Closing Out Your Workers' Compensation Benefits Claim
If you are injured on the job, your employer is responsible to pay workers' compensation benefits. These include reasonable and necessary medical expenses and a portion of your lost wages during the period you cannot work. If the injury is permanent, you are entitled to be paid an additional sum of money as compensation for your permanent injuries.
A workers' compensation case remains open throughout your lifetime. This means that the insurance compensation carrier is responsible for paying all future medical bills and any future periods of lost time that are a direct result of the original workplace injury, or a relapse or aggravation of the injury. Even after you have returned to your job and are no longer receiving medical treatment or workers' compensation benefits, your case remains open with the responsible insurance carrier.
The Stipulated Agreement
In some cases, you may want to agree to a final settlement that closes out the claim. The advantage to the insurance company is that it can close out its file and have no further payment responsibility. The advantage to you is that the insurance carrier will pay you an additional sum of money, over and above the workers' compensation benefits already paid, to close out the case. The agreement to close out a workers' compensation case is called a stipulated agreement or final stipulation.
In the usual situation, you and the insurance carrier agree on a one-time lump sum payment as a final settlement. After receiving payment, you will have no further claim to benefits from the insurance carrier, even if further medical problems develop which are related to the original work injury. The final stipulation must be in writing, and must be approved by a workers' compensation commissioner after a hearing. The commissioner has the authority to deny the final stipulation if he or she feels that the agreement is not fair to the injured worker.
An insurance company will not consider entering into a final stipulation if you are still employed by the same employer where the accident occurred. The reason for this is that the insurance company does not want to take the chance that you will suffer a similar type of injury in the course of employment and file a new claim for the same or similar injury.
Once the stipulation is approved, the insurance company usually pays the lump sum settlement within two to three weeks.
How Much Will I Receive if I Close Out My Case?
From the insurance company's point of view, the value of a final stipulation depends on how much money the insurance carrier is likely to spend on this claim in the future:
- Is there a reasonable chance of future surgery?
- Is there a probability or possibility of some period of total disability in the future?
- Will there be future wage loss directly related to this claim?
In other words, the insurance company will consider its risk on the file and place a value on what its future exposure might be.
As the injured party, you should certainly consider your potential future medical costs, whether you are likely to be disabled in the future as a result of the injury, and whether there are any unpaid benefits that the company still owes. Pain and suffering, which are important in a civil case, generally do not increase the value of a stipulation.
Final stipulations should never be entered into hastily. Once a final stipulation is approved, it is almost impossible to reopen the case. A case may be reopened if there were material facts that would have affected the claim that were not known to either party prior to the stipulation.
Another important point — neither side can be forced to agree to a stipulation. Not even a workers' compensation commissioner can order the insurance company to enter into a final stipulation. Either both parties agree to an amount of money, or there is no final stipulation.
Contact a Skilled Connecticut Permanent Disability Attorney and Workers' Comp Lawyer
Closing out your workers' compensation case will enable you to receive a lump sum payment for your work-related injuries. In many cases, closing out your workers' compensation case is a sound financial decision. However, if you are considering a final stipulation, you should be cautious and make sure that you understand both the advantages and the disadvantages of closing out your workers' compensation case. In some cases, it may be more prudent to keep your workers' compensation case open and seek additional benefits as you become eligible for them.
A Bridgeport workers' compensation benefits lawyer can help you decide whether closing out your work injury compensation case is a good option for you. At the Law Offices of John J. LaCava, LLC, we have been helping put lives back together for more than 25 years. We can help you, too.
Our main offices are located in Stamford, Connecticut, but you can reach us at any of our three convenient Fairfield County locations by calling 877-293-6717 or by contacting an attorney online with a brief description of your situation. You can speak with a workers' compensation lawyer directly about your case.
We have three locations, in Stamford, Norwalk and Bridgeport, to conveniently serve our clients with day or evening appointments. Initial consultations are always provided free of charge. Appointments can be made for evenings, weekends and off-site locations for your convenience.
You will pay no fees or costs unless we recover compensation in your case.