What Is Your Case Worth When You Need More Treatment?

The most popular Illinois work comp law question we get is, “What is my case worth?”  I get it and we try to answer that question when we can.

The thing to know is it’s not black and white and every case is different. So if you call us and want to know how much a torn bicep tendon is worth, we need to ask a lot of questions to give you an accurate answer and sometimes we can’t do that without seeing your medical records.

A recent caller wanted to know what his case was worth after tearing his meniscus and having surgery. That injury is usually fairly straight forward and most people make a good recovery. In this case though, the recovery wasn’t great and his doctor told him that he’d likely need a total knee replacement down the road and in the mean time would need injections to his knee every year.

This is a classic case of there’s no way to tell you what it’s truly worth without seeing your medical records. The major issue is that this worker needs to be compensated for his future medical care. This can be done by leaving his medical rights open, but insurance companies don’t like to do that when they give you a settlement.  It can also be done through a Medicare set aside which requires the insurance company to get an estimate as to what the future medical costs will be and give you that money now. You have to pay for your care out of that fund until it runs out and if you don’t and ever need Medicare you could be out of luck.

Another way around this is to not settle, but go to Arbitration. If you d this, you keep your medical rights open and may have a way to be compensated in the future when you can’t work when you have the knee replacement surgery. It’s probably a smart play and you’ll still receive money similar to the settlement amount through the Arbitrator making an award. If you aren’t concerned that the case could be lost for some reason, you should seriously consider this option.

Big picture is that when you need more medical care in the future, especially if it’s for something serious like replacing a fusion, knee replacement, etc, your case is unique and you have to really have someone look at this from all angles. You might think the settlement they offer you sounds great, but in our experience, the cases are usually worth much more because they are trying to close your case while limiting what they are obligated to do in the future.

By Mile Helfand

Courtesy of Illinois Workers Compensation Law Blog

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