Determining when to settle a worker's compensation claim, and for how much, is not always a simple task. You might not understand what rights you're giving up by settling, or how to properly value your claim, especially if it's your first time getting injured at work.
Below, we offer some information about settling your workers' comp case in Missouri.
A worker's compensation settlement is a voluntary agreement between an employee and employer, or its insurance company, to close out a disputed worker's compensation case in exchange for a sum of money. Workers' comp settlements in Missouri are typically paid in a lump sum.
Settlements in Missouri are usually "full and final," which means you are giving up your right to all workers' comp benefits. The settlement funds are all you will ever receive for your injury, even if your condition worsens in the future. However, if you have a documented need for extensive future medical care, the insurance company might agree to cover your future medical treatment as part of the settlement.
The best time to settle your case is after your doctor reports that you've reached maximum medical improvement (MMI). This means either that you're fully healed or that you're as good as you're going to get. Although Missouri law does not prohibit settlements before MMI, it's risky to do so. Until you reach MMI, you won't know the extent of your disability (if any) and what medical care you may need in the future.
If you have health insurance, don't assume that it will cover your medical bills after you settle. Your health insurance policy may exclude treatment for work-related injuries. If you're thinking about settling your case before you reach MMI, be sure to speak with an attorney about how your future medical expenses will be handled.
The vast majority of cases settle without proceeding to a worker's compensation hearing. If you and the insurance company can't reach an agreement on your own, Missouri has a dispute resolution process to assist you. At a settlement conference with a workers' comp judge, you can ask the judge to shed some light on the value of your case. However, the insurance company must also agree to this request.
All settlements must be approved by a judge at the Missouri Worker's Compensation Commission. Your attorney, if you have one, will submit a Stipulation of Compromised Settlement to the judge, which outlines the important details of your settlement.
Settlements are rarely rejected by the judge. Under Missouri law, settlements must be approved unless:
After the judge approves your settlement, the insurance company will cut the settlement check. If you have an attorney, the settlement check will be sent to your attorney's office. Your attorney will then cut your check after deducting attorneys' fees, costs, and other relevant items. (For more information, read our article on worker's comp attorney's fees.)
The value of your claim depends on many factors, such as the nature and extent of your injuries, your ability to return to work and in what capacity, and your wages prior to the injury. You can get a general idea of how much you might be entitled to by reading our article on worker's compensation benefits in Missouri. However, for advice on whether a particular settlement offer is a fair one, you should consult with a Missouri workers' comp lawyer.
Some injured workers believe that the more medical treatment you receive for your injuries, the more money you'll get. However, this is not necessarily true. Workers' comp covers reasonable and necessary medical treatment. Getting unnecessary medical treatment for your injuries can cause the insurance company to be more skeptical of your claim and deny payment of your medical bills.
Because a settlement is nearly impossible to reverse, it's important that you understand the terms of your settlement inside out. Settlement contracts include legal terminology that is often confusing. A good attorney will review your contract line by line and make sure you understand what you're signing. If the settlement has unfair terms, a lawyer might be able to negotiate you a better deal.
For more information on what qualities you should be looking for in a lawyer, read our article on finding a great worker's compensation attorney.