While “fill out the Accident Report and turn it in to your supervisor” seems like a simple enough starting point, in the end you, your employer, and the insurance company that provides insurance coverage for the employer will all be involved in trying to bring your WC claim to a satisfactory conclusion.
Unfortunately, what sort of outcome is considered “satisfactory” to your employer and the insurance company they work with may be very different from what is satisfactory for you.
Any time you receive the suggestion to settle, you need to ask yourself the following question:
“Is it more beneficial for me to settle my Workers’ Compensation case, or will it benefit me more to have the matter decided by the Workers’ Compensation Commission?”
There are three ways to resolve a compensable workers’ compensation claim once you have reached “maximum medical improvement”:
1) Have the matter decided by the Workers’ Compensation Commission. The Commission will decide what future medical treatment, if any, you are entitled to and how much you are entitled to for permanent disability. You will have one year from the date you receive payment of permanent disability benefits to re-open the claim on a change of condition in the event your condition worsens related to your work injury.
2) Form 16. You can voluntarily resolve your claim with the employer/insurance company and preserve your right to future medical treatment and rights to re-open the claim on a change of condition. We call these settlements “Form 16 Settlements” because of the name of the form filed with the Workers’ Compensation Commission for this type of settlement approval.
3) Clincher. You can voluntarily fully, finally and forever resolve your claim. With a clincher, you will be compensated for your permanent disability and also give up any and all rights to future medical treatment and to re-open your claim on a change of condition. Because you give up two very important rights, the right to medical treatment and to re-open the claim on a change of condition, insurance companies normally offer more to clincher than what they will offer on a Form 16.
Many workplace injuries worsen over time if not properly and promptly treated, so settling may mean no longer having access to payments when you really need them.
This is why any consideration of settling a Workers’ Compensation claim should only be done after meeting with a legal representative, who can walk you through any and all suggested terms and how they would affect you.
It depends on how the case is settled. If the Commission orders the Employer/Insurance Company to continue to provide you medical treatment or you reach an agreement on a Form 16 then your employer/insurance company will still pay for your medical treatment. If you clincher the claim, however, you are responsible for your future medical treatment.
How is the Settlement Amount Determined?
Let’s state one essential fact first — every Workers Compensation case is totally different.
We can’t tell you what the specific settlement terms for your case might be in a general blog post like this, because the specifics of each workplace injury, employer, and insurance company may lead to a different series of calculations.
Before choosing to start on the path to settling your Workers’ Compensation case, you’ll want to gather any and all documentation regarding your injury: documents regarding medical diagnosis, treatment, your original injury report as turned in to your employer (always ask for a copy to keep for your own records!), any and all documents sent to you by the insurance company… anything related to your injury or illness, bring to your meeting with a legal representative.
That way, we’ll be able to get an accurate look at the larger picture and calculate what sort of Workers’ Compensation benefits you may be eligible for that would be removed through settlement and whether or not the evidence for your case supports a settlement.
If you’re filing for Workers’ Compensation in Columbia, SC or throughout South Carolina, you deserve legal representation that is dedicated to fighting for your individual rights. Settling a Workers’ Compensation case can be complex and time-consuming, and it’s important to have someone with experience in this area of practice on your side.
At BNTD Law, our Workers’ Compensation team makes it their mission to represent injured workers in South Carolina, and we’re proud of our attorneys’ membership in Injured Workers’ Advocates. To request your FREE consultation, just give us call at (803) 779-7599 or contact us online at any time.