What are Workers’ Compensation Settlements in Ohio?
Settling your Ohio Workers’ Compensation claim means you and your attorney, your employer, and the Ohio Bureau of Workers’ Compensation (BWC) have agreed on a sum of money to be paid to you and therefore close out your claim. While obtaining a lump sum is far more attractive than fighting with the BWC for years or more, it’s important to keep in mind that according to the BWC, Ohio workers’ compensation settlements, “forever resolves all past, present, or future medical and compensation issues and liabilities in the claim, whether known or unknown”.
Partial settlements are an exception to this rule, but they do not happen as frequently. There are various factors in establishing settlement values typically. These include estimating future medical costs the work injury will incur, as well as the indemnity, or actual compensation costs. Though less common, an indemnity only settlement means the claimant remains eligible to receive compensated medical treatment under the claim.
In addition, if you have more than one workers’ compensation claim you may be able to settle one or all of them. A knowledgeable workers’ comp attorney at Schaffer & Associates, LPA in Toledo, Ohio can help you decide when to settle a claim, especially if you have multiple claims active at the same time.
Download Our Guide: Five Essential Steps to Take After Your Ohio Work Injury
Do I Have to Hire an Attorney to Apply for a Workers’ Compensation Settlement?
There is no requirement to hire an attorney to file for a settlement with the BWC. An injured worker can file their own Settlement Agreement and Application for Approval of Settlement Agreement (Form C-240). This form documents agreement to the terms and conditions of the settlement, and will need to be signed by you, your workers’ compensation lawyer (if you have one), your employer, and your employer’s legal representative.
This assumes a state funded case, meaning the Ohio Bureau of Workers’ Compensation insures your employer. The process for claims against self-insured employers, however, looks different. In this case, you will typically submit a Self-insured Joint Settlement Agreement and Release (Form SI-42) and an acknowledgment form (Form S1-43). This paperwork will be reviewed by the Industrial Commission (IC) rather than the BWC.
Either way, it is important to make sure you comprehend the terms of any signed agreement. This is especially critical regarding Ohio workers’ compensation settlements. The BWC and any managed care organizations (MCO) involved in your case will not and cannot advise you on settling your claim. However, having an attorney can be hugely beneficial. Your workers’ comp claim attorney will not only help negotiate the settlement dollar amount and facilitate paperwork and communication. They will also ensure a settlement agreement is the best option for you and your case.
How Much Can I Settle My Case For?
The BWC does not have pre-set formulas to determine a claim’s value. Thus, the value of settlements vary greatly from case to case. Again, the BWC will evaluate a claim’s settlement value by projecting the future costs of the claim. This can include upcoming surgeries, continuing treatments, and expected lost work time. It’s important to know the BWC does not consider pain and suffering in settlement value decisions.
There are several factors that can impact your settlement value. Common workers’ comp issues include conflicting medical evidence, outstanding overpayments, overdue child support, and unpaid medical bills. Our Toledo attorneys are experienced in these negotiations. We work to finalize your Ohio workers’ compensation settlement for the highest dollar amount possible.
When Can I Apply for an Ohio Workers’ Comp Settlement?
You may choose to settle and close your claim at any time. Again, it’s important to remember that this will prohibit you from obtaining medical or monetary compensation regarding your injury in the future. This is why settling your claim too early can be a bad idea. If you’re unsure of whether or not you should apply for an Ohio workers’ compensation settlement, it’s best to seek the advice of an experienced, Toledo, OH workers compensation attorney.
Before settling, most injured workers wait for a determination of Maximum Medical Improvement (MMI). To be found MMI means your physician has declared your condition to be stable or stagnant, and that your condition will not improve with further treatment.
How Long Does Settling a Claim Take?
After receiving the necessary documents, the BWC or IC will examine your paperwork and determine if it is acceptable. For state-funded cases, a 30-day waiting period begins on the day that the BWC mails you your settlement agreement. For self-insured cases, the 30-day waiting period begins after the IC approves the settlement. During this time, either party may change their mind about the settlement. This means that anyone can propose changes to the settlement or withdraw from it entirely.
In Ohio, all workers’ compensation settlements are voluntary. If you decide to revoke your settlement agreement, you must file a written notice of withdrawal before the 30-day waiting period ends. Otherwise, your settlement is full and final.
If I Was Hurt at Work, Will I Get a Settlement?
Yes, if you are hurt at work in Ohio, it is possible to receive a settlement for your workers’ compensation claim. Settlements in workers’ compensation cases are voluntary agreements reached between the injured worker and the Ohio Bureau of Workers’ Compensation (BWC) or if your employer is self-insured, it is an agreement between the injured worker and your employer.
The decision to pursue a settlement is typically initiated by either the injured worker or the BWC or a self-insured employer. If both parties agree to the terms of the settlement, it can result in a lump sum payment to the injured worker in exchange for the closure of their workers’ compensation claim.
The possibility of receiving a settlement depends on various factors, such as the extent of your injury, the impact on your ability to work, the need for ongoing medical treatment, and the overall circumstances of your case. It is important to consult with an attorney experienced in workers’ compensation law to assess the viability of a settlement in your specific situation and to help you navigate the settlement process.
Remember that settlements are not guaranteed, and you have the option to pursue ongoing benefits and medical treatment through the workers’ compensation system if a settlement is not reached or not in your best interest. Consulting with an attorney can help you understand your rights, explore your options, and make an informed decision about pursuing a settlement or pursuing ongoing benefits.
What types of settlements are there?
There are different types of workers’ compensation settlements in Ohio, including:
- Full and Final Settlements: This type of settlement permanently closes the injured worker’s claim for all benefits related to the specific injury. The injured worker receives a lump sum payment that is intended to cover future medical treatment, wage loss, and other compensation related to the injury. It is important to note an injured worker covered by Medicare may not switch the cost of their workers’ compensation claim to Medicare. In these cases, injured workers are required to take the medical portion of the settlement and place it in a separate interest-bearing bank account and pay for medical costs out of that account. These Medicare Set-Aside Accounts require yearly documentation to the Centers for Medicare and Medicaid Services. Furthermore, Medicare will only recognize services that are covered by Medicare plans and only the amount Medicare covers. Thus, these arrangements are quite complicated, and injured workers should seek advice from legal counsel as to whether settlement of their medical coverage is truly in their best interests.
- Indemnity-Only Settlements: In some cases, an indemnity-only settlement may be reached to resolve future compensation in the claim while leaving the medical portion of the claim open for further benefits.
Who is eligible for a workers’ compensation settlement?
- Injured Workers: If you have sustained a work-related injury or developed an occupational disease while employed in Ohio, you may be eligible for a workers’ compensation settlement.
- Accepted Claims: To be eligible for a settlement, your workers’ compensation claim must be accepted by the Ohio Bureau of Workers’ Compensation (BWC) or the employer’s workers’ compensation insurance carrier. This means that your claim has been reviewed and approved, acknowledging that your injury or illness is work-related.
- Medical Treatment and Compensation: Generally, settlements are more common when there is a need for ongoing medical treatment or when you are entitled to wage replacement benefits. The extent of your injury, the impact on your ability to work, and the need for future medical care can influence the likelihood of a settlement.
- Agreement of Both Parties: For a settlement to occur, both parties—the injured worker and the BWC, the employer of record, or the self-insured employer—must agree on the terms of the settlement. The decision to pursue a settlement is typically initiated by either the injured worker or the BWC, the employer of record, or the self-insured employer, and negotiations take place to reach a mutually acceptable agreement.
What is involved in the settlement process?
- Evaluation and Negotiation: The process begins with evaluating the merits of your case and determining if a settlement is a viable option. This often involves gathering relevant medical records, wage information, and other evidence. If a settlement is deemed appropriate, negotiations will take place between you, your legal representation (if you have one), and the Ohio Bureau of Workers’ Compensation (BWC) the self-insured employer.
- Proposal and Counterproposal: During negotiations, a settlement proposal is presented by either party. The proposal outlines the terms and conditions, such as the amount of compensation, potential ongoing benefits, medical treatment provisions, and other relevant factors. Both parties may engage in back-and-forth discussions, making counterproposals and addressing any concerns or issues that arise.
- Settlement Agreement: Once an agreement is reached, the terms are documented in a formal settlement agreement. This agreement outlines the specifics of the settlement, including the amount of compensation, any ongoing benefits, medical treatment provisions, release of liability, and other relevant terms. It is essential to review the agreement carefully and ensure that it accurately reflects the terms you have agreed upon.
- Industrial Commission Approval: The settlement agreement must be submitted to the Ohio Industrial Commission for approval. The Industrial Commission reviews the agreement to ensure that it complies with Ohio law and is fair to all parties involved. If the Industrial Commission approves the settlement, it becomes binding and enforceable.
- Distribution of Settlement: After the settlement is approved, the agreed-upon compensation is typically disbursed to you. Depending on the terms of the settlement, it may be a lump sum payment or structured payments over time. Any ongoing benefits or medical treatment provisions specified in the settlement agreement will also come into effect.
It is important to note that the settlement process can vary depending on the specific circumstances of your case, and having legal representation familiar with Ohio workers’ compensation law can provide valuable guidance and advocacy throughout the process.
What are some things to consider after settlement?
- Compliance with Settlement Terms: It is crucial to ensure that you comply with all the terms and conditions outlined in the settlement agreement. This may include adhering to any ongoing medical treatment requirements, submitting necessary documentation, or fulfilling any other obligations specified in the agreement.
- Closure of Claim: Once a settlement is reached and approved, your workers’ compensation claim is typically considered closed for the specific injury or condition covered by the settlement. It is important to understand that you will no longer be eligible for additional benefits or compensation related to that specific injury or condition.
- Future Medical Treatment: The settlement agreement may address the issue of future medical treatment. It could include provisions for continued medical care, specifying the extent and duration of coverage. It is essential to understand your rights and obligations regarding future medical treatment and seek clarification from the Ohio Bureau of Workers’ Compensation (BWC) or your attorney if you have any questions.
- Impact on Employment: A workers’ compensation settlement does not necessarily guarantee continued employment with your employer. If you are still employed by the same company, the settlement should not affect your employment status. However, it is advisable to consult with your employer or legal counsel to understand any potential implications or changes that may arise due to the settlement.
- Medicare and Social Security Considerations: If you are eligible for Medicare or Social Security benefits, a workers’ compensation settlement can have implications. It is important to consider the potential impact on these benefits and consult with an attorney or financial advisor who specializes in Medicare and Social Security to assess the potential consequences.
- Tax Implications: The tax implications of a workers’ compensation settlement can vary based on the specific circumstances. In general, compensation for lost wages and medical expenses related to a work-related injury or illness is typically not taxable. However, it is advisable to consult with a tax professional to understand the tax implications specific to your situation.
- Future Claims: A workers’ compensation settlement generally pertains to a specific injury or condition. If you experience a new work-related injury or illness in the future, it would be considered a separate claim and would not be affected by the previous settlement. It is important to understand your rights and obligations in case of any future work-related incidents.
Remember, each workers’ compensation settlement is unique, and the post-settlement considerations may vary based on the specific terms and conditions outlined in your settlement agreement. It is recommended to consult with an attorney experienced in workers’ compensation law to fully understand your rights, obligations, and any potential post-settlement implications.
Contacting an Attorney Who Understands Settlements Near You
The attorney you select will have a major effect on the outcome of your case. It is essential to choose an attorney who understands settlements and has the experience necessary to negotiate the highest compensation package for you. At Schaffer & Associates LPA, we work alongside our clients to help with the following aspects of the claims process:
- Develop medical, vocational, and other evidence
- Negotiate Ohio workers’ compensation settlement agreements
- Represent you at an appeals hearing or workers’ comp trial
- Provide guidance on other claims and benefits opportunities
Some workers’ compensation issues are more complicated than others. If you sustained serious, debilitating injuries or your employer is raising disputes, for example, seeking assistance from a knowledgeable attorney can be beneficial. Similarly, if you are unsure of whether a settlement offer is fair, an attorney can provide the guidance necessary to navigate these issues.
Our Toledo Team Can Help You With Your Ohio Workers’ Compensation Settlement
Due to the final and impactful nature of settlements, it’s always a great idea to discuss your case with an attorney before settling your claim. Schaffer & Associates‘ team of workers’ compensation lawyers have decades of experience in both assessing cases to determine the best time to execute a settlement, as well as negotiating settlement amounts. Call (419) 350-8227 or send us a message to discuss your Ohio workers’ compensation settlement today.
