Settling Your Claim - YouTube

Settling Your Claim

Workers' compensation provides payments as needed for lost wages and lifetime

medical care for an injury or illness. But you and the insurance company can agree

to permanently close your claim in exchange for one lump sum payment or an annual

payment. This is known as settling the claim with a section 32 waiver. It's a

waiver because you are waiving your right to future compensation in exchange for

this payment today. Because a workers' compensation claim can pay both lost

wages and medical care we'll review how a section 32 waiver affects both of

these. You can settle one and keep the other open so you get benefits the same

way you do today or you can close both. That's up to you and the insurance

company. What parts of a claim can be permanently closed. First, let's talk

about the lost wages. You can take one lump sum payment for your future lost

wages or receive an annual payment. The amount is whatever you, your lawyer, and

the insurance company agree upon it is subject to negotiation and like all

workers' compensation it's tax free. But remember, it's the last workers'

compensation payment you'll receive for lost wages due to your injury. Medical

care. If you choose to end your medical care coverage through a section 32

waiver, the insurance company will never pay for your medical care again. You will

receive a one-time lump sum payment. You may need to set money aside from the

lump sum payment in a special account to pay for future medical treatment for

your workers' compensation injury

Medicare set-asides. Choosing to end your medical care coverage to a section 32

waiver may affect your right to Medicare benefits in the future. When settling a

workers compensation claim the parties must take into account Medicare's

interests. This is most often done by setting up a Medicare set-aside account

out of the proceeds of the section 32 waivers settlement, which will be used to

pay for future medical treatment for your workers' compensation injury. Failing

to take into account Medicare's interest when you settle your claim can result in

Medicare refusing to pay for treatment for your workers' compensation injury.

Check with Medicare to learn your rights and responsibilities. Because Medicare is

a federal program the Workers' Compensation Board has no jurisdiction

over it. What happens if I spend all the settlement money for my medical care?

After you spend your settlement payment designated to cover your medical care

such as out of an MSA, you can pay for care either through Medicare or out of

pocket. To be eligible for Medicare you must either meet the age requirement or

be receiving social security disability insurance. Check with Medicare to learn

your rights. Because it's a federal program the Workers' Compensation Board

has no jurisdiction over it. If medicare is not an option you must pay for future care

out of pocket. Health insurance does not cover the cost of work related

conditions, so health insurance will not cover the cost of your care even if

bought through a state or federal program. You should keep in mind that you

and the insurance company can agree to keep the medical portion of your claim

open. The insurance company will pay for your care as it does now.

What's the process? First, either your lawyer will approach the insurance

company or the insurance company will contact your lawyer to settle the claims.

If you don't have a lawyer, you negotiate with the insurance company and its

lawyer. The insurance company will most likely draw up the agreement. When you,

your lawyer, and/or the insurance company agree on the terms of the settlement, the

Workers Compensation Board will review your agreement. A section 32 waiver

agreement is not final and binding on you and the insurance company until it's

approved by the Board. You have 10 days from the date of submission to withdraw

from the agreement and that date depends on whether or not you have a section 32

hearing. If you have a hearing, the date of submission is your hearing date. if the

law judge approves the agreement at the hearing and none of the parties

withdrawal in writing within the 10 day period the board will mail you the final

section 32 decision this is called a notice of approval

section 32 waiver agreement and is sent only after the withdrawal period and

once the final decision is issued after the initial ten day period the carrier

is then required to pay you within the following 10 days at the hearing is not

necessary and the board approved the agreement you will be sent a proposed

but not yet final decision called a proposed notice of approval

section 32 waiver agreement this decision will include the submission

date you have 10 days from the submission date to withdraw in writing

the decision will also tell you the specific date that the agreement will

become final you know parties withdrawal within the 10 day period the carrier is

required to pay you within 10 days of the final agreement date the board is

required to check for child support leads by law any money you receive in a

settlement is put towards the child support lead

you will then receive the balance if you use the lawyer his or her feet as

approved by the Board will be deducted from the money due to you so let's

review agreeing to a section 32 waiver is a serious decision if you decide to

settle your wages you are ending your claim or part of it in exchange for a

payment you are also permanently waving your right to any future benefits or

payments if you decide to settle your medical benefits you must carefully plan

for your medical care and how you will manage the money you receive now to

supplement future lost wages only you can decide of a section 32 waiver

agreement is right for you if you have questions before signing speak to your

lawyer if you have to contact the Workers Compensation Board with

questions about the process

call 877 6324 996