlement arrangement, the employer and insurer pay a certain sum of money to the injured worker to settle all past, present and future financial obligations. In return for these settlement funds, the employee gives up any and all future demands and claims against them. Therefore, a workers’ compensation settlement must be very carefully negotiated to ensure that that all your current and future needs will continue to be met.

When you sign a settlement agreement, you give up the following rights under the workers’ compensation benefits system:

Temporary disability benefits
Permanent disability benefits
Permanent total disability benefits
Future medical treatment
Disfigurement compensation
Penalty fees against the insurance company and/or your employer
The right to reopen your case
The right to make any claims for additional benefits for unknown injuries
Your attorney should be able to negotiate these expenses, claims, and potentialities into your settlement agreement, because you only get one shot at this. Barring very minute exceptions, once you sign your settlement agreement, you are stuck with the consequences.

Reopening Your Settlement

In Colorado, when you enter into a settlement agreement, you give up the right to reopen your workers’ compensation case due to a mistake or if your condition worsens. It may be possible to reopen the settlement agreement, but only if you can prove fraud or that a mutual mistake of material fact occurred.

Mutual Mistake of Material Fact

This is a high bar to meet. The mistake must be one made by both sides of the agreement, and it must be an error that has essential bearing on your case. Higher unanticipated bills or additional medical treatment requirements do not constitute a mutual mistake of material fact. Discovering a new medical problem may not qualify either, even if you discover that this previously unknown medical issue was the result of your settled work injury. Fortunately for Victor England, this wasn’t the case.

England v. Amerigas Propane

This case is an example of the stringent requirement for reopening a workers’ compensation settlement agreement. The Colorado Supreme Court decided the case on September 30, 2017. Truck driver England was injured in 2012, and he entered into a settlement agreement governed by the Colorado Worker’s Compensation Act. In 2013, England’s doctor discovered a previously undiagnosed stress fracture to his scapula. The settlement form used included a paragraph prohibiting a reopening of the settlement unless there was fraud or mutual mistake of material fact. England petitioned the ALJ to reopen his settlement and won, but the employer appealed, and the Court of Appeals ruled against the employee. England appealed to the Colorado Supreme Court, which finally agreed that this issue demonstrated a mutual mistake of material fact. His case was reversed and remanded.

Turn to an experienced and knowledgeable Colorado workers’ compensation lawyer to help you determine the best approach when you have been seriously injured at work. If a settlement agreement is your best option, your attorney can skillfully negotiate terms that will ensure your continued care and financial stability in the wake of your injury. Get a free review of your workers’ compensation case with our expert Denver area workers’ compensation attorneys now.

What Does MMI Mean?

Workers Compensation Blog

Other than the date a worker was injured, the next most important is the date that the Doctor placed the worker at “Maximum Medical Improvement” also called MMI.  When a worker is placed at MMI, certain benefits can shut off, and other begin, but most worrisome, it marks the time that the insurance company will try to close the workers’ compensation case.  For that reason it is best to have a lawyer before you are placed at Maximum Medical Improvement.

When the Doctor places you at Maximum Medical Improvement (MMI) he or she is NOT saying that you are “cured.”  MMI means ONLY that there are no other treatment options (rest, therapy, injections, surgery) that will get you BETTER.  Although you may get better over time – the law says that the passage of time alone is not medical care.

Often the most frustrating part of any injury is realizing that you may never get better or pain free.  Often times, particularly with injuries as serious as our clients have, there are no cures that will completely restore the worker back to 100 percent.  If an injured worker has ongoing pain and problems the Doctor will and should continue to see you for maintenance medical care – care that will not get you better but help you deal with your pain.

When our clients are placed at Maximum Medical Improvement we get them a second medical opinion in order to determine that no stone went unturned to improve their condition as well as to get medical care for body parts that the company doctor either ignored or refused to provide medical treatment.

Medical care is the most important benefit for injured workers, so it is important that you have an attorney who will help you fight for medical care.  Call us at (866) 356-9898 or click HERE for a free consultation to see how we can help you.