If you are discussing a settlement offer with your workers’ compensation lawyer, you might hear him or her use the term “future medical”. This refers to the specific terms of the proposed settlement, which may allow all future medical claims related to the injury or just some claims.
The insurance company may decide to settle your claim because of a dispute over the amount of a benefit, denying a benefit altogether, or stopping payment of benefits. When you agree to a settlement, you release some or all claims for workers’ comp benefits arising from your injury in exchange for a check from the insurance company.
Future Medical Claims Open
Sometimes workers realize that they will need expensive medical treatment for years to come because of their injuries, and a lump sum settlement will not necessarily cover the costs. To get the case settled, they can try to negotiate a settlement with future medical left open. A full, final, and complete settlement that leaves future medical claims open is a common type of workers’ compensation settlement.
If your settlement leaves future medical claims open, you may make claims in the future for payment of medical expenses related to the injury. Some injuries take a long time to heal or require long-term medication. Or you might need replacement of glasses, an artificial limb, or other medical equipment. When these needs arise, you can contact the insurer to pay for the costs. But you cannot make claims for other types of benefits, just medical expenses.
Some Future Medical Claims Open and Some Closed
Rather than being vague about which future medical claims will not be released by a settlement, sometimes the injured worker and the insurer negotiate to leave only some medical claims open. The settlement agreement then lists specific kinds of medical claims that are not released. If the worker has these kinds of medical expenses in the future, he or she can make a claim to the insurer. For example, the insurer might agree to continue paying for your physical therapy, but not for acupuncture.
All Future Medical Claims Closed
Finally, some settlements close out all future medical. The settlement agreement would simply require the insurer to pay the worker a lump sum in full and final settlement. If the insurer in your case proposes a settlement that does not leave future medical open, you should consider the possible long-term costs of medical care for your injury. It simply might not make sense to take only a lump sum.
Your Future Medical Settlement and Determining Future Medical Costs
To help determine your future medical costs, there are three factors to consider: consistency and frequency of your treatment, type of treatment, and the cost of treatment.
Consistency and Frequency of Treatment
It is easier to estimate how a potential settlement will fund your future medical needs if your treatment schedule is going to be predictable. For example, how often will you be seeing the doctor or taking medications? The answer to these and other questions will enable you to more accurately calculate your future medical expenses. The funding in any settlement proposal you consider needs to match or exceed the cost of your current and any future treatment schedule.
Type of Treatment
If you will likely only require the same treatment for years to come, then it is easier to budget your future medical costs. However, if treatments may vary, it is more challenging to determine the necessary funding you need from a medical settlement to cover future expenses. However, many cases can result in a settlement that sufficiently funds the costs of potential future medical treatments or that may or may not be needed, such as the need for a certain medical device or surgery.
Cost of Treatment
Understanding the costs of various treatment options can help you determine what you can afford. Find out what the costs are of the major items in the settlement offer. If the actual costs of treatment options match what the proposed settlement provides, you may be able to determine if the settlement funds will adequately cover your medical expenses over time.
Need help getting workers’ compensation for your injury? Do you have future medical settlement questions? Joe Osterbauer, Esq. and the Osterbauer Law Firm stand up for injured Minnesota workers’ rights. Joe’s 27 years of workers’ compensation experience and his team’s speedy service combine to get clients the results they need. To schedule a free consultation, visit Osterbauer Law Firm online or call Joe’s office at (612) 334-3434.