A Compromise & Release Is One Settlement Option To Consider In California Workers’ Compensation Claim Disputes
In the workers’ compensation claim context in California, a compromise & release is one settlement option. This type of settlement, which brings about a clean break between the employee, the employer’s insurance carrier, and often the employer itself a full buyout of future medical and all other costs related to a workers’ compensation claim.
Assigning Percentage of Disability in order to Calculate a Compromise and Release
In a workers’ compensation claim, the amount of benefits paid out is a factor of the nature and extent of the injury suffered by an employee. The injury is referred to as a “disability,” and can be categorized as either temporary or permanent, and is assigned a percentage by a doctor. For example, an employee who suffers knee damage in a work-related accident and fails to fully recover after surgery might be assigned a 15% permanent disability rating, as well as a need for future lifetime medical care, including doctor’s visits, equipment, MRIs, and even additional surgeries. Disputes can arise because an employee may want a higher percentage, whereas the insurance carrier might argue for a lower one. Thus, negotiation is a key part of any compromise & release settlement.
From the insurance carrier’s perspective, step one is assigning a dollar amount to an injury report sent by an injured employee’s physician. This report is called a “permanent and stationary” report with regard to permanent disabilities because it refers to the threshold language for such an injury. The dollar amount is broken down by category, and by year, in accordance with the anticipated lifespan of the injured employee. By doing this, the employer’s insurance carrier is able to create an estimate of the maximum benefits it might have to pay out.
Because they do not want to pay the maximum, the insurer’s next step is to create arguments for lowering the estimate. One way of doing this is to argue that the employee’s treatment history suggests less extensive long-term treatment needs than those forecasted in the doctor’s permanent and stationary report. Even if case handlers at the insurer obtain permission from the insurer to pay out the maximum estimate of benefits, such a payout will almost certainly never occur in the early stages of negotiation with an injured employee. For this reason, an experienced California workers’ compensation attorney skilled in the art of negotiation and familiar with the tactics of employer insurance carriers will be of great assistance in securing the best compromise & release payout possible. An attorney will show how insurance carrier valuations of future treatment costs are incompatible with real out-of-pocket future treatment costs for an individual employee. An attorney will also make sure that you are compensated for every aspect of medical treatment covered in your doctor’s report on your injury, and will argue for any potentially necessary treatment not included in the report. The insurance carrier will be represented by experienced counsel; with your health and financial future at stake, make sure you are as well.