The Hidden Complexities in Workers’ Compensation Cases


While most people understand they may be able to receive benefits through workers’ compensation if they are injured on the job, many more don’t realize the many issues that may serve to either de-rail a claim before it starts, or may come back to haunt them after a settlement.

For example, while an injured worker has two years to file a claim under workers compensation, any on-the-job injury must be reported to the employer within ninety days of when it happens. While this may seem simple on the surface, what if you have an injury that doesn’t happen on a particular date (such as injuries that may come on gradually, like carpal tunnel syndrome, certain neck or shoulder problems, etc.)? In these instances, the injury must be reported within ninety days of when the employee knew or should have known the problem was related to work. This can be a tricky matter, and is often a source of contention with the employer and the workers’ compensation carrier.

Turning to the end of a workers’ compensation case – did you know that the federal government has an interest in each and every workers’ compensation claim that is settled, and that those interests must be protected in each case? The federal government, through Medicare, requires the parties involved to ensure that future medical costs for a work-related injury are never shifted to Medicare. Since all workers have an expectation of being on Medicare at some point in the future, this consideration applies to all settlements in workers’ compensation. In some instances, if the carrier is not going to continue paying for related medical costs directly in the future, Medicare requires that a formal estimate of future medical costs be submitted for pre-approval by the Center for Medicare Services. Once approved, that figure is then paid to an account, which may be used exclusively for related medical treatment, and the injured worker must account for every penny spent from that account to Medicare each year. If these requirements are not met, it could spell major trouble down the road if Medicare determines its secondary payer status was not adequately protected.

These are just a couple of examples of how even a seemingly straightforward workers’ compensation case can become quite complicated to handle for an injured worker. In light of these hidden complexities, it is always a good idea to talk to an attorney when you have suffered a work-related injury. At KD Trial Lawyers, we do not charge for initial consultations, so it won’t cost a thing for you to talk with us to get a better understanding of what you may be facing as you move forward in the workers’ compensation process.

by Jeremy A. Dantin
Attorney Jeremy A. Dantin

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