After your Workers’ Comp case comes to an end: what happens if you need more medical treatment? Would you be able to get what you need to recover from an injury successfully?
The answer, as with many situations within the Workers’ Comp system, is it depends. In this case, it basically comes down to the type of settlement you've received.
To properly approach this issue, first let's define or understand what “over” or “finished” means in Workers’ Comp. Acase is “over” when you've settled with your insurance company, or when a final disposition has been reached at trial.
Moreover, when you decide to settle you have two choices: Stipulation with Request for Award (Stips) or Compromise and Release (C&R). Every option has its pros and cons, depending on your particular situation and needs. learn more about it in this article.
There are 2 Types of Settlements in CA
1. Stipulated Award Settlement
A stipulated award is a settlement where you agree to a certain level of permanent disability as determined by your doctors. In addition to disability benefits, a stipulated award may also include open future medical care.
Open medical care means that your physician considers that, although you’ve medically plateaued, you still need ongoing medical treatment. This treatment may include injections, physical therapy, medicines, etc.
2. Compromise and Release Settlement
A Compromise and Release is a settlement where the insurance company offers a lump sum of money in exchange for your rights to any future medical care and disability benefits.
After a C&R settlement, the insurance adjuster is no longer responsible for authorizing any additional medical care that your doctors may request.
How to Get Medical Treatment After a Finished Case?
If you settled your case through a stipulated award, and your condition has worsened, you might be able to reopen your claim. To do so, you need to file a petition to reopen for new and further disability.
It pays to know that your condition, apart from getting worse, could spread to other body parts. You can add those new body parts to the previous case through the reopening. This option would entitle you to a new permanent disability and a new ongoing right to medical care for the other corresponding need.
On the other hand, in certain circumstances, you may be able to continue to receive medical treatment after a C&R settlement. This is possible if your condition worsens due to an intervening factor, such as a new job, that can make your injury more severe.
Your condition can get more severe for other intervening sources, not necessarily caused by the natural progression of your injury. In this case, you may be able to file a new Workers' Compensation case with your new employer's insurance.
Conclusion
In Workers’ Compensation, every case is different. It highly depends on factors such as the type of injury and the treatment you need to overcome your accident and get back on track.
It is vital for you to carefully consider your options before settling your Workers' Compensation case. Remember that it may affect your ability and chances to receive future medical treatment in case you need it.
If you decide to pursue medical care after your case is over, an attorney can give you an advantage and improve the chances of receiving the medical treatment you need.
Need help with your medical treatment? Contact Pacific Workers’, The Lawyers for Injured Workers for a free, confidential case evaluation. Call us at 800-606-6999 or make an appointment here.