Consider this situation - I have a work injury that happened around May of 2012 to my lower back. I received some treatment for about six months, but then the doctor said I no longer need treatment. My back was still hurting though. I called the insurance company who said they would not allow any more treatment. They told me that I should settle my case. They sent me some papers and offered me around $1,500.00. I signed and received the money. My back still hurts. Will the insurance company still pay for treatment for my injury? A coworker told me that he gets lifetime treatment for his case.
The answer depends on what type of settlement occurred. There are two types of settlements in workers’ compensation, and this determines if the injured worker is entitled to future medical. One is a Compromise and Release which is a complete closure of your case. This will include closing out any future medical. Although rare, there are times when a case settles by Compromise and Release with future medical. However, most of the times a Compromise and Release means the insurance company is not liable for any ongoing treatment.
The other type of settlement is Stipulations with Request for Award. This type of settlement will allow future medical for life for treatment related to the injury. The future medical will be guided to some degree by the report that the case settles on. Utilization review is also used to address reasonableness of treatment. It is possible but unlikely that this type of settlement can occur without a finding for future medical.
In the above case, if the matter resolved by Compromise and Release, then the worker will not get future medical. If the case settled by Stipulations with Request for Award, then the injured worker be allowed future medical treatment.
If you have questions about your workers' compensation injury and want to talk to an attorney in Fresno, please call 559-408-7436 or fill out the form to the right.
The materials available at this web site are for informational purposes only and not for the purpose of providing legal advice. You should contact an attorney to obtain advice with respect to any particular issue or problem. Use of and access to this Web site or any of the e-mail links contained within the site do not create an attorney-client relationship between the Law Offices of Jeremy K. Lusk, Inc. and the reader.