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Workers Compensation Settlement- Maryland Workmans Comp Attorney

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Workers Compensation Settlements

Maryland Workers Compensation Attorney Andrew M. Rodaugh Esq.

Workers compensation settlements should not be taken without a full comprehension of what benefits are being given up for exchange of the compensation to be paid to the injured worker.  Not only is it imperative to understand the rights that are to be given up, but the injured worker should also understand the difference between workers comp settlement and permanency, the settlement process, timeline, and what factors to consider when settling a case.

For a free consultation call Maryland workers compensation attorney and personal injury attorney Andrew M. Rodabaugh now  Call UsClick to email  or just fill out the form at the bottom of the page and Mr. Rodabaugh will contact you!

Settlement of a Workers Compensation case versus Obtaining Permanency in a Workers Compensation case

Settlement and permanency are often referred to synonymously by injured workers.  Here are the ways to obtain compensation at the end of a Maryland workers compensation case and it should be understood taht settlement and permanency are very different

A Hearing to obtain permanency money in a workers compensation case

A Permanency hearing is the only way an injured Maryland worker can force the workers comp insurer to pay compensation to them.  To be clear workers compensation settlements are voluntarily entered into by both the injured worker and the insurance company.  Permanency is obtained at a point in the case when treatment has come to a stand still and the claimant continues to have permanent problems.  There is the option to go to a hearing and have the Maryland Workers Compensation Commissioner decide what percentage impairment you have because of this injury.  The option for future medical treatment and further compensation would remain open however there is no guarantee that you would get the future treatment or compensation.  You may have to go to another hearing to get more medical treatment with your Maryland workers compensation attorney and there is a chance of losing.  Hearings are often a roll of the dice and results can really depend on factors that are completely out of the control of the parties involved.

Stipulating to permanency in a workers compensation case

This is an agreement between the insurance company and the injured worker and his attorney as to the percentage of permanent impairment the injured worker now has.  This is similar to going to a hearing but it alleviates any risk as to a low or unfavorable award.  If the insurance adjuster or defense attorney for workers comp is not willing to stipulate than a hearing is the only option.

99% of the time if a hearing is held the commissioner does not agree exactly with the injured employees rating doctor or the insurance company’s doctor.  Often the Maryland Workers Compensation commission  will issue a number somewhere close to the middle of the numbers.

Types of Maryland workers compensation settlements

Attorneys can get very creative when drafting a workers compensation settlement however most settlements follow one or more  of the following variations.  Most settlements revolve around settling the money portion (indemnity) of the case or the medical treatment portion of the case.

Full and Final workers compensation Settlement

This is an agreement to completely close the workers comp case between the injured Maryland worker and the workers comp insurance company.  Settlement of this nature will close out all opportunity for the injured worker to receive any benefit under the workers compensation claim.  Often this form of workers compensation settlement means the most money to the claimant because he or she is giving up their right to any potential future medical treatment or any compensation in the case.  Before exploring this option the injured worker  should decide with their workers compensation attorney whether getting the most money is in their interest when it means giving up the option to obtain future treatment in the case.

Indemnity Only Workers Comp Settlement/ Open Medicals

In this circumstance the injured employee would likely receive more compensation than if he or she would go to a permanency hearing or stipulate to permanency.  This is because Maryland workmans comp is in essence buying out the injured workers right to any future money through the workers comp case.  Maryland workers compensation settlement of this nature would leave open the injured workers right to obtain medical coverage in the future although there is no guarantee that the treatment will be paid.  Settlement with the option for “open medical treatment” is usually a less amount than a “full and Final” settlement because the insurance company continues to be exposed to the risk of paying for medical treatment.

Maryland workers comp Settlement with a cost projection or Medicare Set-Aside

Similar to the “Full and Final” settlement, these forms of Maryland workers compensation settlements close the case out completely and the injured worker will lose their right to obtain any medical treatment or compensation in the particular case forever.  The distinction between a full and final settlement and a settlement with a cost projection or Medicare Set-Aside is that a portion of the settlement money is designated to be used for future treatment.

With a Medicare set aside the injured employee must abide by strict rules regarding the money placed in the set aside bank account.  Essentially the injured employee has little control of the money other than withdrawing it for medical treatment.  There are also Medicare set aside cases which provide a medical set aside that is administered by an independent third party.  Where the money is an extraordinary amount, or it is thought that the injured worker will have difficulty managing the money it is sometimes mandatory the set aside be administered by someone else, usually a company rather than individual.  Maryland Workers Compensation settlements that include a Medicare set aside are the only settlement option for many injured workers.

Settlement with a cost projection would provide the injured worker a sum of money that is determined adequate enough to be used for any future treatment they may need.  A professional determines the amount of treatment the worker will need and for how long and estimates the cost of the treatment.  The money is then designated as a cost projection for future medical treatment.

It is always best to consider hiring an experience Maryland workers compensation attorney to provide guidance and answer questions along the way.  The above is only a brief explanation as to final compensation for the injured worker and a full understanding of the process is necessary to make wise decisions.

For a free consultation call workers compensation and personal injury attorney Andrew M. Rodabaugh now at  Call Us, Click to email  or just fill out the form at the bottom of the page and Mr. Rodabaugh will contact you!

 

Maryland Workers Compensation Settlement Considerations

There are a number of considerations to be made when settling a comp claim.  Failure to account for the various benefits and possibility of obtaining those benefits can lead to a significantly lower settlement.  The injured worker must also take into account that over exaggeration can lead to a failed workers compensation settlement attempt.  At any given time some or all of the following factors may need to be accounted for in settlement negotiations.

Injured Maryland workers should not attempt to settle their case without first consulting an experienced and qualified workers compensation attorney.  In many cases having an attorney involved can lead to significantly more compensation for the injured employee.  The below content is for informational purposes and not to be construed as legal advise.

Does the workers compensation settlement consider back owed lost wages?

If the injured worker lost time from work and was written an out of work note by their doctor they may be entitled to lost wage payments.  There are other factors to consider when determining if past lost wages are owed however in most cases if the period of time lost is under a few months then the injured worker should consider that in any settlement demand.  This will provide, at the very least, some negotiating room.  If the period of lost time from work is greater than a few months the injured worker should ensure they have out of work notes from their treating physician, proof that no light duty was offered to them from their employer, and confirm they were not terminated from employment.  The injured worker should also note that an independent medical evaluation (IME), termination from employment, lack of out of work notes, or an offer of light duty work can have serious effects on whether workers comp will even consider including lost wages in a workers compensation settlement.

Does the settlement consider future medical coverage?

In some cases the Maryland workers comp adjuster will add an additional sum of money to settle the medical portion of the case.  If the adjuster is not willing to do so will he or she include a medical cost projection or medical set aside?  These are projections or estimates as to what future medical treatment may be required as it relates to the work injury.  If there is no suggested future treatment then obtaining more compensation to close out the medical portion of the case may be difficult because there is no added financial exposure on the adjusters side.

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Does the Maryland workers compensation settlement consider permanency and reopening for worsening?

At a certain milestone in the workers comp case the injured worker is entitled to permanency and if the case is thereafter reopened then they can obtain more permanency for worsening of physical condition.  For further reading see: Money in Maryland Workers Compensation Cases OR Did I go to permanency or settle my case?

Has the potential for vocational rehabilitation been considered in the workers compensation settlement?

Is voc rehab considered in the settlement? While the injured worker is assisted by a job counselor they will also receive lost wage money.  Essentially they are paid by workers comp to look for a job or if the job search is unsuccessful they may be paid to go to school.  There are a number of factors to consider when determining if voc rehab money should be considered in the settlement demand.  If the injured Maryland worker is unable to return to the occupation in which they were injured because of their related disability then they may qualify however there work function must be determined by a physician or in some cases a functional capacity evaluation (FCE).  If there is a strong argument that the employee will eventually have to undergo vocational rehabilitation the expense can be considered in any workers compensation settlement demand.  The wage payments should be considered as well as the money workers comp would have to pay to the vocational counselor.

I needed a lawyer for my workers compensation case. I was referred to Mr. Rodabaugh. I was very nervous about the case, and a little overwhelmed. Mr. Rodabaugh took extra time to talk to me (lots of questions he answered over the phone) and explained step by step of how everything worked. He was very confident, and made me feel comfortable with my case and decision. I highly recommend Mr. Rodabaugh.
  • Five Stars
L.F.Technician

When will my Maryland Workers Compensation case settle?

A Maryland Workers Compensation case can settle at any time during the below process if all parties are on the same page regarding the terms of the settlement and it is in the best interest of the injured worker.  As previously stated, a Hearing is the only way to force the workers compensation insurance company to pay any money for settlement.  The settlement process can be found here:

There are a number of events that may take place before a Maryland workman’s comp case is settled.

This statement must be qualified however.  A case can be settled at any time during the workers compensation process but the settlement would be far less than what the hurt employee deserves, and to which they are entitled.  Most comp attorneys can pick up any one of their files and demand a nominal workers compensation settlement amount with quick acceptance by the workers comp defense.  This is not advisable.  Benefits and compensation should be just- without obtaining a fair settlement the injured employee often feels lost or cheated.  As a workers comp attorney this is the last thing that I would want.

Maryland Workers Comp cases can be settled at various times in the process.  It is important to know at most milestone there must be a physician indicating no future treatment in order to settle the case completely and forever.

Settling workers compensation cases in a contested posture

At the relative beginning of any workers compensation case the insurer will decide if they are going to accept the case as a compensable accidental injury.  What this means is the insurer must decide to pay lost wages and begin to pay for treatment or they can “contest” the case and make the injured employee prove their case.

It is at this point that the case can usually be settled without a doctor indicating that future treatment is necessary because of the accident.  Other than at this point, vary rarely do Maryland workman’s comp cases get settled without a “no future treatment” indication.

It is important to realize that at this point in the case it is difficult for a qualified Maryland workers compensation attorney to evaluate the true value of the case.  Here is the reasoning: Ordinarily at this point in the case minimal treatment has been provided to the injured worker.  There has been little in the way of diagnostic tests and evaluations by expert physicians to determine if there is some underlying pathology.  What this means for the attorney is that they can not determine the severity of the work injury.  The extent of the injury is important to determine the value of the injury.  An example would be a large spinal herniation that was not discovered because there was no MRI or CT scan performed.  Spinal herniation can lead to large  workers compensation settlements however a large settlement will not be obtained with no confirmatory diagnostics, and at the contested stage of the case.

There are occasions when settlement at the “contested” stage of the case is in the best interest of the injured worker.  In the event the work injury is not covered under Maryland law or in the event the representing workers comp attorney believes the case will be lost at hearing it may be in the best interest of the injured worker to settle at this point in the case.  Factors such as previous injuries or accidents, how well the injured worker is expected to testify, the circumstances surrounding the claim filing process, and other legal considerations assist the attorney in deciding if settlement is best at this point.

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If treatment is being challenged than settlement of the Maryland Comp case may be delayed

There may come a time in the workers comp case that the insurance company refuses to pay for some form of treatment.  It may be a course of physical or psychological therapy, surgery, injections, or other medical procedure.  It is at that point the workers compensation attorney should file for a hearing before the  commission.  The Maryland insurance company will likely obtain an Independent Medical Evaluation (IME) to support their denial of treatment.  Without an IME the workers comp insurer’s chances of succeeding at a hearing are limited. 

If and when the IME report is provided to the injured workers attorney the attorney will gain some insight as to how the case will play out moving forward.  It may be the case that the injured will certainly not be successful at the hearing.  If so, it may be time to settle the case.  Depending on the chosen physician performing the IME it may be time to settle the case once the report is produced.

If temporary total disability has been terminated settlement may be postponed

Like the scenario of treatment being terminated, lost wages/temporary total disability payments may also be terminated.  The same steps are taken by the attorney as well as the comp case manager.  The attorney files for a hearing and the adjuster schedules an IME.  Again, the workman’s comp attorney will review the IME report, however this time the physician will comment on the employees ability to return to work.  Depending on the IME report, and the treating providers notes this may be the time best to  try a workers compensation settlement in the case.  

Permanency will affect the timing of settlement

This is, in my opinion, most often the time Maryland workers compensation settlements take place.  For the injured worker this is a frustrating concept because far before permanency the injured worker is anxious for money.  Once the employee has been discharged from treatment the case will move to permanency.  This takes time because both the defense attorney and the injured workers attorney must obtain all updated medical reports, have the worker attend a “rating” appointment for each side, and a hearing must be scheduled.  If the treatment went on for 3 years then settlement is not until atleast 3 years.

While there is a long waiting period, being able to obtain a rating is very helpful to the workers compensation attorney because he will be able to more accurately determine a just settlement amount.

Evaluating workers compensation cases for settlement

     Determining the value of a workers’ compensation claim is not an easy task and there are a multitude of factors that go into this analysis.  What is important to understand is that the final compensation (see permanency vs settlement) to be paid is based on remaining issues that the injured worker has after they are discharged from their treating physician.  If the Maryland injured worker has recovered 100% and has no remaining physical issues then the value of their case is essentially zero.  If the injured worker is part of the majority and has some remaining issues then under Maryland law they are entitled to at least some compensation.  The law does not provide compensation for the pain, suffering, aggravation, and inconvenience that was brought about by the work injury.  In some scenarios a qualified attorney can obtain a Maryland workers compensation settlement even when there are no permanent complaints.

Percentages and Ratings in a Maryland Workers Comp case

     Once the injured worker is discharged from care he or she will be sent to a rating doctor for an independent medical evaluation by their Maryland workers comp attorney.  The injured workers’ attorney will send him or her to a carefully selected orthopedic surgeon or internal medicine doctor for an evaluation and determination of the nature and extent of the injury.  The doctor will indicate in writing the percentage impairment he believes the worker has sustained as a result of the injury.  The doctor will indicate the percentage impairment for each injured body part.  For example if the worker broke his wrist and sprained his ankle the doctor would indicate x% impairment to the ankle and x% impairment to the wrist.  These ratings will help the attorney determine the workers compensation settlement value.  The insurance company will likely also have the injured worker scheduled for a rating.  These ratings will be placed into an algebraic equation for a very rough determination of the amount of compensation expected.

     The problem most often arising- the insurance company doctor issues a low % impairment and the claimants’ doctor issues a high percentage impairment thus creating a conflict which will often lead to a hearing before the Maryland workers compensation commission.  The workers compensation commission will decide the percentage impairment after the parties put on their case.  If however the attorneys are experienced enough they may be able to determine a fair and just  workers compensation settlement amount rather than having to go to a hearing.  Again, settlements are completely voluntary on both sides so the only way to force money from the insurer is to go to a hearing.

Percentages and Weeks of Payment applicable to workers compensation settlements

     The impairment percentage will be broken down into a certain amount of weeks of payment.  The Maryland Legislature has determined that each body part is worth a certain number weeks of payment.

Shoulder-    500 weeks

Knee/leg-    300 weeks
Back/neck- 500 weeks
Arm–           300 weeks
Hand–         250 weeks
Foot–           250 weeks
Fingers, toes, vary by each digit.

Maryland workers compensation Permanency Tier system

     Maryland law provides a tier system which determines the rate of compensation to be paid for the permanency award to the injured employee.    There are multiple tiers however most cases will fall within the first or second tier payment rates and only these first two tiers will be discuss herein.  A permanency award will fall within the first tier rate if 74 weeks or less is awarded.  The award will fall within the second tier if 75 weeks or more is awarded.  The pay rates for first and second tier differ greatly and are increased every year.

Year  Tier 1/Tier 2

2010  142/307
2011   157/314
2012  162/322
2013  166/330
2014  167/333
2015  168/335
2016 172/343
2017 176/351

Calculation permanency for purposes of a workers compensation settlement

     For any rating you would take the percentage awarded and multiply it by total weeks for body part.  You will then multiply that number by the applicable tier rate.  For example an injured shoulder is rated by the claimants doctor at 14% for an injury in 2016.  14% x 500= 70 weeks. 70 x 172 (first tier rate for 2016)= 12,040.  Note that the average weekly wage can have a significant effect on these calculations so the Tier rates may not necessarily be accurate for any particular case.  When calculating permanency ratings for the purposes of workers compensation settlement the injured worker must be very attentive to the average weekly wage as an inaccurate calculation can result in a gross under or overestimation of the value.

Other Considerations for a Maryland workers compensation settlement

     When evaluating a case for settlement or permanency there are a number of other factors to consider and the calculations are simply a starting point for the Maryland workers comp attorney.  The amount of treatment the injured worker received in the case should also be considered.  Cases involving surgery, pain management, injections, or extensive treatment are generally going to be considered of higher value .  If the worker is no longer able to perform the same job duties, or has sustained a loss in earning capacity the value of a case may also be considered a bit higher.  Also, when considering settlement over permanency the motivation of the Workers Compensation Insurer must also be contemplated.  The greater the exposure to expenses the higher the value.  A qualified Maryland Workers Compensation attorney can help maximize settlement or permanency recovery with concise legal arguments considering industrial loss, future medical expenses, vocation rehabilitation exposure, and threats of reopening.  In the majority of cases a represented workers compensation Claimant will recover significantly more by hiring a lawyer than handling a case on their own.

 

For a free consultation call workers compensation and personal injury attorney Andrew M. Rodabaugh now at  Call Us, Click to email  or just fill out the form at the bottom of the page and Mr. Rodabaugh will contact you!

 

I needed a lawyer for my workers compensation case. I was referred to Mr. Rodabaugh. I was very nervous about the case, and a little overwhelmed. Mr. Rodabaugh took extra time to talk to me (lots of questions he answered over the phone) and explained step by step of how everything worked. He was very confident, and made me feel comfortable with my case and decision. I highly recommend Mr. Rodabaugh.
  • Five Stars
L.F.Technician

 

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Workers Compensation Settlement- Maryland Workers Comp Attorney
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Workers Compensation Settlement- Maryland Workers Comp Attorney
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Maryland workers compensation settlements- understand the benefits that affect the settlement, how to evaluate for a workers comp settlement, the various forms of workers compensation settlements, and the settlement timeline and process.
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Work Injury Maryland
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