Friday, December 23, 2011

Calculating a MN Work Comp Settlement

Under Minnesota workers’ compensation law, there is no automatic right to a lump sum settlement. That means that neither side can force the other side to settle the case. That being said, in the majority of cases, the parties can, and do, reach some kind of settlement.

There are a variety of different kinds of settlements of workers’ compensation cases, but generally, they are either full, final, complete settlements, or to-date settlements. When people want to settle their Minnesota workers’ compensation case in exchange for a lump sum payment, they are usually thinking of what is known as a full, final, complete settlement, which is a lump sum settlement of all past and future claims, which sometimes closes out an employee’s right to future medical expense benefits, or sometimes leaves open an employee’s right to future medical expense benefits.

While there are literally dozens of factors that need to be evaluated in every case before attempting to put a monetary value on the claim, generally speaking, there are several things that we calculate in every Minnesota workers’ compensation demand. The best way to get an accurate valuation of your Minnesota workers’ compensation claim is to consult with a Minnesota workers’ compensation lawyer.

Past wage loss claims: We calculate claims for any past wage loss to-date, if the workers’ compensation insurer owes any past wage loss benefits. This can include temporary total disability benefits, if the employee has been completely off work, or temporary partial disability benefits, if the employee has been working, but earning less money. In some cases, it can include past permanent total disability benefits. It can also include underpayment claims if the insurer has been paying benefits at an incorrect rate. Factors that play into this calculation include the employee’s average weekly wage and compensation rate at the time of the injury, whether or not the employee has reached maximum medical improvement or not, whether the employee has consistently had work restrictions during the relevant time periods, whether the employee has conducted a diligent job search during the relevant time periods, and whether any third parties have paid wage loss benefits during the same time periods.

Future wage loss claims: For a full, final, complete settlement demand, which contemplates a close out of future wage loss benefits, we also calculate what the employee will realistically incur in future wage losses as well. Several factors come into play in this calculation, including how many weeks of wage loss benefits the employee remains entitled to, whether or not the employee has reached maximum medical improvement, whether the employee is currently working or not working, how much longer it is anticipated that the employee will be off work, whether the employee has permanent work restrictions and the nature of those restrictions, the employee’s anticipated future earning capacity, the employee’s average weekly wage and compensation rate at the time of the injury, and whether the employee is eligible for any other wage loss benefits, such as PERA disability benefits, retirement pension benefits, or social security disability benefits.

Permanent partial disability claims: Based on the type and severity of the injury, we determine whether the employee may have claims for permanent partial disability benefits. Factors that come into play in estimating the value of permanent partial disability benefits, include the nature and extent of the injury, whether or not any permanent partial disability has already been paid, the nature and extent of any pre-existing conditions, and whether a doctor has assigned a permanent partial disability rating.

Out of pocket expenses/medical mileage: If the injured worker has incurred out of pocket expenses or medical mileage, we typically include a claim for reimbursement of these expenses.

Close out of rehabilitation/retraining benefits. Often, a full, final complete settlement also includes a close out of entitlement to rehabilitation and/or retraining benefits. While an injured worker doesn’t actually receive money for rehabilitation benefits, this is a benefit that has monetary value to the insurance company, because they pay for this benefit. If an employee is a strong candidate for retraining, which can be a costly benefit, the value of closing out this type of benefit may be higher.

Payment of outstanding medical expenses/third party intervenors. In addition to the monetary benefits claimed, normally a settlement demand directs that the insurer will also be obligated to satisfy any outstanding medical expenses, and reimburse any third party payors, such as a person's private health insurance, if any of the medical expenses have been paid by a third party. 

Close out of future medical care. In some cases, it may be appropriate to consider a close out of an employee's rights to future medical care in exchange for a monetary payment. In some cases, consideration of a close out of future care is not appropriate. This depends on a variety of factors, such as whether the underlying claim is admitted or denied, the nature and extent of the employee's injury, and the nature, extent, and expense of any anticipated future medical care.

In addition to the actual hard numbers in valuing a Minnesota workers’ compensation claim, obviously, the strengths and weaknesses of any claims or defenses must be taken into account. For example, on a workers’ compensation case where the insurer doesn’t have strong defenses to the claims, it is much more likely that an injured worker will get a settlement that is closer to the demand amount. For cases where the insurer has strong defenses to the claims, or stronger defenses on liability for the underlying injury, while the potential value of the case may be high, that must be weighed against the higher risk that the insurer will successfully defend against those claims.

Crunching the numbers on a Minnesota workers’ compensation claim can be complicated, but coming up with the numbers is actually the easy part. The harder part is determining the true value of a claim to ensure that you’re getting a fair deal on a settlement of your workers’ compensation claim. Workers that try to settle their cases on their own usually undervalue their claims, or unknowingly give up rights to valuable future benefits. Do not trust the workers’ compensation insurance company to give you a fair valuation of your claim!

The best way to ensure that you’re getting a fair deal in settling your claim is to have a Minnesota workers’ compensation lawyer assist you with the process. For a FREE, NO-OBLIGATION case consultation call Meuser & Associate at 877-746-5680, or click here to send us an email. We’ve been helping injured workers for over 20 years, and have recovered millions of dollars in workers' compensation benefits for our clients. We can help you get a fair settlement of your Minnesota workers’ compensation claim. 

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