Can I Get Medical Care Under Workers’ Compensation After my Case Settles?
Generally, the answer is “no.” Once the stipulation setting forth the terms of your settlement with the insurance company is approved by the Georgia State Board of Workers’ Compensation, you can no longer expect your employer to pay for work injury related medical care.
Several years ago, settlements were common that contained months or even years of “open medical” care. If you previously filed a workers’ compensation case or know someone who did in years past open medical may have been used.
Within the past few years, however, open medical provisions are far less common. Insurance companies dislike these provisions because their potential financial exposure is unknown and these companies want to avoid costly litigation relating to medical care on a closed case.
Further, with the introduction of Medicare set-asides into workers’ compensation settlements, it is difficult to account for the value of an open medical provision. Here, too, no one benefits when there is a dispute about payment of medical expenses.
Cost of Future Medical Care Incorporated into Settlement Figures
In the absence of an open medical provision, your settlement should account for future medical costs. When I evaluate a case for settlement, future medical costs can constitute a sizeable chunk of what I consider to be the insurance company’s exposure.
Timing of Settlements
Because settlement means the end of company paid medical care, I pay a lot of attention to my client’s medical records and prognosis. Sometimes I advise my clients to wait until after a particular medical procedure before thinking about settlement. Sometimes, the idea of reaching a financial settlement may seem tempting when you are facing a foreclosure or repossession, but the long term consequences in terms of future medical care may weigh against ending your case.
If you are unrepresented and are reaching a point where the insurance company is talking about settling, you should speak with an experienced lawyer before signing anything to make sure that you fully understand what you are doing. My number is 770-351-0801 and I would be happy to speak with you.