So, the workers comp adjustor wants to pay you some money to settle your claim. Should you settle?
"It all depends," as most lawyers say. Here are some factors to consider:
1. Is the adjustor using the correct compensation rate? (2/3 of your gross pay at the time of the accident + $5 for each dependent per week)
2. How will you pay for future medical treatment? Private insurance companies (i.e., Cigna, Select Health, Blue Cross, etc.) usually put a clause in their contract saying you--the injured worker--must reimburse them for any costs they incur treating your industrial injury. This is called "subrogation" and can be a real game-changer when considering settlement.
3. Can you hang on a little longer financially so you can have an attorney review the case with you? From what I know now, I would not settle a claim without counsel from an a lawyer. Personally, I will not enter into an attorney-client relationship unless I feel that it is in the client's best interest to have my services.
4. Now back to future medical treatment: What is your prognosis? Are you completely healed? If you've had a lumbar fusion, will you need a revision in the future?
5. How strong is your evidence? This is another area where legal advice is very helpful. Some injured workers do not think they had a pre-existing condition although in the eyes of the Labor Commission judges they do. On the other hand, some injured workers feel their pre-existing condition will prevent them from obtaining workers compensation, which is not always correct. It helps to talk with an attorney who knows the case law. (I'm going to brag now: I have read and taken notes on 275 workers compensation cases so far. Bragging done.)
6. Are you thinking of applying for Social Security Disability (SSDI)? If so, why? Because of your industrial accident?
7. The aggravation rule: Some injured workers might acknowledge that their work injury was only one fact leading to their current medical condition. In Utah we have the "aggravation rule" which basically says if your work aggravated, accelerated, or worsened your medical problem, you may have a valid claim.
8. What if you don't know the precise moment you got hurt? What if you got hurt gradually? In Utah we have the "cumulative trauma" rule. If you get hurt from repetitive lifting, you may have a valid claim. (This rule is currently being reviewed by the Utah Supreme Court.)
So, these are some important factors to consider when the adjustor wants you to settle your claim. The adjustor has a lawyer working for him/her. Injured workers should ALWAYS ask a lawyer for a "free initial consultation." (And be prepared to provide your medical records and pay stubs because that will help the lawyer give you better advice.) Have a question? Call me at (435) 592-1235 or visit www.timothydanielslaw.com.