The parties to the case may come to settlement terms during any phase of the case. The settlement terms can include a settlement with one or more of the following parties: insurer, self insured employer, SIF or UEF. Settlements may include a settlement of the indemnity payments, settlement of past and or future medical treatment, vocational rehabilitation benefits or may leave the future medical treatment open. The Commission has started to reject settlement agreements that close medical treatment in certain cases. In those cases where the settlement agreement is rejected, the parties must obtain an MSA (Medicare set aside) or future cost projection to protect the right of the claimant to have future medical treatment. Claimants’ cannot settle their case without taking Medicare’s interest into account and getting the settlement approved by the Maryland Workers Compensation Commission. In certain cases, the parties will need approval of Medicare to settle the case. Medicare will not even review a settlement agreement unless the claimant is a recipient of Medicare and the amount of the settlement is over $25,000.00. If the claimant is not on Medicare, Medicare will only review the settlement if the settlement amount is greater than $250,000.00 and the claimant is expected to be on Medicare within the next 30 months.
While the insurance company almost always wants to try and find a way to facilitate a settlement of a workers compensation case, a settlement might not always be in the claimant’s best interest. The claimant would want to consider the impact of closing out medical treatment on their life, as that is usually the main thrust from the insurance company. Some injuries will most certainly require a lifetime of medical care while other injuries will not require any future medical care. In either case, the Maryland Workers Compensation Commission will require a letter from one of the physicians involved in the case stating that there will be no future medical care needed or the parties will need to obtain a medical set aside or medical cost projection to consider the cost of future medical treatment.
On the other hand, there are many reasons why a claimant would want to try and settle their case. Claimant’s may not care about future medical treatment or have a confidence that they will not need future medical care. Some minor injuries may never need more treatment, while other serious accidents may require more treatment. Some claimants have life events that require them to settle their cases or move out of the area or country. Some cases can even settle before a hearing on compensability. Frequently, cases are settled while they are on appeal. Appeals take time, there is usually a lot at stake on the appealed cases and both parties on an appeal usually have advantages in coming to settlement terms. Whatever the reason, the claimant and their lawyer shall evaluate all reasons to consider a settlement.
The documents needed for a case to be submitted to the Maryland Workers Compensation Commission for consideration of a settlement are the settlement worksheet, affidavit, settlement agreement that sets for the terms of the agreement, any supporting medical records, IME and bill, MSA or future cost projection and all costs and bills for which the attorney seeks reimbursement.