Written by attorney Michael H. Gruhin


When should an Ohio Workers’ Compensation Claim be settled & how much is your OhioBWC claim worth?

Every day, Injured Workers seek information on what is the settlement value for their particular claim. They are probably wondering when an Ohio Work Comp Claim should be settled and how much is the claim worth? The problem with that question and the results of internet searches just won’t give you the answer.

Let me say this one more time. NO ANSWER TO THAT QUESTION CAN OR WILL EVER BE FOUND IN ANY INTERNET SEARCH. EACH WORK COMP CLAIM IS UNIQUE IN ITS CIRCUMSTANCE AND ULTIMATE VALUE. A Board Certified Ohio Work Comp Specialist Attorney can correctly analyze the settlement value of a BWC claim.

Evaluating the settlement amount of a workers’ compensation claim is based on experience and legal knowledge in the OhioBWC claim system. This is a prime area in which an unrepresented injured worker who ventures into the unknown territory of work comp settlement will likely undervalue the claim causing irreparable damage in their lives or will likely overvalue the claim resulting in a rejection of the settlement demand and a claim that will not settle.

Are there times when a claim should not be settled? The answer is never a simple yes or no. If you’re unable to work and you have no alternative avenue of obtaining continuing income, you’re probably receiving temporary total disability, living maintenance, or wage loss. In that instance you may not be in a position to settle your claim. However, there are instances where you may be tempted to or where it’s in your best interest to work out a lump sum settlement rather than accept biweekly payments based on a percentage of your weekly earnings or to keep the medical component of your claim open. When to seek a Lump sum settlement is a continuing issue among injured workers. Understanding the timing and/or the options can be confusing. Making the wrong decision can result in financial disaster. In order to understand the settlement process you should consult with a Board Certified Ohio Work Comp Specialist Attorney.

During the life of an OhioBWC claim, every injured worker is eligible to seek a lump sum settlement. But, is settlement the right thing to do in your particular circumstance? Depending on the extent of your injuries, your ability (or inability) to work, your ability (or inability) to obtain alternate health care services, together with a myriad of other factors, there are times during which you may be better off not seeking a lump sum settlement. That’s why you need the advice of a Board Certified Specialist.

There is one instance where you should investigate lump sum settlement. When your health condition is questionable, it is critical to understand that your Ohio BWC claim expires upon your death. In that instance, a settlement must be discussed with an Ohio Work Comp Board Certified Specialist Attorney. Once a claim is settled and the 30 day cooling off period expires, should an injured worker die, his/her family will obtain the funds through the deceased estate. However, should the injured worker die during the claim or the 30 day cooling off period, the claim dies with the injured worker and no funds settlement funds are paid.

Mike Gruhin, Board Certified Ohio Work Comp Specialist Attorney will work closely with you to determine what’s in your best interest when it comes to evaluating whether it is the ‘right’ time to settle your Ohio Workers’ Compensation claim. At Gruhin & Gruhin, first and foremost, we look out for your best interest. In doing so, we may be able to 1) discover that your wage was set incorrectly, which may result in a recalculation award of prior compensation paid; and/or 2) obtain additional condition allowances, which may result in additional claim value, including, but not limited to continuing medical treatment, a new period of temporary total disability payments, additional permanent partial disability compensation, or permanent total disability. Check out what our clients think of our services.

The first thing to know about work comp settlements is that they are purely voluntary. The OhioBWC, and in some instances your employer, does not have to agree to settle your claim. Once you have submitted a settlement request, you do not have to agree with a settlement offer proposed by the OhioBWC or your employer. Additionally, in Ohio there is a 30 day ‘cooling off’ period during which any party may withdraw from the settlement agreement, making it null and void.

If you are discussing settlement regarding one or more aspects of your workers’ compensation claim, or considering pursuing settlement, you may be wondering how much you will receive in the settlement. There are a few preliminary considerations, but in all circumstances an injured worker does not have the ability or expertise to figure out the true value of a workers’ compensation claim.

The OhioBWC’s settlement information page lacks critical information necessary to settling many claims. The most glaring omission is that it contains no mention or information related to the settlement of a claim while the injured worker is Medicare eligible and/or receiving Medicare benefits. In such instance, a CMS Medicare Set Aside Secondary Trust is necessary. This will be discussed later in this article. The second omission is advising the injured worker that he/she most likely does not have the necessary experience to evaluate the true value of their BWC claim. But the BWC does make it clear that the injured worker does not need an attorney to evaluate, negotiate, and/or settle a BWC claim.

In order to avoid the settlement problems that can arise from an OhioBWC settlement, an indemnity only settlement can be pursued. This type of settlement leaves the medical open. Therefore, there is no need for a Medicare Secondary Trust. Additionally, the US Life charts must be utilized to avoid Medicare’s utilization of the settlement as a current lump sum rather than allocating the settlement amount over the injured worker’s lifetime. All of these considerations must be taken into account. Attempting such settlement yourself is just a recipe for disaster.

If You Don’t Settle Your Claim, What You Are Entitled To? When considering settlement, it is important to know what work comp benefits you are entitled to, and what rights you are relinquishing, as part of a proposed settlement agreement. Consider the following types of benefits and how they are often handled in workers’ compensation settlements. Furthermore, among other factors, giving up these potential rights is what is used to calculate a settlement demand amount for a workers’ compensation claim. Bottom line, if you are interested in seeking a settlement of your Ohio you should consult a Board Certified Ohio Work Comp Specialist Attorney. Don’t undervalue your settlement by trying to do it alone. The OhioBWC says you don’t need an attorney to settle your claim, but don’t be fooled into trying to figure out one of the most important decisions you can make without the training and knowledge of every aspect of claim value.

Temporary Total Disability I f your work-related injuries resulted in some type of temporary total impairment, where you are unable to work, you are likely to be entitled to a monetary award to compensate for your inability to work. Temporary Total Disability is paid until you reach Maximum Medical Improvement (MMI). This compensation, its anticipated duration and future value, is factored into your settlement demand. There are additional avenues to explore once you have been found MMI.

Wage Loss Compensation If your work-related injuries resulted in some type of work restriction, you are likely to be entitled to seek wage loss, working wage loss and/or non-working wage loss. This compensation, its anticipated duration and value, is factored into your settlement demand. For claims with an injury date prior to August 25, 2006 the wage loss payments can extend to 400 weeks. For claims with injury dates on and after August 25, 2006, wage loss payments can extend to 225 weeks.

Permanent Partial Disability If your work-related injuries resulted in some type of permanent impairment, but did not render you totally disabled, you are likely to be entitled to a monetary award to compensate for your permanent partial impairment. You are entitled to seek increases to your permanent partial disability award at any time during the life of the claim. This compensation, its anticipated duration and value, is factored into your settlement demand.

Permanent Total Disability An injured worker applying for or receiving Permanent Total Disability may be interested in seeking a lump-sum settlement. In these instances, it is critically important to seek the advice and counsel of a Board Certified Ohio Workers’ Compensation Specialist Attorney.

Considerations in Deciding Whether to Accept a Settlement First, consider that a settlement is a guaranteed benefit. Your Ohio Work Comp Claim expires on your death. An Ohio Work Comp Claim expires at statutorily designated times. If you have an older workers’ compensation claim that has little activity, you should think about a lump sum settlement. A settlement is a guarantee to provide you with certain benefits and takes out the risk associated with litigation.

A second consideration is that you will probably have to give up your right to future compensation awards and/or medical treatment for your injury.

In Ohio, settlement of a workers’ compensation claim can be obtained as an indemnity only settlement. In that instance, your medical component remains open. In this instance, the OhioBWC will reduce its offer because it keeps the medical component of the claim open. In an instance where an injured worker is Medicare eligible or a Medicare beneficiary, the indemnity only settlement is the only way to settle a claim without the need to allocate a large portion of the gross settlement amount towards the CMS Medicare Set Aside Trust.

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If You Settle Your Claim, What You Are Entitled To? A Board Certified Ohio Workers’ Compensation Specialist will meet with you to go over the dollars previously paid by the OhioBWC and the anticipated future medical and prescription money to be paid in your claim. All of the above items are analyzed and after a comprehensive face to face meeting, I can advise you as to the best course of action you should take. I handle work comp claims as though I am the injured worker, but with all of the experience and knowledge I have. I take the injured workers’ best interest into account in a lump sum settlement review. I will tell you when it is not in your best interest to seek settlement. Having a Board Certified Specialist Attorney explain all of the settlement options available and specific to your claim is critically important. Lump Sum Settlements cannot be approached on a cookie-cutter basis. Each claim has its own specific issues and, although claims are similar, no claim is identical. Once a claim settlement is concluded, there is ‘no going back’. There are no ‘do-overs’. An important thing to remember is that you will be required to give up something for this money. You may be giving up the right to argue that you are permanently and totally disabled, or the right to argue that a specific medical condition was related to your workers’ comp claim, or the right to any future medical care. If a lot of money is at stake, you should consult a Board Certified Ohio Workers’ Compensation Specialist Attorney to discuss the implications of ta lump sum settlement or the pursuit of additional avenues of compensation in your claim without the requirement of ‘closing it out’. Most times claim settlement is a personal decision. However, there are specific ways to settle your claim depending on interrelated legal issues. If you want the information you need to make that informed decision to protect your best interests and not that of the OhioBWC, please call me to discuss your claim. You need the experience and advice of a Board Certified Ohio Workers’ Compensation Specialist Attorney to guide you, not only through the settlement process, but through your OhioBWC claim in order to obtain all of the benefits available to Ohio’s injured workers. For more information on OhioBWC claim settlements, give Mike Gruhin a call at (216) 861-5555 or (800) 861-5555. You can also send an email regarding any claim question you might have. Hopefully this article has given some additional insight into the settlement of an Ohio Workers’ Compensation Claim. Feel free to download Mike Gruhin’s FREE Ohio Workers’ Compensation Guide for information about many aspects of an Ohio Workers’ Compensation Claim. © 2012, Gruhin & Gruhin Attorney's. All rights reserved.

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