What To Do When Your Condition Worsens After Settling Your Workers' Compensation Case

While many people's conditions improve after receiving medical care for injuries they sustained on the job, some people actually get worse. If this occurs before you settle your workers' compensation claim, then you would simply make adjustments to the claim to account for changes in your condition. However, what do you do if your condition gets worse after your claim has been settled? Your ability to collect additional compensation for a worsening injury will depend on the circumstance of your case and settlement.

The Terms of Your Settlement

The first thing you'll need to do is look at the terms of your settlement. In the best case scenario, your settlement will state you'll be compensated for future costs related to your injuries. All you would need to do in this scenario is submit your bills to workers' compensation and the insurer would take care of them.

However, to keeps costs low, many times workers' compensation will require claimants to sign agreements releasing the insurer from any future claims related to the injury. This is typically referred to as "full and final release" or "clincher" deals. If your settlement includes this type of clause, then you're essentially barred from seeking further compensation for damages.

Possible Workarounds

There are three instances in which you may be able to bypass a full and final release clause and get workers' compensation to pay for medical expenses related to a worsening injury. If you live in a state where these types of clauses are illegal, then you can file a lawsuit to have the court invalidate that part of the settlement and allow you to obtain money to pay your medical bills.

You can also get workers' compensation to reopen your case if you can prove your employer engaged in some type of fraud during the claim. Specifically, if you can show that your employer misrepresented the facts or terms of the settlement agreement then workers' comp may be willing to reopen the closed claim. Be aware, though, that this can be difficult to do, especially if there is no supporting evidence such as audio recordings or emails.

The third option for getting compensation for a worsening condition is to have it qualify as a new injury. However, this is only possible if another incident occurs that re-injures the affected body part. For instance, if you slip and fall and the accident causes your back pain from a previous incident to worsen, then you may be able to submit a brand new claim for damages to workers' comp.

All of these options require a careful reading of the law and a sound legal strategy. It's best to consult with a workers' compensation attorney before taking any action.


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