Workers Compensation Settlements
There are two ways to settle a Rhode Island Worker's Compensation case; Commutation and Denial and Dismissal
Commutation - A commutation is a settlement for a lump sum of money of an injury that has been accepted by the workers' compensation insurance company, either voluntarily or as ordered by the Court. The settlement is in lieu of any future weekly checks the employee would have been entitled to as a result of their injury.
The Attorney's fee is 20% of the settlement and the net to the employee is tax free.
Commutations typically occur after an injured worker has exhausted all treatment and can no longer return to their normal job duties due to physical restrictions suffered as a result of the work injury.
Although neither the insurance company or employee can force a settlement, it may be in the best interest of both parties to settle the case.
Almost every settlment by Commutation has two potential drawbacks that may prohibit settlement. The first is that the employee will have to sign a resignation and they won't have a job waiting for them. Although there is nothing in the law that would prohibit an employer from rehiring an employee, in most cases the employee must understand that they will have to find another job.
The second drawback is that any additonal medical expenses incurred to treat the employee for the work related injury after the settlement has been approved is the responsibilty of the employee. Typically this isn't an issue as most cases are settled at a point where the employee has reached maximum medical improvement (MMI) which essentially means that there are no additonal medical procedures that will improve the employee's condition.
Denial and Dismissal - Also know as a D&D, these settlements occur only in cases where liablity for the employee's injury has not been accepted. A D&D often occurs when there is a dispute over liability. For example there may be a dispute over where the injury took place or whether the injury is work related.
Payment of a lump sum of money in a D&D is simply a compromise of a disputed claim. The payment of the settlement does not mean that the worker's compensation insurance company has accepted responsbility for the injuries. In fact, approval of a D&D settlement also comes with a finding by the Court that the claimed injury is deemed NOT work related.
In a D&D settlement, the employee is often responsible for any outstanding medical bills incurred as a result of the injury.
A D&D will typically require the employee to sign a resignation from their employment. The Attorney's fee is typically 20% and the net to the employee is tax free.
Finally, if an injured worker receives Temporary Disability benefits (TDI) and subsequently settles their workers compensation claim by way of a D&D, the employee is not responsible for reimbursing TDI for any money they received.
How Much Is My Case Worth?
This isn't a quesiton that can be answered with any certainty and is dependant upon several factors including the nature and severity of the injury, the employee's job duties, the period of time the employee has been disabled, whether the employee has been deemed partially or totally disabled and the employee's weekly compensation rate. If you would like to discuss the possible settlement of your workers compensation case, call and speak with an experienced workers compensation attorney today!
In some cases, a Medicare Set-Aside will be required as part of the settlement of the workers compensation case. The purpose is to set aside a sum of money that is to only be used by the employee to pay for any necessary future medical treatment for the work related injury after the settlement has been approved.
Depending upon the settlement, the set-aside may have to be formally approved by Medicare and the funds placed in a separate interest bearing account. In this case, the employee cannot use the money for any other purpose other than to pay for future medical treatment for their work related injury and the employee will have to make a yearly accounting of how much money was spent and whom it was paid. In addition, if the injured worker fails to use any of the money, their only option is to leave any remaining funds in their Last Will and Testiment.
Pain & Suffering
Workers' compensation in Rhode Island is known as an exclusive remedy. In other words, just about every worker injured in Rhode Island has no other choice but to seek benefits through the workers' compensation system as the law prohibits them from "sueing" their employer for their injuries. Because of this prohibition, damages such as pain and suffering are not recoverable like they would be in a traditional lawsuit filed against someone who caused another personal harm.
The prohibition against an injured employee sueing an employer also holds for intentional torts. An intentional tort is an intentional act that results in the harm of another. For example, if an employer willingly and intentionally removes a safety feature of a machine which causes an injury to one of its workers, unless the injured employee retained their common law rights at the time they were hired, they have no choice but to pursue a workers' compensation claim for their injuries despite the fact that the employer removed the safety feature intentionally.
There is only one exception to the above and that is if the employer did not have workers' compensation insurance at the time the employee is injured. In that case, pursuant to R.I.G.L. Sec 28-36-10, the injured employee must provide notice, in writing, to the employer, within ninety (90) of the injury, that they intend to pursue their common law rights (i.e. negligence). Provided this is done, the employee can puruse damages such as pain and suffering in addition to lost wages, medical expenses etc. However, one must keep in mind that the burden of proof in a negligence claim is different and arguably more difficult than the burden of proof in the Workers' Compensation Court.