Dealing with workers compensation can be confusing and overwhelming. When you suffer a serious injury, you have to worry about recovering from this injury while supporting your family and paying your bills.
On top of all that, doctors, adjusters, and case managers are talking with you about all sorts of legal and medical terms with which you may not be familiar. To receive the benefits you should while you recover, you need to make sure you understand all of these terms or have someone on your side who does.
I write articles on our blog with that in mind. I hope that these articles provide some helpful information to help you better understand the world of workers compensation and help you better understand it.
In this article, I am going to discuss and explain two terms that you may have heard:
- Catastrophic injury
What is a workers compensation settlement
A workers compensation settlement is an agreement between you and your employer and workers compensation insurance company for you to accept a lump sum amount of money and give up your workers compensation case. Essentially, the insurance company is buying your workers compensation case from you.
This article is going to focus specifically on settlements in catastrophic workers compensation cases. But, I have an article that provides a lot of good general information about settlements. If you have not read that article and want to do so, you can read it here.
What is a catastrophic workers compensation case
A catastrophic workers compensation case is a special designation that applies to certain types of injuries. There are six different types of catastrophic workers compensation injuries.
- Certain types of spinal cord injuries
- Certain amputations of the arm or leg
- Certain brain or closed head injuries
- Certain types of burns
- Injuries which prevent you from performing your prior work and work available in substantial numbers in the national economy
Qualifying for a catastrophic designation provides certain advantages such as the removal of certain limits on your case and the availability of additional benefits. To get a catastrophic designation, you either need agreement by the workers compensation insurance company or an order from a judge declaring your case catastrophic.
What is different about settling a catastrophic workers compensation case
There are several things that can be different when you settle a catastrophic workers compensation case. One common difference is that you may have qualified or be expected to soon qualify for Medicare benefits.
People who suffer catastrophic injuries often qualify for Medicare benefits because they end up qualifying for Social Security disability. After a period of eligibility for Social Security disability benefits, you become Medicare eligible.
Medicare eligibility or a reasonable expectation of Medicare eligibility can change what you need to do when you settle your case. This article talks more about Medicare Set Asides and how Medicare eligibility can affect your case.
Another thing that is different about settlement of a catastrophic case is your future eligibility for workers compensation benefits. If your case is not catastrophic, your right to future wage loss benefits and medical benefits is significantly limited. When you qualify for a catastrophic designation, many of those limits on benefits do not apply. This is important to consider in settlement.
Do I have to settle my catastrophic workers compensation case
No. You do not have to settle your workers compensation case. Settlement is completely voluntary on your part.
What happens if I do not settle my workers compensation case
If you do not settle your case, then your case stays open. Now, this does not necessarily mean that you will continue to receive workers compensation benefits. It just means that your case is not over.
Many things could happen that could end your right to benefits. The doctor could say that you are one hundred percent better. You could go back to work. You could reach the time limit for benefits.
When you settle, you are giving up that potential for some future benefits in exchange for a guaranteed lump sum amount. You know what you are getting from a settlement as opposed to leaving your case open which is uncertain.