A worker who sustains an injury that is debilitating enough that he receives a permanent disability rating needs to reach a settlement agreement with the workers' compensation carrier. In these cases, the best path typically is to hire an attorney experienced in workers' compensation law to represent you at the settlement meeting. If an agreement cannot be reached, depending upon the state in which the injury occurred, the case goes before a workers' compensation law judge or appeals board.
Wait for the permanent and stationary (P&S) report provided by the qualified medical examiner in your case. Once the doctor deems your injury permanent and stationary, negotiations can begin on permanent disability settlements, which often include a lump sum payout and payments for all future medical treatments.
Meet with an attorney experienced in workers' compensation law to review your particular case. State law provides for representation in workers' compensation cases to ensure your best interests are taken into account.
Review the P&S report from the doctor. Go over the permanent disability ratings schedule found on your state's workers' compensation website. Each state sets the rating schedule for permanent injuries. If you disagree with the doctor's report, most states allow you to obtain a second opinion. Pursue this avenue if warranted.
Calculate any potential lost earnings that result from the workers' compensation injury from the date of the injury through retirement age. Include regularly scheduled cost of living increases to get an accurate figure. Also calculate the cost of all future medical treatments, if needed.
Arrive at a figure with the help of your attorney based upon the calculations in Step 4. Permanent disability lump sum payouts are calculated based upon the age of the injured worker, the rating of the disability and the years until retirement for earnings.
Schedule a settlement meeting involving you, your attorney and the claims examiner to discuss settlement options. Consider all the alternatives and options presented. Settlement claims for debilitating injuries often include vocational rehabilitation if you cannot return to work in the same position. If you cannot return to work at all, you might not want to include a lump sum payout for future medical, as medical costs will continue to rise. Instead you might include a provision in the settlement agreement for continued payments, whatever the cost, by the workers' compensation insurance company.
Discuss your options with your attorney after reviewing the offer made by the claims examiner or his attorney. If you agree to the company's offer, accept it. If not, make a counter offer and wait for the response.
Move the claim up to a workers' compensation law judge or appeals board if you do not accept the offer made by the claims examiner or his attorney. At this juncture, the results of your claim are determined by the workers' compensation adjudication process for your particular state. Before seeking adjudication on an unsettled claim, discuss all your options for settlement with your attorney. The option on the table may be better than one awarded through adjudication.
State workers' compensation laws provide the option for you to have an attorney. However, legal representation is not required.
Once a settlement is reached, it cannot be changed. Ensure all your future medical needs are covered by the settlement.