When Can I Get My Scar Money?

When Can I Get My Scar Money?

Question

When Can I Get My Scar Money?

Answer

The point in time at which you are likely to receive this benefit is when a doctor has given an opinion that your disfigurement is at “end result,” meaning that further medical care is unlikely to enhance the appearance of it.
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When Scar Money Arrives

The Rhode Island Workers’ Compensation Act does provide for a separate benefit, i.e. a separate check and amount of money if you have disfigurement from the injury, whether that is a scar, a burn or some other deformity. Once you are at that point in time, your lawyer and the insurer will meet with you to view the deformity or disfigurement and try to agree on a number or a dollar amount that is fair.

How Much Scar Money is Worth

The value of your scarring or disfigurement is highly subjective. However, a lawyer who has done this many times will have a very good idea as to whether you are better off taking the offer that is on the table for the scarring or proceeding to workers’ compensation court and having a judge determine the amount of your scarring benefit. This usually occurs about six months after the date of the injury, but it could happen earlier or later.

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What Is The “Going and Coming” Defense To Workers’ Compensation?

What Is The “Going and Coming” Defense To Workers’ Compensation?

Question

What Is The “Going and Coming” Defense To Workers’ Compensation?

Answer

The going and coming rule is a rule that Rhode Island recognizes as a bar or a prohibition against receiving compensation.
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The Rule

Generally, the rule states that injuries sustained while going to or coming from the workplace are not compensable under the Rhode Island Workers’ Compensation Act and do not entitle the employee to any benefits. In reality, however, case law over time has expanded the number of exceptions to that rule—so much so that it is commonly considered that the exceptions have swallowed the rule. If you are unsure whether your injury qualifies under one of these exceptions, consulting a Rhode Island workers comp attorney can help you understand how the rule applies. You may also find additional background in our RI workers’ comp benefits, which explains how compensability is evaluated.

You're Neither Entitled or Barred

That’s not to say that if you were hurt going to or coming from work that you will automatically be entitled to benefits. Employers and insurers will aggressively pursue a going-and-coming defense the moment they identify one. This makes it essential that your lawyer is well-versed in this area of the law because these cases can be heavily contested. At the end of the day, the mere fact that you were going to or coming from work when you were injured does not automatically bar you from compensation. Understanding related issues such as special insurer roles or third-party administrators may also help you see how these claims are handled behind the scenes.

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Is There A Danger Of Getting Less Than What An Insurance Company Initially Offered At Trial?

Is There A Danger Of Getting Less Than What An Insurance Company Initially Offered At Trial?

Question

Is it possible to get less when my workers’ comp case goes to trial?

Answer

If you go to trial, it’s always possible to lose and therefore end up with less than what you were offered.
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The Compromise

The offer is a compromise on both sides, because the insurance company could ultimately wind up not owing you anything. On the other hand, you may prevail and they may owe you significantly more than what they initially offered. An experienced attorney can help you weigh these outcomes and assess the true risk. Speaking with our workman’s compensation attorneys can give you a clearer understanding of how settlement negotiations differ from trial results. For broader context on how disputes are decided, you may also want to review our denied claim appeal in RI.

Difficult Cases

These types of situations require a great deal of judgment and experience on the part of your workers’ compensation lawyer. They also require careful consideration from the injured employee, because everyone’s circumstances are different—what may be a good settlement for one person may not be appropriate for another. For better decision-making, consider the risks behind trial risk and lower than offer outcomes.

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What Can I Expect If My Claim Goes To A Hearing Or Trial?

What Can I Expect If My Claim Goes To A Hearing Or Trial?

Question

What happens when my claim goes to trial or a hearing?

Answer

Anytime you file a petition in the workers’ compensation court in Rhode Island, the matter comes on for a pretrial hearing.
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During the Pretrial Hearing

If there is a dispute about whether or not you’re entitled to benefits under the Rhode Island Workers’ Compensation Act, your lawyer may file what is called an original petition, which determines whether you should be on workers’ compensation at all. Once filed, that petition triggers a “pretrial hearing,” which is a court date you and your lawyer must attend. During this hearing, a judge will informally listen to arguments from both sides, review any available evidence, and make a preliminary determination without conducting a full hearing. In some cases, a judge may determine at the pretrial hearing that additional evidence or a full trial is necessary. Our workers compensation lawyers in Rhode Island can help prepare you for this critical first step. You can also learn more about the appeal process in our denied claim appeal in RI.

Why Pretrial is Important

In reality, the pretrial conference on your original petition is the most important day in your Rhode Island workers’ compensation case. If your original petition is granted at this first pretrial hearing, you will immediately begin receiving everything you’re entitled to under the workers’ compensation act. You essentially gain control of the legal landscape from that point forward.
If your case is denied at the pretrial level, you must take a “claim for trial” (an appeal), and you will not receive benefits while that process unfolds. Claiming a trial can be long, difficult, and financially stressful, especially without income replacement. Understanding related issues such as how long the court process takes or what happens if your claim is denied may also help you prepare.

Why Petitions Aren't Granted

There are many reasons why a petition may not be granted at the pretrial level. While lawyers try to avoid proceeding further than the pre-trial hearing, doing so can be necessary. There are also some cases in which the lawyer and the employee realistically know that the case has serious legal problems. In those cases, the lawyer should make his or her client very aware of the fact that a denial at the pretrial level is likely.

They should already be prepared for how they’re going to attack the case after that point, whether it’s to target some sort of settlement through a denial and dismissal, or to proceed through a full trial. If doing the latter, a strategy has to be determined and the cost to the employee of prosecuting the case in the absence of receiving any benefits must be considered.

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If There Is No Settlement, Will A Workers’ Compensation Claim Go To Trial Or A Hearing?

If There Is No Settlement, Will A Workers’ Compensation Claim Go To Trial Or A Hearing?

Question

My case didn’t settle- will my claim go to a trial or hearing?

Answer

If there is no settlement, a workers’ compensation claim will not necessarily go to trial.
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Settlement Can Happen at Anytime

Oftentimes the idea of settlement will come up in the life of your case during the time when nothing is actually pending in court. It may simply be that you’ve been collecting weekly benefits for some time and the carrier or someone else reaches out and asks whether there’s any interest in ending the case with a lump-sum settlement. For general guidance on how settlement fits into a workers’ comp case, our Rhode Island workers comp attorney can help you understand your options.

When Settlement Pops Up

In many cases, however, the prospect of settlement rears its head during a contested hearing or a trial. That may be a trial regarding whether or not you’re even entitled to continuing benefits under the Workers’ Compensation Act. Alternatively, an ancillary dispute may come up regarding payment of a particular medical bill or authorization for a particular type of treatment, which may be the impetus for the parties or even the judge to suggest that settlement be explored. If you want to understand how hearings fit into the broader process, reviewing our denied claim appeal in RI can be helpful. You may also want to learn more about what to expect during a hearing, such as workers’ comp hearing procedures.

How Settlements Work

One of the things that the judge will ask the employee during the settlement hearings is whether or not they understand that they do not have to settle the case. The employee should be aware that he or she could go to trial or proceed with the full hearing, present evidence, present witnesses, and have a judge make the official determination. In making that determination, there could be a decision that the employee is no longer entitled to benefits or whatever they’re asking for. In that case, weekly checks would stop. On the other hand, the matter could be decided in the employee’s favor, in which case the weekly checks would continue. In light of the consequences of proceeding further, the employee has to make an intelligent decision about whether or not settlement is in his or her best interest. Understanding the process—such as how to prepare for a hearing—can help you make informed choices.

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Does The Settlement Have To Be Approved By The RI Workers’ Compensation Agency?

Does The Settlement Have To Be Approved By The RI Workers’ Compensation Agency?

Question

Does my settlement have to be approved by the state workers’ comp agency?

Answer

Any type of settlement- whether it’s a denial and dismissal or a lump sum commutation- has to receive the approval of a judge from the Rhode Island Workers’ Compensation Court before it is official.
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Settling Right

This is because the Rhode Island Workers’ Compensation Act is remedial in nature and is designed with benevolent purposes for helping the injured worker. So, the last thing a judge would want to see is that an employee is trying to settle a case that is clearly not in his or her best interest. For general settlement guidance, our workers compensation lawyers in Rhode Island can help you understand how approval works. You can also review our RI workers’ comp benefits to understand how settlements affect long-term rights.

What the Judge Looks At

The judge will look at whether or not the employee understands the settlement and the consequences of the settlement, as well as whether the employee is capable of some sort of work, even if it’s light or restricted in nature. The judge will also consider whether the employee has a plan in place to receive future medical treatment, since a settlement typically means the insurance company will no longer be responsible for paying medical bills. Judges may also ask additional questions to ensure the settlement is in the best interest of all parties. It may help to review related topics such as how settlements work or choosing the right settlement option.

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Do All Parties Have To Agree In Order For A Settlement To Proceed?

Do All Parties Have To Agree In Order For A Settlement To Proceed?

Question

Does everyone have to agree for my case to settle?

Answer

Generally, all parties have to agree in order for a settlement to proceed.
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Agreement is Key

A settlement can’t be approved if the employee does not agree. Likewise, no settlement can move forward unless the insurance company—the party typically funding the settlement—also agrees. In addition, the Workers’ Compensation Act requires a showing before the judge that the employer or employer’s company understands that a settlement is being proposed. To better understand how these approvals work, our RI workers comp lawyers can help you evaluate your settlement options. You may also find it useful to review our denied claim appeal in RI for broader context on how the Rhode Island system handles disputes and agreements. Exploring related topics such as how settlements work or the finality of settlements can also help you understand the process.

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How Long Does It Take To Get A Workers’ Compensation Settlement?​

How Long Does It Take To Get A Workers’ Compensation Settlement?

Question

My workers’ comp case just started- how long will it take to start getting my checks?

Answer

There is no rule about how long it takes to get a workers’ compensation settlement. In fact, many cases will never settle.
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The Average Case

Having said that, if a particular case is the type of case where settlement makes sense, then it will typically take at least six months of being on benefits before settlement discussions even come up. The only exception to this is when an individual is clearly entitled to workers’ compensation benefits and receives compensation for some time. In that scenario, the settlement is usually a lump-sum commutation, which often requires more time to process. For a clearer understanding of settlement timelines, our Rhode Island workers compensation attorney can help explain what factors may speed up or slow down the process. You may also want to review our RI workers’ comp benefits to understand how settlements fit into the broader claims system.

Denial and Dismissal Settlements

Another type of settlement involves situations where there is a dispute over whether the injured worker qualifies for workers’ compensation benefits at all. In such cases, parties may consider a settlement known as a denial and dismissal (a “D&D”), where the employer pays a smaller lump sum in exchange for the employee giving up the claim entirely. Whether this makes sense depends on the specifics of the case and the worker’s likelihood of success going forward. Understanding the distinction between D&D settlements and commutations is important when discussing Rhode Island workers’ compensation settlements. Exploring related topics like how settlements work or types of settlements can help clarify these differences.

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Is The Settlement I Agree To Final?​

Is The Settlement I Agree To Final?

Question

I just settled- is it final or can I change my mind?

Answer

The settlement you agreed to is final.

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The Decision is Final

The settlement that you agree to is final. Any settlement must involve an appearance or hearing before the workers’ compensation court so a judge can determine whether to approve the agreement. The judge and the lawyers will question the employee at length to ensure he or she understands the full consequences of the settlement. For general guidance, our workman’s compensation lawyers can help explain what finality means in a Rhode Island settlement. You may also want to review our RI workers’ comp benefits to understand how settlements fit within the broader workers’ compensation system.

"Meds Open" Cases

It is important that the employee understand that they will never be able to return to court to reopen the case or request additional money. Recently, however, some cases settle with medicals still being paid for. These “meds open” settlements involve paying the employee a lump sum and stopping weekly checks, while keeping the insurance carrier responsible for ongoing medical bills. To better understand how this structure compares to other options, reviewing related topics such as how settlements work or calculating settlement value can be helpful.

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What Is A Lump Sum Settlement In Rhode Island?​

What Is A Lump Sum Settlement In Rhode Island?

Question

What does a lump sum settlement mean in Rhode Island?

Answer

A lump sum settlement is an agreed-upon value paid to the employee that ultimately closes the case.

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Lump Sum aka Commutation

A lump sum settlement in Rhode Island workers’ compensation cases is often referred to as a commutation. This situation generally involves a person who has been on workers’ compensation for six months or more. If it does not appear likely that the employee will return to the job for any reason, then a lump sum settlement or commutation may be considered. In these cases, the goal is to calculate a fair number based on how long the worker might still be eligible to receive checks versus the realistic likelihood of collecting those checks before being discontinued by the employer. For a full understanding of how lump-sum options work, our workers comp lawyer in Rhode Island can help explain the process. You may also want to review our RI workers’ comp benefits for broader context on eligibility and long-term rights.

Appearing Before The Judge

We try to arrive at a number that both sides are willing to accept. To finalize the settlement, both parties must appear before a judge of the workers’ compensation court and explain the terms. The judge will ultimately determine whether the settlement is in the best interest of both parties and decide whether to approve it. Learning more about related topics such as settlement calculations or how settlements work can help you better understand what the judge considers during this process.

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