Well, I start by advising what the most anyone can receive is for a scar under the Rhode Island Workers Compensation Act, and that is \$45,000. So if you have horrific disfigurement—if you’re burned from head to toe—unfortunately, that is the most you would get: \$45,000. So we revisit the question of how much is your scar worth in that context. Unlike loss of use, which is a statutory formula that is black and white in terms of the amount you will get for a particular loss, scarring is subjective. There is no formula. It’s negotiated, it’s subjective, and it turns on a lot of factors like how bad does it look, where is it—is it in an area that’s conspicuous that people will see, or is it a place most people will never see? Is the scar wide, is it pink, is it keloid, is it raised, is it linear? All of these qualities or characteristics are considered in trying to come up with what the value of the scar is. And it really comes down to having a workers’ compensation lawyer who has experience negotiating scarring and can tell you within some range where the value of that scar lies. Your lawyer will make a demand to try and get as much as he or she can for you for that scar, the insurance company will offer you something less at times, and if negotiations don’t succeed, you file a petition in Workers Compensation Court. The judge will look at the scar and set the award, and everyone has to live with that number.

If you get a bill from a doctor or a hospital for treatment that relates to your work-related injury, you should not be paying it. The workers’ compensation insurance company is responsible for that. What I tell clients when that happens—and it does happen fairly often—is take that bill, call your lawyer, send it to them, and say, “Hey, I got this bill in the mail.” The lawyer should then handle it from there. Sometimes, the bill you receive isn’t in the correct format that the workers’ comp insurance company uses to process payment. So your lawyer will request a copy of the treatment records for the services that led to the bill, and also ask for the bill itself in the proper form with procedure codes and all required information. Then your lawyer will send those documents to the workers’ comp insurance company with a demand stating, “My client received this bill for treatment related to a work injury. Enclosed are the records and the bill. Please pay it in accordance with the Workers’ Compensation Act or the fee schedule.” That schedule defines the standard rates doctors can charge for workers’ comp cases. Once the demand is sent, the insurance company has 21 days to pay. If they don’t, your lawyer can file a petition in Workers’ Compensation Court to get that bill paid.

If you’re killed in the workplace and you can’t show that some third party’s at fault, you’re only entitled to—your surviving spouse or dependent children are only entitled to—your weekly benefits. They’re only entitled to workers comp benefits. So there’s that scenario where if someone’s killed on the job, that would be a death case. That would be, if there’s a surviving spouse and surviving dependent children, then they have the right to bring an action or a petition for workers compensation benefits on account of death and receive weekly benefits. And then those cases typically end up settling because obviously the death—you know, the death is an unchanging circumstance. So that’s—that’s like someone was total for their whole—and so the surviving spouse would be entitled to receive that until her death or the dependents until they reach, you know, the age of majority or are able to earn on their own.

Generally, your employer has to continue—if they do provide you with health coverage—has to continue to provide that health coverage to you, provided that you pay your contribution towards it, and that is the law in Rhode Island. And there are, of course, exceptions to it, as there are with all cases. But health insurance through your employer is something that is important to have so you can treat for non–work-related injuries, and the obligation is for the employer to hold it, provided you’re paying for it at their cost.

If you’re collecting Social Security disability benefits and workers comp, there will be an offset—meaning you will receive your full workers compensation benefit, however, your disability benefit may be lowered in some respect on account of you receiving workers compensation benefits.

The other interaction that’s important: if you’re on Social Security Disability or, for whatever reason, are eligible to receive Medicare as a form of your health insurance, you want to be very careful to ensure that Medicare is not paying for any of your medical treatment that relates to your work-related injury. That should always be paid by the workers compensation insurance company, but in all cases, it should never be paid by Medicare—at least while your case is still active.

It’s also important to consider Medicare’s interest, because you are legally required to by federal law when settling your case. If people are on Medicare or entitled to Medicare, then you’ve got to be able to show that you took into account Medicare’s future interest—meaning, what did you put aside from your settlement to pay for medical treatment for the work injury into the future so that Medicare is not doing that. And of course, there are companies and vendors that will do that and advise you and come up with these MSA’s—or Medicare Set-Aside agreements or accounts—and that’s a very important part in interplay with workers compensation as well for people who are on disability.

Yes you can. Uh, when someone is injured who has more than one job, that can have a few different effects. No. 1, your average weekly wage should be determined from all of your employment. And if you’re unable to do any of your jobs because of your injury at one particular job, then your workers comp—your weekly compensation benefits—should, um, take into consideration all of your earnings that you’re missing out on because of your injury.

To give you a rough turnaround time from agreeing on a workers’ compensation settlement to actually receiving your check: first, your lawyer will need to draft the settlement paperwork for you to review and sign. That process can take anywhere from a few days to a couple of weeks. Once you’ve reviewed, understood, and signed the documents, they are sent back to the insurance company or their attorney. After that, a hearing is scheduled in the Workers’ Compensation Court. At the hearing, you’ll go over the settlement terms again, answer questions from your lawyer in front of the judge to show you understand the agreement, and then the judge will decide whether to approve it. Once the settlement is approved, the insurance company has 14 days to send your check. So, from start to finish, the whole process typically takes anywhere from a few weeks to a couple of months.

Yes, settling a workers’ compensation case is essentially agreeing to accept a lump sum of money—whatever that amount may be—in exchange for giving up your right to receive weekly benefits forever. Once you settle, your weekly workers’ compensation checks will stop permanently. In many cases, your right to have future medical treatment paid for by your employer or their workers’ compensation insurance company also ends, although that depends on the specific terms of the settlement. Some settlements may carve out or preserve medical coverage, but most include a full and final closure of both wage and medical benefits.

Workers’ compensation lawyers above all should be the best person to advise you on what the value of, um, a settlement would be in your particular case. In workers’ compensation, um, cases, value doesn’t necessarily turn on how badly you were injured—unfortunately, uh—because again, there’s no pain and suffering or non-economic damages that come into play when you’re valuing personal injury or medical malpractice cases.

What you’re looking at primarily in workers’ compensation cases is how much a week you receive in your benefit. And, you know, if that is a low amount, then valuing the case in terms of how long you might collect or what the six-year gate looks like value-wise, um, that’s obviously gonna be lower just because your average weekly wage is lower than someone else’s. Someone else may have a higher average weekly wage, may not be as badly hurt, and their case may settle for more than yours, uh—or vice versa.

So, uh, in terms of getting a better settlement, your lawyer is obviously the best person to do that. Um, and there are different ways and different tactics we use to negotiate and to drive settlement value. At the end of the day, it’s important to have a lawyer who’s honest with you about value and can guide you through the questions you have to ask yourself before you can, um, intelligently accept a settlement offer.

No, you never have to settle your case. If you’re offered a settlement, the first thing your lawyer should be telling you is, No. 1, you don’t have to settle. You never have to, um, you should only settle your case if you think that’s your best option amongst all the options. That’s not to say that sometimes settling, um, isn’t a good idea or is a good idea. It all depends, but the most important thing to know is that a settlement has to be voluntary. You have to, um, agree to it, and no one can force you to agree. Likewise, some people really want to settle their case, but they can’t force the insurance company to settle with them. The insurance company, if they really want, can sit back and keep writing you that weekly benefit check every week until they can figure out a way to stop it. But, uh, no, you don’t have to accept a settlement offer. And if anyone is pressuring you to accept a settlement offer, it’s a good idea to think about why that might be and what the true value of your case is and whether it’s a good idea to settle or not.