What If My Claim Was Settled But I Need Further Medical Care?

If you have settled your workers’ compensation claim, but you need further medical care you might be left wondering what to do. In this situation, you should talk with your workers’ compensation attorney because it depends on the terms of your settlement.

You could settle your claim for a lump sum amount with medical benefits continuing, or you might settle for a lump sum amount that includes a payout for future medical needs with the understanding that future medical expenses will not be covered.

For example, a physician has said there is a 50% chance you will need back surgery in the next five years and that surgery will cost $10,000.

That payment is included in your lump sum with the understanding that you have that money regardless of whether you need the surgery, but if you need surgery it will not be covered because you have waived those future benefits.

Needing Future Medical Care

If you agreed to waive future medical benefits, you will need to cover the costs of those expenses from the funds you received in your lump sum settlement.

Workers’ compensation and your employer will not be responsible for those expenses, so you will cover the costs of that medical care.

If you have given up Lifetime Benefits in your settlement, then none of your future medical expenses are covered.

If you have not given up medical benefits, workers’ compensation should continue covering the costs related to your additional medical care related to your work-related injury or occupational illness.

If you did not give up Lifetime Medical benefits and workers’ compensation doesn’t want to cover the costs of your care, you will need to consult with your workers’ compensation attorney.

If your condition worsens after your settlement, it depends on the wording of your settlement as to who is responsible.

Getting Medical Care

If you need further medical care, consult with your attorney. You should then get the care that you need regardless of who is responsible for the cost. Your health should be given a priority.

And, if you have given up Lifetime Medical benefits, you should have a settlement that includes funds to help cover those costs.

After all, your attorney consulted with your caregivers to determine if future care might be needed and if so, the extent of that care. That way, you should have gotten a fair settlement that addressed those future medical needs.

In some cases, your medical insurance might help cover the costs, but that once again, is dependent on many factors.

What If My Claim Was Settled But I Need Further Medical Care?

Consult with a Workers’ Compensation Attorney

If you have settled your claim but need further medical care you should consult with a workers’ compensation attorney who is licensed in your state.

You want to make sure you are following proper procedure and you want to know who is responsible for the expense related to your medical needs at this point. Your settlement should detail this kind of scenario.

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