Workers Comp Carrier Refusing to Cover Future Medicals in Back Injury Settlement...
by Tammy (NY)
We are about to close and settle a back injury case from a work related injury in 1995. The workers compensation insurance carrier has agreed to settle but will not cover future medicals for the back injury.
Is that normal?
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.
ANSWER for "Workers Comp Carrier Refusing to Cover Future Medicals in Back Injury Settlement...":
Yes it is normal. Workmans Compensation benefits cover medical expenses and a percentage of lost wages. There is normally an additional amount paid as part of a final negotiated settlement.
Regrettably Workmans Compensation benefits end there. The facts indicate the injury occurred about 15 years ago. If that’s the case, then you should have a pretty fair idea of the cost of the past medical treatment and the cost of any future treatment.
With that in mind your negotiated settlement amount should reflect the approximate cost of such future medical treatment. That is the purpose of the final negotiated settlement. The final settlement amount will not include any amounts for future lost wages. The amount is theoretically for future medical treatment and not for past or future pain and suffering, emotional distress or mental anguish.
If you are not represented by an Attorney, you might consider contacting one. At this point in the case it wouldn’t be prudent to hire an Attorney, but if you are lucky and find a cooperative Personal Injury Workmans Compensation Attorney, you might be able to get in to see her for a brief consultation.
Be honest and tell her you don’t really need to retain her services. Tell her your case is about to settle and you could really use some legal advice to make sure you are settling the case for an appropriate amount, and that all of your other options have been covered.
Offer to pay for an hour of her time and advice. Spending a small amount now could save you a large amount down the line. Her time and advice are the only tools she has, and as such offering to pay for her for her good counsel would be your best bet.
The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.
The accuracy of information provided on this site is not guaranteed. It is generic information for informal purposes only. It is NOT formal legal advice. Your use of this site does NOT create an attorney-client relationship. Before relying on any information found in this site you should consult with a licensed attorney in your state. If you are currently represented by an attorney, you should strictly abide by his/her counsel.