People call our office very often. Many ask if they can settle their L&I claim. Also, some of them have a self-insured employer claims. In fact, what most of them ask is: “How can I get paid in exchange to my claim?”. The entire topic of claim settlement is very complicated. There are several ways to do it. Here, we’ll go over all the different options below.
L&I Claim Settlement
Firstly, there are 2 types of work injury claims in Washington State. One is an L&I claim. Naturally, the Department of Labor and Industries (L&I) administers these claims. Then, there are self-insured employer claims. This is when your employer has private insurance to cover workers’ compensation claims.
L&I settlement options are not exactly the same as self-insured settlements. Either way, there are 4 ways to settle an L&I claim and get paid. They are:
(1) PPD award;
(3) Sidebar agreement; and
(4) Structured settlement.
Every L&I claim is different. Moreover, the settlement options are not available for everyone. Your L&I settlement options will depends on your claim.
L&I settlement with PPD award
Let’s start with #1: The PPD award. First, you must be at Maximum Medical Improvement. This means that your medical treatment is over under the L&I claim. However, it doesn’t mean that you are as healthy as you were before the work injury. Explicitly, it means that there’s nothing more that doctors can do for you to make you better.
At this point, you may still have some left-over medical conditions from the work injury or occupational disease. If you do, you’ll get a P.P.D award. PPD stands for Permanent Partial Disability. It’s a complicated topic of its own. To learn more, I suggest you check out our video about PPD awards in L&I claims.
With PPD, an IME doctor or your attending physician will rate your PPD. Then, the amount of money you get depends on your P.P.D rating and the date of injury. You can find the PPD payout amounts on the L&I website. For reference, in 2021 the total body impairment payout was $214,222.98. Now, let’s move on to #2: Pensions.
Settle L&I claim with pension
L&I pensions are complicated. Also, they are very hard to get. An L&I pension means that L&I pays you for the rest of your life because you cannot return to work. You can think of this as time-loss compensation payments for the rest of your life. To qualify, you must show that you cannot return to work and maintain work. Furthermore, you must also show that you cannot work because of your work injury or occupational disease. Not only at your job before the work injury. At any job.
Pensions can be sometimes be good. However, that’s not always true. It really depends on what you want to get out of your claim. For example, say you’re in your thirties and you job of injury was a low paying job. Does it make sense to you to get time-loss compensation payments or approximately 60% of your low salary for the rest of your life? Is this the best quality of life you can get for your future? Probably not.
However, say you are older and worked one job for your entire life, such as construction. You don’t know how to do anything else. Also, let’s say that you’re unable to return to your job because of your work injury. Then, it might be best to get an L&I pension. Now let’s talk about #3: Sidebar agreements.
Self-insured employer claim sidebar agreement
Sidebar agreements are very rare. Also, they can only happen when you have a self-insured employer. A sidebar agreement is a way to resolve claims quickly. Simply put, under a sidebar agreement the insurance company pays you to “go away”. First, you get some money. Then, in exchange, the insurance company rejects or closes your claim.
Many people like the option of sidebar agreement. If you’re considering it, it’s very important to hire a workers compensation attorney. The attorney will help negotiate the financial amount and ensure that the legal agreement is good. Finally, there’s #4: Structured settlement.
L&I claim structured settlement
If you search online, you’ll sometimes see the term CRSSA. It’s a common term in L&I claims or self-insured claims. CRSSA stands for Claim Resolution Structured Settlement Agreement. This option is available for work injury claimants who are 50 years old or over. To qualify, your claim must be at least 6 months old.
Doing a structured settlements means that you get some money and you agree to close your claim. You might get a lump sum. Also, you might get partial payments over time. Structured settlement are good because you can still receive additional medical treatment. In fact, you can get treatment if your medical condition from the work injury gets worse.
If your claim is with L&I, they’ll consider a structured settlement after you reach maximum medical improvement. Self-insured employers also like doing structured settlements because it lets them close claims faster. Either way, it’s good to consider a this settlement option if you qualify. If you do, make sure to get a workers compensation attorney. Why? Because you have to make sure you’re getting a fair and good payout. Also, you have to make sure you’re not giving up any rights that you shouldn’t. For example, rights for future medical treatment.