How do New York Workers' Compensation Cases Settle?
Well, that's a great question!
The answer is .. it depends. And there isn't quite a straightforward answer to such a straightforward question.
Some Workers' Compensation cases settle with a "waiver agreement", pursuant to WCL Section 32. This involves execution of a formal agreement and other forms which resolve some or all issues in a claim. A full and final Section 32 waiver agreement is the only legal way to definitively end a Workers' Compensation claim in New York. This type of settlement is by no means appropriate for all workers and cases. The Court takes this type of settlement rather seriously as it involves a waiver of important benefits that would otherwise potentially be available for the lifetime of the worker. It is also frequently the best way to derive the most value from a claim payable at once, rather than over time.
Other cases resolve with a "schedule loss of use" award. This is a payment of compensation fixed by statute, depending of the loss of use the worker sustains to a particular body part. This type of award or settlement is only available for certain body parts or conditions, i.e. loss of an arm or loss of vision. It is subject to deduction for prior payments of compensation. It also allows the injured worker to apply to reopen the case in the future if there is a change of condition. This type of award or settlement is most commonly seen where the worker has returned to work and the injury is stable and not in need of ongoing active treatment.
And still other cases resolve with a "permanent partial disability" classification award. This involves a payout to the injured worker over time for the worker's permanent injuries. The right to ongoing medical treatment is preserved. The amount and duration of the award varies based on the "loss of wage earning capacity" either agreed to by the parties or fixed by the Court. Classification that is payable as an ongoing award is most commonly seen where the worker has a disabling injury to a systemic body part, i.e. head, neck and/or back injuries, and either remains out of work or returns to work albeit in a limited capacity with a reduction in earnings.
And still ... some cases do not ever "settle." And they shouldn't.
Some cases are not compensable and should be disallowed by the Court, perhaps because the injury did not arise out of employment or because the claim simply lacks merit.
Other cases involve serious, life-changing, catastrophic injuries, where "settling" is not appropriate and it is necessary to protect the lifetime interests of the worker, both in terms of money benefits and in maintaining the right to ongoing medical treatment, perhaps with the goal of obtaining a "permanent total disability" classification. Zealous, aggressive, and experienced representation is often essential to achieve this goal which could result in a lifetime monetary award for the worker.
And then there are workers who perhaps were injured at work, had a temporary disability, but made a full recovery and are now "status quo ante" and have no "further causally-related disability." Settlement of claims under these circumstances are difficult. Often the worker gets no further monetary compensation beyond that which was paid when the worker had initial lost time. The worker can always apply to reopen the claim if there is a change of condition.
And yet there are other types of settlements that can be agreed upon via Stipulation that resolve individual issues in a case, like authorization for a treatment, or resolution of the amount of weekly compensation payable to the worker for a fixed duration of time.
This article is not meant to describe all types of settlements or awards in a New York Workers' Compensation case. Nor is it intended to be or should it be construed as legal advice.
Not sure what is best for your case? Not sure how you should close a claim or how to value your exposure? Call us for a free consultation!