Structured Settlements and Workers’ Compensation

The legal system is often thought of by lay people as being complicated, and legal cases may take months or even years to resolve a case.  Unfortunately, workers’ compensation is not always an exception to this, as the nature of the cases often include injuries that take time to heal before it can be determined whether a worker is permanently or temporarily disabled, the type of accommodation the worker requires, or whether the worker can even return to work at all.  Both sides are often looking for ways to shorten the process and come to a settlement.  With a settlement, the parties can avoid the time and expense of a court case that drags out and costs both sides dearly.  One way to complete this in a workers’ compensation case is a structured settlement.

A structured settlement is a settlement agreement wherein the employer or its insurance provider agrees to make a series of periodic payments to the injured worker (or the surviving family) over a period of time.  Some structured settlements provide that each payment amount will be exactly the same, but other settlements can provide additional flexibility.  In some cases, the settlement may provide for a lump sum to be paid up front before the regular payments start.  This lump sum may be to assist with housing, transportation, or medical needs.  In addition, the settlement can take future cost of living expenses increase or inflation rates into account, and provide for future increases at specific times.  It should be noted that a separate account is often set up to handle the injured workers’ future medical expenses, and that the periodic payments are meant to represent the lost wages.

One advantage for the employee in accepting a structured settlement is that the periodic payments are not subject to federal income taxes.  An employer will often benefit from a structured settlement in cases where there has been a catastrophic injury that is likely to result in a finding of permanent partial or total disability, especially where the injury is so severe that the worker is unlikely to be able to return to meaningful employment.

We have extensive experience helping our clients understand what types of settleemnts may be best for their business.  Call us today to talk about what we can do to help you.

Making Sure You Properly Investigate an Injury

Making Sure You Properly Investigate an Injury

All workers’ compensation claims have one thing in common – they all start with an alleged work-related injury.  A savvy and conscientious employer will have procedures in place, ready to go for when an employee reports  an injury on the job.  These procedures include obtaining medical care, providing necessary forms and paperwork to the employee, and investigating the injury properly.  Failure to conduct a proper and thorough investigation of a work-related injury sustained by an employee could lead to much bigger problems down the road.

It is first essential to obtain a completely clear account of the accident directly from the injured employee.  This account should be in writing, and should provide as many details as the employee can recall.  Every step should be taken to get this written account as soon as possible following the injury.  By providing a description of the event and the injury early on, it will be much more difficult for an employee to fraudulently expand the injury at a later date.  For example, if an employee injures her hand during an accident, if she has already provided this written account, it will be much more difficult for her to later include her foot as part of a work-related injury.  Getting a clear account of the accident can also provide important feedback to an employer about how to prevent similar injuries to other employees in the future.

Another critical step is to obtain witness statements.  Like the statement from the employee, the witness statement should be in writing and gathered as soon as possible following the incident.  Witness statements will assist in rooting out inconsistencies between an employee’s claimed injury and what actually happened.  Having a supervisor review the witness and employee statements is also an important step.  The supervisor can provide important insight as to whether the claimed injury is an injury that is realistic or if it shows red flags of fraud.

If there are red flags, an employer may want to consider hiring a private investigator to look into the employee’s behavior outside of work.  An investigator can give the employer insight as to whether the employee is engaging in activities that are inconsistent with a claimed injury.

Although the vast majority of workers’ compensation claims are legitimate, it is very important to investigate each injury with as much detail as possible.  Contact us today at (714) 516-8188  to talk about your case and what investigative steps should be taken for your business.

Reducing Workers’ Compensation Costs

Recent years have seen definite drops in employee work-related injuries. This is a happy development, but, unfortunately, has not lead to corresponding drops in workers’ compensation insurance premiums to employers. Despite this, there are ways to help reduce the cost of your workers’ compensation.

The first way is the most obvious – continuing to reduce injuries. Continuing to keep up with the latest safety measures and technology to reduce work-related injury is an excellent way to ensure continuing drops to injuries. Making sure your machinery, work place, and equipment is in good repair is also vital.

Next, make sure your staff is receiving adequate training. Training manuals and videos are good tools for this, but it is also important to make sure that the employees are actually reading and absorbing this material. The material also needs to be up-to-date. For example, if you have implemented new safety procedures and new safety technology, it is imperative that manuals and training materials are updated accordingly.

Third, it can be beneficial to incentivize your employees. Set goals for meeting particular safety benchmarks, and make the benefits applicable to the entire workplace. This not only will compel each individual employee to try to maintain safety standards, but will also generate an atmosphere of cooperation and positive peer pressure to make sure that the safety procedures are appropriately utilized.

It should also go without saying that you need to be honest with your workers’ compensation insurance company. Make sure the company is aware of the safety procedures you have implemented and maintain an open dialogue to make sure that your premiums are set appropriately.

If a worker is injured on the job, contacting the appropriate medical personnel immediately is vital. This will help ensure that the worker does not sustain further injury.

If you have failed to maintain insurance, a worker gets injured, and the Uninsured Employers Benefits Trust Fund is seeking to place a lien against your business, another way to “after the fact” help reduce the cost is to seek assistance from a lawyer trained in workers’ compensation matters. That attorney may be able to help you negotiate payments or even reduce the final lien amount with the Trust Fund.

Businesses should take all available precautions to help reduce their workers’ compensation costs through training and procedure. If a lien or judgment is established, the business should contact an attorney to help negotiate that amount. I have significant experience and training in workers’ compensation, and can help you. Contact me today at 714-516-8188 to discuss your business and its liabilities.

Department of Labor Wants Changes to Workers’ Compensation

Under the current workers’ compensation system, each state more or less makes its own set of laws. These laws vary wildly between states. For example, Texas allows companies to opt out of workers’ compensation insurance while our state of California provides harsh civil and criminal penalties for failure to carry the mandatory insurance. Meanwhile, the United States Department of Labor is weighing in.

The Department of Labor recently released a statement urging changes to the spotty, state specific approach currently in force for workers’ compensation insurance. The Department of Labor recognized that workers’ compensation is a key protection for employees. The statement called workers’ compensation insurance a “key component of the country’s social benefit structure” and expressed concern that it has no federal oversight and a lack of federally mandated minimum standards. The Department of Labor recognized that other social benefit programs have grown, citing the Affordable Care Act, Social Security, and Medicare, while the benefits provided to workers under workers’ compensation system have failed to keep pace, and have sometimes eroded.

The Department of Labor further expressed frustration  that the actual cost of a work-related injury is often borne in large part by the employee, and not by the actual employer. With high insurance premiums and constantly rising medical costs, this puts injured employees in very real danger of financial disaster and bankruptcy. Recent changes in workers’ compensation benefits were recognized, and that the result of these changes was often a diminished amount of benefits and security to a worker.Specifically noted were denial claims that were previously compensable, discouraging workers from filing a claim at all, and a decrease in the cash benefits awarded. Higher evidentiary bars, opt out systems, and exclusion of certain injuries also made the list of concerns.

Ultimately, the Department of Labor concluded that a dramatic overhaul is necessary in order to prevent the continued trend of erosion to benefits provided to workers. These changes would include increased benefits to the worker while decreasing costs to the employer. The Department of Labor also did not overlook the fact that the first step would be continuing efforts to reduce the incidence of work-related injuries in the first place. The Department of Labor goes on to explore whether the federal government should step in to provide more oversight, and whether it may be important to expand other social programs such as Medicare and social security.

In today’s political climate it is clear that change is imminent to many programs, including workers’ compensation. I can discuss with you what changes are likely to happen and how to make sure your business is ready for the future. Contact me today at 714-516-8188 for an appointment.

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