Tenacious.
Compassionate.
Many issues that arise in the context of a worker compensation claim are far from black and white. Can the employee return to his or her previous work or other work? Is the work injury still a substantial cause of an ongoing disability? Was the injured worker an “employee” or an “independent contractor”? Did a heart attack arise in the scope and course of employment or was it going to happen anyway?
When the employee and insurance company face these disputes, they can take the all or nothing approach of having a Department of Industrial Accidents judge decide, or they can compromise by way of a lump sum.
By and large, lump sums comprise future benefits that are being paid now. Let’s say a teacher falls down stairs while accompanying children. She breaks a bone in her foot which does not heal well. Eventually, the insurance company argues that the employee can get a different more sedentary job. No one really knows how quickly the employee may find or adapt to such a position, or whether it would pay as much as she earned as a school aide.
The insurance company can present evidence of the employee’s capabilities, or her ability to be transitioned to different work with some vocational help, and ask a judge to terminate weekly benefits. Instead the parties may agree on a period of time within which the employee probably can rejoin the workforce, and the insurer will pay up front the amount of weekly benefits that otherwise would be paid during that period.
If an employee can return to work in a lesser paying job, the workers compensation insurer is obliged to pay a portion of the difference for up to five years. If the parties dispute how long the returning worker’s income will be lower, they may settle these anticipated “partial compensation” payments.
They may be fighting about whether ongoing disability from a back injury is because if a work event or simply because of the employee’s pre-existing degenerative disc disease. They may disagree on whether the employee is just malingering, or whether the injury was even job related. All of these controversies lend themselves to lump sum settlements.
Workers compensation is a limited remedy: medical treatment, 60% of earnings loss for a limited period of time, and very small amounts for loss of function and disfigurement. It does not cover “pain and suffering”. So a reasonable lump sum must account for the reduced percentage of wage loss paid under workers compensation, and the durational limits on potential weekly benefits.
A lump sum settlement ends the insurance company’s liability for weekly benefits. The insurer usually, but not always, remains liable for injury related medical care. The flip side is that the employee has payment now, and the employee can go back to work without putting workers compensation benefits at risk.
It takes a very knowledgeable and skillful attorney to navigate the multiple nuances and issues that can secure a good lump sum settlement for an injured worker. More importantly, you need an attorney who will take the time to explain these details to you so you understand. At Marcotte Law Firm, our Lawyers have achieved numerous six figure settlements, some between half a million dollars and a million dollars, even within the constraints of statutory caps on the insurance company’s liability.
Settlement must be approved by a judge. The judge will ask you if you understand the terms of your settlement and that your lawyer explained it thoroughly and answered all your questions. There are many things you are giving up by settling, and a lawyer should explain the pros and cons of the offer. Attorneys fees, which can only be payable if and when there are settlement proceeds, are statutorily capped and subject to a judge’s approval.
If you have a dispute with an insurance company, an experienced Workers Comp lawyer is invaluable. At Marcotte Law Firm, our Lowell Workers Compensation Lawyers have decades of experience representing injured workers. You are risking nothing and can only gain by calling the Lowell Workers Compensation Attorneys of Marcotte Law Firm.