Settlement of Workers' Comp Claims

SETTLEMENT OF WORKERS’ COMPENSATION CLAIMS
By: Steven Babitsky, Esq.

Attorney H.D. Battle III, speaking at the SEAK National Workers’ Compensation and Occupational Medicine Conference, recommended early settlement as a method of closing potentially protracted and costly claims.

He recommended:

Allow you to identify difficult legal issues that will prevent early resolution, in some circumstances, you may have to litigate the issue
intoxication, horseplay, self-infliction
multiple medical problems and using workers’ comp as primary payor
- Allow you to identify possibility of early resolution through mediation or settlement
- Force you to follow a detailed case management plan and adjust at critical milestones
- Cause you to coordinate litigation and claims management strategies
IME’s
Vocational Plans
Identify return to work obstacles like difficult or reluctant managers, need for modified duties, or limited physical activities
Always keep in mind the discrimination statutes in your jurisdiction and the interplay with FMLA, ADAA, USERRA, and other employment rights legislation
Value: cannot assess liability from the viewpoint that claim in denied status is worth nothing (unrealistic reserving of claim by claims adjusters when looking at rejected claims)
Cannot view a finding of MMI as cutting off liability
- maintenance level pain management, physical medicine, counseling – treatment even when at MMI to reach baseline pre-injury
- In more serious claims, you have to look at other compensable claims, total in PPD awards (proximity to PTD threshold), likelihood of progression, claimant’s age, etc.
- helps reduce likelihood of liberal judge determining condition
- helps get treatment quicker and healing quicker
- consider conditional approvals as opposed to extending initial ruling deadline
- Early and frequent communication with treating physician
- Early involvement of nurse case manager
- Peer-to-peer reviews
- Early IMEs
- Foster communication among insurer, TPA, employer, and attorneys to establish goals early (i.e. settlement, RTW, limitation of liability), so that all involved focus on RTW or restoring function and can be prepared to adjust