Settling Your Workers' Compensation Case in Massachusetts

An overview of the workers' comp settlement process in Massachusetts.

If you have a Massachusetts workers’ comp claim, the insurance company will probably approach you about a settlement at some point. Many workers benefit from settlements: You get a lump sum to pay your bills and no longer have to deal with the workers’ comp system. A settlement might also be in your best interest if you have a good chance of losing at a hearing. However, you should never take the decision to settle lightly.

What Is a Lump Sum Settlement?

When you accept a lump sum settlement, you give up important rights in your Massachusetts workers’ comp claim in exchange for a single payment. However, there are some limits to lump sum settlements. You cannot settle unknown injuries or injuries that occur in the future.

If the insurance company denied your claim and never paid you any benefits, a lump sum settlement typically means giving up all of workers’ comp benefits relating to that claim. However, if you settle a disputed claim, you can reopen your medical benefits within one year of your settlement if:

  • your condition significantly worsens, and
  • this deterioration was not foreseeable.

This is a relatively rare occurrence, though, so you should never assume you will be able to reopen your claim in the future.

If the insurance company accepted your claim and is paying benefits, you cannot be forced to give up your right to future medical treatment or vocational rehabilitation (a benefit that helps you find a job if you’re unable to return to your old one). However, your right to enter a vocational rehabilitation program only lasts for two years from the date of your settlement.

When Can I Settle My Massachusetts Workers’ Comp Claim?

In Massachusetts, you typically can settle your workers’ comp claim at any time. However, it is in your best interest to wait until your doctor finds that your condition is stable and unlikely to improve further with treatment (called “maximum medical improvement” or MMI). Settling your claim before reaching MMI is very risky. Your recovery might take longer than expected and your injuries might cause a permanent impairment. If you settle before you have a good understanding of your medical conditions, you could lose out on valuable compensation.

How Much Will I Get in a Settlement?

Lump sum settlement values are not based on a simple formula. Your settlement value will be higher if:

  • you have a permanent disability
  • you're unable to return to your job
  • you need expensive medical treatment in the future, and
  • it's clear that your injury was caused by work.

Most workers are unable to evaluate their workers’ comp claims’ worth on their own. Instead, they rely on the experience and advice of a Massachusetts workers’ comp lawyer. When you work with a lawyer, he or she will assess your claim’s value, negotiate with the insurance company, and ensure that your settlement is in your best interest. It’s common for unrepresented workers to accept an undervalued settlement.

Certain items will be deducted from your settlement. Depending on the nature of your claim, these costs might include:

  • attorneys’ fees and legal costs (read our article about Massachusetts workers’ comp attorneys’ fees)
  • unpaid medical bills
  • unpaid child support, and
  • a Medicare set-aside account (money to cover future medical expenses related to your work injury, which must be spent before Medicare will cover treatment).

To learn more about these deductions, read our article discussing how much of your settlement you will get to keep.

How Do I Finalize My Settlement?

To finalize a settlement, you must submit a Request for Lump Sum Conference (Form 116) to the Massachusetts Department of Industrial Accidents (DIA). The DIA will schedule a settlement conference. At your settlement conference, a workers’ comp judge will review your settlement. If the settlement is in your best interests, the judge should approve it. Practically speaking, judges approve most settlements—especially if you have a lawyer.

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