Visitor Question

Workers Comp Carrier Refusing to Cover Future Medicals in Back Injury Settlement…

Submitted 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: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.


Dear Tammy,

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.

Learn more here: Back, Neck and Shoulder Injuries

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck,


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