Workers’ compensation is supposed to provide financial relief when you’re injured on the job, covering medical expenses and lost wages. But what happens when the benefits you receive aren’t enough?
Unfortunately, this is a reality for many workers who find themselves struggling to make ends meet after a workplace injury. If you’re in this situation, there are several steps you can take to make sure you don’t have to cover the difference out of pocket.
Understand Your Settlement Options
Workers’ comp settlements generally come in two forms: lump sum payments or structured payment plans. Each has its own advantages and limitations, and understanding the differences can help you make an informed decision.
“With a lump sum payment you will receive a one-time payment that covers all of your medical costs and other reimbursement under the claim,” John Price Law Firm explains. “With a structured payment plan you will receive regularly scheduled payments over a specified time.”
A lump sum settlement can be beneficial if you need immediate funds to cover large expenses, such as extensive medical bills or home modifications due to your injury. However, it also means that once you accept the settlement, you typically can’t go back and request additional funds if unexpected medical costs arise later.
On the other hand, a structured payment plan guarantees you a steady stream of income over time, which can provide long-term financial stability. (Though it may not offer the flexibility you need for large, immediate expenses.)
If your workers’ comp claim isn’t covering your full needs, you may want to revisit the terms of your settlement and discuss whether a different option would work better for your situation.
Appeal Your Claim If Benefits Are Denied or Reduced
Sometimes, the reason your workers’ compensation benefits aren’t enough is that your claim wasn’t fully approved. If you believe you were wrongfully denied benefits or that your settlement amount doesn’t accurately reflect your injuries and losses, you have the right to appeal the decision.
Each state has its own process for appealing a workers’ compensation decision, but in general, it involves filing a formal request for reconsideration and providing additional evidence to support your claim. This might include medical records, witness statements, or expert testimony. Many workers don’t realize they have the power to challenge an unfair ruling, but appealing a claim can make a significant difference in the amount of compensation you receive.
Look Into Disability Benefits
If your injury is severe and prevents you from returning to work for an extended period – or permanently – you may qualify for additional benefits beyond workers’ comp. Programs such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) can provide long-term financial assistance.
To qualify for SSDI, you must have a condition that meets the Social Security Administration’s definition of disability and have worked long enough to earn sufficient work credits. SSI, on the other hand, is designed for individuals with limited income and resources who have a qualifying disability.
Explore a Third-Party Claim
Workers’ compensation laws prevent you from suing your employer for injuries sustained on the job, but if a third party was responsible for your accident, you may have additional legal options. A third-party claim allows you to seek compensation from someone other than your employer – such as a negligent contractor, equipment manufacturer, or property owner.
For example, if you were injured because of faulty machinery, you might be able to file a product liability claim against the manufacturer. Similarly, if another company’s employee caused your accident at a shared job site, you could pursue legal action against their employer.
Third-party claims can provide additional compensation for damages that workers’ comp doesn’t cover, such as pain and suffering or full wage replacement. If you suspect that a third party played a role in your injury, consult with an attorney to explore your legal options.
Negotiate Outstanding Medical Bills
Medical expenses can be one of the biggest financial burdens following a workplace injury, especially if your workers’ comp settlement doesn’t cover all your treatment costs. If you’re struggling with unpaid medical bills, you may be able to negotiate lower payments with healthcare providers.
Many hospitals and doctors’ offices are willing to work with patients by offering discounts, setting up payment plans, or even reducing the total amount owed. If your bills are overwhelming, don’t hesitate to reach out to your providers and ask about financial assistance programs. Additionally, some nonprofit organizations offer grants or assistance to injured workers facing financial hardship due to medical expenses.
Work With a Workers’ Compensation Attorney
Navigating the complexities of workers’ compensation law on your own can be challenging – especially when your benefits aren’t enough to cover your expenses. A skilled workers’ comp attorney can help you understand your rights, explore additional legal options, and maximize the compensation you receive.
An attorney can also help you negotiate a fair settlement, appeal a denied claim, and determine whether you’re eligible for other forms of compensation, such as Social Security benefits or third-party claims.
