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Workers’ Compensation Future Medical Settlements in New York

May 23, 2018 By Paul Giannetti

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In New York, employees who have been injured on the job have several options regarding workers’ compensation settlements. There are actually two parts to a worker’s comp claim, lost wages and medical. What many people don’t realize is that they can settle one part and leave the other part open in many cases. Can you get future medical payments in one lump sum? Is that a permanent arrangement? A knowledgeable New York workers’ compensation attorney can help you sort it all out. It helps to have an understanding of the law and how the process works.

Main Takeaways:

  • There are two parts to a worker’s compensation claim, lost wages and medical.
  • Workers can settle one part of their settlement and leave the other part open (in many cases).
  • The Walk-In Stipulation Calendar, or WISK, allows claimants to address specific issues via a written stipulation that they or their legal counsel prepare.
  • A Section 32 Settlement results in either a one-time settlement of both lost wages and medical or closing either the lost wages or the medical, while leaving the other one open.
  • A lump sum settlement bundles your medical and lost wages into one lump sum that is paid to you

What Is the Wisk Program in New York?

The Walk-In Stipulation Calendar, called the WISK Program, allows claimants to address specific issues via a written stipulation that they or their legal counsel prepare. They then request a hearing which usually occurs very quickly, often within a week. The case then goes before the New York Worker’s Compensation Board which decides on the case and within five days issues a written Notice of Decision to the claimant. This decision cannot be appealed, and it is final.

If the medical portion of your claim is pretty straightforward and you have a good idea of the expenses that you will incur, this may be a good option because it is so fast and easy. It is great for claims that are not very complex or extensive.

What Is a Section 32 Settlement for Medical?

There are two possible scenarios for a Section 32 Settlement in New York.

  • The first is a one-time settlement of both lost wages and medical that will close your case completely without any future benefits on your workers’ comp claim.
  • The second only closes one part, either the lost wages or the medical, while leaving the other one open. Often, the medical benefits are left open while the lost wages are settled. This would allow for future medical benefits to be paid as long as that portion of the case remains open.

If you close both, you can negotiate a settlement for future medical, but it will be a lump sum. This means that if your condition worsens or you require more treatment than you planned for when negotiating your settlement, it will come out of your own pocket. Leaving the medical portion of your case open-ended may be a wise choice, especially if your injury is extensive or you know you will have future surgeries and other treatments later on.

Lump Sum Settlement

This type of settlement may work for you if your medical expenses are routine and easily calculated. It generally bundles your medical and lost wages into one lump sum that is paid to you, ending your worker’s compensation claim. This is different from a Section 32 Settlement in that it completes the case with a single payment.

This settlement is typically negotiated by the insurance company and your attorney (or you if you don’t have legal counsel). Negotiations may take some time as the insurance will propose a settlement and your attorney will either counter or accept it. Once you receive the funds, it will be up to you to budget so that the money is used appropriately. You want to make sure that you don’t run out and can’t pay your bills, especially if you have medical bills that you incur after the settlement is finalized.

Reopening a Case

In some rare cases a New York worker’s compensation case can be reopened if it is within 18 years from the date that the accident occurred. If your condition has gotten worse or if you received compensation for your medical bills and lost wages but never negotiated a settlement you may be able to reopen your case to address those issues. If you are considered to be 80% permanently disabled by your doctor, and that designation is given after your case is closed, you may be able to reopen it if it is within the time frame as allowed by law.

Most requests to reopen a workers’ comp case are denied so it is best to have experienced legal representation to help you and increase your chances. Still, you may be better to choose to either leave the medical portion of your case open or carefully plan and negotiate your future medical settlement so that it will cover all of your expenses in the weeks, months, and years to come – or as long as you are treating your injury.

Finding Legal Assistance

If you’ve been hurt on the job, you probably have some questions about workers’ compensation payments and settlements. As an experienced New York workers’ compensation attorney, Mr. Giannetti has the background and education to handle all aspects of your case. He will answer your questions so that you better understand the process, and he will fight for you to ensure that you are fully compensated and get all that you deserve. Call today for your free consultation.

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