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Identify Claims for Settlement Early
Identifying suitable claims for settlement at an early stage is a cornerstone of this process. It involves establishing clear triggers that signal when a claim is ready for settlement consideration. One key trigger is the injured worker reaching medical stability. Settlement is not advisable during periods of medical uncertainty, such as pre- or post-surgery, due to the unpredictable nature of future medical expenses.
Other critical triggers include:
- Frustration with Denials: Workers tired of ongoing denials for medical treatments often become open to settlement discussions.
- Financial Concerns: Fear of depleting funds or difficulty supporting their family may prompt a desire to settle.
- Desire for Medical Autonomy: Frustration with the limitations of the WC system, such as restrictions on seeing preferred doctors or undergoing independent medical exams, can lead to a willingness to negotiate.
- Medicare Set-Aside (MSA) Requirements: Federal law requires that Medicare’s interests be protected in WC settlements. Identifying red flag cases involving Medicare considerations early on is essential, especially for catastrophic injuries or workers nearing Medicare eligibility.
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“8 ‘Think Outside the Box’ Tactics to Settle Workers’ Comp Claims”